bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of explicit model predictive control to a vehicle semi-active suspension system
Authors: Houzhong Zhang , Jiasheng Liang , Chaochun Yuan , Xiaoqiang Sun , Yingfeng Cai
Published: January 2019

The vehicle semi-active suspension is a typical multiple-input multiple-output system with strong couplings, actuator constraints and fast dynamics. This paper addresses the damping force regulation of shock-absorber in vehicle semi-active suspensions using an explicit model predictive control (EMPC) approach, which allows minimizing the system control objective function while satisfying the actuator constraints. The main advantage of the proposed approach is that the control law computation requirement is low, and thus the EMPC system is suitable for implementation in a standard automotive microcontroller. The design of the EMPC system consists of mathematical modeling, objective function determination, controller formulation and simulation validation. Presented simulation results verify that a superior control performance of the vehicle semi-active suspension system is achieved by the proposed EMPC control approach compared with the performance obtained using conventional control method.
Intraoperative Assessment of Sentinel Lymph Nodes in Breast Cancer Patients Post-Neoadjuvant Therapy
Authors: Wong Willard , Rubenchik Illana , Nofech-Mozes Sharon , Slodkowska Elzbieta , Parra-Herran Carlos , Hanna Wedad M. , Lu Fang-I
Published: January 2019

Background:

Shift toward minimizing axillary lymph node dissection in patients with breast cancer post neoadjuvant therapy has led to the assessment of sentinel lymph nodes by frozen section intraoperatively to determine the need for axillary lymph node dissection. However, few studies have examined the accuracy of sentinel lymph node frozen section after neoadjuvant therapy. Our objective is to compare the accuracy of sentinel lymph node frozen section in patients with breast cancer with and without neoadjuvant therapy and to identify features that may influence accuracy.

Design:

We identified 161 sentinel lymph node frozen section from 77 neoadjuvant therapy patients and 255 sentinel lymph node frozen section from 88 non-neoadjuvant therapy patients diagnosed between 2010 and 2016 in 2 institutions. The frozen section diagnoses were compared to the final diagnoses, and clinicopathologic data were analyzed.

Results:

The sensitivity, specificity, and accuracy of frozen section analysis were comparable between neoadjuvant therapy patients and non-neoadjuvant therapy patients (71.9% vs 50%, 100% vs 100%, and 88.3% vs 81.8%). Nine (11.7%) of 77 neoadjuvant therapy patients had discordant results, most often due to undersampling (tumor absent on frozen section slide). Four of these patients subsequently underwent axillary lymph node dissection. Discordant results (all false negatives) were significantly more likely in neoadjuvant therapy patients with Estrogen Receptor-positive/HER2-negative status, and in sentinel lymph node with pN1mic and pN0i+ deposits; age, preneoadjuvant therapy lymph node status, histotype, nuclear grade, tumor size, and response to neoadjuvant therapy showed no significant differences. For non-neoadjuvant therapy cases, large tumor size, lobular histotype, and sentinel lymph node with pN1mic and pN0i+ were associated with false-negative frozen section assessment.

Conclusion:

Sentinel lymph node frozen section diagnosis post-neoadjuvant therapy has comparable sensitivity, specificity, and accuracy to the sentinel lymph node frozen section diagnosis in the non-neoadjuvant therapy setting.
Long-Term Outcomes of Carotid Endarterectomy and Carotid Artery Stenting When Performed by a Single Vascular Surgeon
Authors: Rizwan Muhammad , Aridi Hanaa Dakour , Dang Tru , Alshwaily Widian , Nejim Besma , Malas Mahmoud B.
Published: January 2019

Objectives:

Carotid artery endarterectomy (CEA) and carotid artery stenting (CAS) are 2 effective treatment options for carotid revascularization and stroke prevention. The long-term outcomes of Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) reported similar stroke and death rate between the 2 procedures. This study presents the short- and long-term outcomes of CEA and CAS of all risk patients performed by a single vascular surgeon in a real-world setting.

Methods:

We retrospectively reviewed all patients who underwent CEA and CAS from September 2005 to June 2017 at our institute. Student t test, χ2, and Fisher exact tests were used to compare patient’s characteristics. Multivariate logistic, cox regression models and survival analysis were used to compare postoperative and long-term outcomes between the 2 groups.

Results:

Over 2000 patients were evaluated for carotid artery stenosis during the study period, and 313 revascularization procedures were performed (CEA: 47%, CAS: 53%). Patients’ age (Mean [95% confidence interval, CI] 68.8 [67.2-70.4] vs 69.7 [68.2-71.3], P = .40) was similar between CEA and CAS. Patients who underwent CAS had significantly higher comorbidities (chronic obstructive pulmonary disease [COPD], chronic heart failure [CHF], hyperlipidemia, and prior ipsilateral intervention, all P < .05). No difference was found in 30-day complications after CEA versus CAS including stroke (2.0% vs 1.2%), myocardial infarction (MI; 0.7% vs 1.2%), death (0% vs 1.2%) as well as combined major adverse events (stroke/death/MI; 2.7% vs 3.0%; all P > .05). Overall 7-year survival, stroke-free survival and restenosis-free survival were similar between the 2 groups ( P > .5). Significant predictors of mortality were diabetes (hazard ratio, HR [95% CI]: 2.41 [1.15-5.08]), chronic kidney disease (HR [95% CI]: 4.89 [1.97-12.13]), and COPD (HR [95% CI]: 3.31 [1.43-7.71]; all P values <.05). Statin use was protective with 71% reduction in risk of mortality (HR [95% CI]: 0.29 [0.12-0.67], P = .004).

Conclusion:

Our experience showed comparable short- and long-term outcomes of CAS and CEA performed for carotid artery stenosis by vascular surgeon. There was no difference between single institutional long-term outcomes and CREST outcomes following CEA and CAS.
Correlations Between Branch Vessel Catheterization and Procedural Complexity in Fenestrated and Branched Endovascular Aneurysm Repair
Authors: Budtz-Lilly Jacob , Liungman Krister , Wanhainen Anders , Mani Kevin
Published: January 2019

Introduction:

The use of fenestrated and branched endovascular technologies in complex aortic aneurysm repair (F/BEVAR) is increasing, with a trend toward using longer sealing zones and incorporating more target vessels. Successful aneurysm exclusion and prevention of long-term treatment failure need to be balanced against the increased complexity of more extensive procedures. The aim of this study was to analyze relationships between the number of catheterized vessels and multiple operative variables as a means for evaluating procedural complexity.

Methods:

Operative data from consecutive F/BEVAR procedures performed at a single center from 2012 to 2015 were analyzed. An equal number of EVAR procedures, randomly selected, from this period were also analyzed. Only intact aneurysms were included. Complex aneurysms were grouped based on the required number of target vessel catheterization. Ten procedural variables, categorized as perioperative, postoperative, and radiologic-related, were compared. Pearson correlation analysis and regression analysis were performed. The correlation coefficients, r, were classified using Cohen boundaries, r ≥ 0.5 indicating a strong relationship.

Results:

There were 63 EVAR, 40 FEVAR, and 22 BEVAR procedures. There was no significant difference in patient comorbidities between conventional EVAR and complex procedure groups. The complex procedures included 23 two-vessel, 20 three-vessel, and 19 four-vessel catheterizations. Strong linear relationships between the number of branch vessel catheterizations and the following variables were identified: accumulated skin dose ( r = .504), contrast volume ( r = .652), fluoroscopy duration ( r = .598), number of angiography series ( r = .650), anesthesiology duration ( r = .742), procedure duration ( r = .554), and total length of stay ( r = .533).

Conclusion:

The complexity of FEVAR and BEVAR procedures reveals strong correlations between multiple peri- and postoperative variables. These exposures and risks should be borne in mind when considering treatment of complex abdominal aortic aneurysms as well as long-term clinical outcomes.
On loss compensation, amplification and lasing in metallic metamaterials
Authors: Droulias Sotiris , Koschny Thomas , Kafesaki Maria , Soukoulis Costas M
Published: January 2019

The design of metamaterials, which are artificial materials that can offer unique electromagnetic properties, is based on the excitation of strong resonant modes. Unfortunately, material absorption—mainly due to their metallic parts—can damp their resonances and hinder their operation. Incorporating a gain material can balance these losses, but this must be performed properly, as a reduced or even eliminated absorption does not guarantee loss compensation. Here we examine the possible regimes of interaction of a gain material with a passive metamaterial and show that background amplification and loss compensation are two extreme opposites, both of which can lead to lasing.
Coronary heart disease mortality trends during 50 years as explained by risk factor changes: The European cohorts of the Seven Countries Study
Authors: Menotti Alessandro , Puddu Paolo E , Kromhout Daan , Kafatos Anthony , Tolonen Hanna
Published: January 2019

Objectives

The purpose of this study was to relate risk factor changes during decades with 50-year coronary heart disease mortality in European cohorts of middle-aged men of the Seven Countries Study.

Material and methods

In the 1950s–early 1960s, nine cohorts of 6518 men aged 40–59 years were examined in five European countries. Smoking habits, systolic blood pressure and serum cholesterol were measured at entry and five times during the next 35 years and a comprehensive Risk Factor Change Score was created. Coronary heart disease mortality data was collected during a 50-year follow-up, modelled by the Weibull distribution, whose shape (Weibull shape) was related to the Risk Factor Change Score by linear regression.

Results

The Risk Factor Change Score showed slight declines in the Finnish and Dutch cohorts, moderate or large increases in the other cohorts. These effects were related to a decrease of smoking habits in all cohorts, an increase of blood pressure in all cohorts except East Finland, a decrease of serum cholesterol in Finland and the Netherlands, whereas serum cholesterol increases were slight in Italy and large in Serbia and Greece. Weibull distribution shape for coronary heart disease mortality showed slight deceleration in one Finnish and the Dutch cohorts, large acceleration in the Serbian and Greek cohorts. The correlation coefficient of the Risk Factor Change Score versus Weibull shape for the nine cohorts was 0.78 ( R2 = 0.60; p = 0.0132).

Conclusions

Spontaneous long-term changes of major coronary risk factor levels were associated with changes in the same direction of coronary heart disease mortality risk modelled by the Weibull distribution, expressing a kind of ‘natural experiment’ with an outcome that matches those of controlled preventive trials.
The inflamed biceps tendon as a pain generator in the shoulder: A histological and biomolecular analysis
Authors: Schmalzl J , Plumhoff P , Gilbert F , Gohlke F , Konrads C , Brunner U , Jakob F , Ebert R , Steinert AF
Published: January 2019

Introduction:

The long head of the biceps (LHB) is often resected in shoulder surgery. However, its contribution to inflammatory processes in the shoulder remains unclear. In the present study, inflamed and noninflamed human LHBs were comparatively characterized for features of inflammation.

Materials and methods:

Twenty-two resected LHB tendons were classified into inflamed ( n = 11) and noninflamed ( n = 11) samples. For histological examination, samples were stained with hematoxylin eosin, Azan, van Gieson, and Masson Goldner trichrome. Neuronal tissue was immunohistochemically visualized. In addition, specific inflammatory marker gene expression of primary LHB-derived cell cultures were analyzed.

Results:

Features of tendinopathy, such as collagen disorganization, infiltration by inflammatory cells, neovascularization, and extensive neuronal innervation were found in the tendinitis group. Compared to noninflamed samples, inflamed LHBs showed a significantly increased inflammatory marker gene expression

Conclusion:

Structural and biomolecular differences of both groups suggest that the LHB tendon acts as an important pain generator in the shoulder joint. These findings can, on the one hand, contribute to the understanding of the biomolecular genesis of LHB tendinitis and, on the other hand, provide possibilities for new therapeutic approaches.
Towards an urban political geography of transport: Unpacking the political and scalar dynamics of fare-free public transport in Tallinn, Estonia
Authors: Kȩbłowski Wojciech , Tuvikene Tauri , Pikner Tarmo , Jauhiainen Jussi S
Published: January 2019

In this article, we study the largest existing fare-free public transport (FFPT) programme, launched in 2013 in Tallinn, Estonia. Instead of focusing solely on the rationale and impact of fare-free public transport in terms of finances and travel patterns, we propose to analyse FFPT from the perspective of urban political geography, and to inquire into its political and scalar dynamics. We analyse how Tallinn’s fare-free programme was developed, and demonstrate the politics of its conception and implementation. We observe who has access to free travel and we reveal how FFPT is embedded in Estonia’s place-of-residence-based taxation system. Finally, we identify where lies the impact of territorial competition exacerbated by FFPT. Therefore, we argue that transport policies – of which FFPT is but an example – should be understood as much more than strategies dealing with transport issues per se. Instead, we propose to approach them as political and spatial projects, whose processual, cross-sectorial and scalar dimensions help to reveal the embeddedness of transport in inherently urban questions of metropolitan governance, electoral strategies, territorial competition and socio-spatial inequalities.
Integration of cell of origin into the clinical CNS International Prognostic Index improves CNS relapse prediction in DLBCL
Authors: Klanova Magdalena , Sehn Laurie H. , Bence-Bruckler Isabelle , Cavallo Federica , Jin Jie , Martelli Maurizio , Stewart Douglas , Vitolo Umberto , Zaja Francesco , Zhang Qingyuan , Mattiello Federico , Sellam Gila , Punnoose Elizabeth A. , Szafer-Glusman Edith , Bolen Christopher R. , Oestergaard Mikkel Z. , Fingerle-Rowson Guenter R. , Nielsen Tina , Trneny Marek
Published: January 2019

Central nervous system (CNS) relapse carries a poor prognosis in diffuse large B-cell lymphoma (DLBCL). Integrating biomarkers into the CNS–International Prognostic Index (CNS-IPI) risk model may improve identification of patients at high risk for developing secondary CNS disease. CNS relapse was analyzed in 1418 DLBCL patients treated with obinutuzumab or rituximab plus cyclophosphamide, doxorubicin, vincristine, prednisone chemotherapy in the phase 3 GOYA study. Cell of origin (COO) was assessed using gene-expression profiling. BCL2 and MYC protein expression was analyzed by immunohistochemistry. The impact of CNS-IPI, COO, and BCL2/MYC dual-expression status on CNS relapse was assessed using a multivariate Cox regression model (data available in n = 1418, n = 933, and n = 688, respectively). High CNS-IPI score (hazard ratio [HR], 4.0; 95% confidence interval [CI], 1.3-12.3; P = .02) and activated B-cell‒like (ABC) (HR, 5.2; 95% CI, 2.1-12.9; P = .0004) or unclassified COO subtypes (HR, 4.2; 95% CI, 1.5-11.7; P = .006) were independently associated with CNS relapse. BCL2/MYC dual-expression status did not impact CNS relapse risk. Three risk subgroups were identified based on the presence of high CNS-IPI score and/or ABC/unclassified COO (CNS-IPI-C model): low risk (no risk factors, n = 450 [48.2%]), intermediate risk (1 factor, n = 408 [43.7%]), and high risk (both factors, n = 75 [8.0%]). Two-year CNS relapse rates were 0.5%, 4.4%, and 15.2% in the respective risk subgroups. Combining high CNS-IPI and ABC/unclassified COO improved CNS relapse prediction and identified a patient subgroup at high risk for developing CNS relapse. The study was registered at www.clinicaltrials.gov as #NCT01287741.
A natural regulatory mutation in the proximal promoter elevates fetal globin expression by creating a de novo GATA1 site
Authors: Martyn Gabriella E. , Wienert Beeke , Kurita Ryo , Nakamura Yukio , Quinlan Kate G. R. , Crossley Merlin
Published: January 2019

β-hemoglobinopathies, such as sickle cell disease and β-thalassemia, result from mutations in the adult β-globin gene. Reactivating the developmentally silenced fetal γ-globin gene elevates fetal hemoglobin levels and ameliorates symptoms of β-hemoglobinopathies. The continued expression of fetal γ-globin into adulthood occurs naturally in a genetic condition termed hereditary persistence of fetal hemoglobin (HPFH). Point mutations in the fetal γ-globin proximal promoter can cause HPFH. The −113A>G HPFH mutation falls within the −115 cluster of HPFH mutations, a binding site for the fetal globin repressor BCL11A. We demonstrate that the −113A>G HPFH mutation, unlike other mutations in the cluster, does not disrupt BCL11A binding but rather creates a de novo binding site for the transcriptional activator GATA1. Introduction of the −113A>G HPFH mutation into erythroid cells using the clustered regularly interspaced short palindromic repeats (CRISPR)–CRISPR-associated protein 9 (Cas9) system increases GATA1 binding and elevates fetal globin levels. These results reveal the mechanism by which the −113A>G HPFH mutation elevates fetal globin and demonstrate the sensitivity of the fetal globin promoter to point mutations that often disrupt repressor binding sites but here create a de novo site for an erythroid activator.
microRNA-22 promotes megakaryocyte differentiation through repression of its target, GFI1
Authors: Weiss Cary N. , Ito Keisuke
Published: January 2019

Precise control of microRNA expression contributes to development and the establishment of tissue identity, including in proper hematopoietic commitment and differentiation, whereas aberrant expression of various microRNAs has been implicated in malignant transformation. A small number of microRNAs are upregulated in megakaryocytes, among them is microRNA-22 (miR-22). Dysregulation of miR-22 leads to various hematologic malignancies and disorders, but its role in hematopoiesis is not yet well established. Here we show that upregulation of miR-22 is a critical step in megakaryocyte differentiation. Megakaryocytic differentiation in cell lines is promoted upon overexpression of miR-22, whereas differentiation is disrupted in CRISPR/Cas9-generated miR-22 knockout cell lines, confirming that miR-22 is an essential mediator of this process. RNA-sequencing reveals that miR-22 loss results in downregulation of megakaryocyte-associated genes. Mechanistically, we identify the repressive transcription factor, GFI1, as the direct target of miR-22, and upregulation of GFI1 in the absence of miR-22 inhibits megakaryocyte differentiation. Knocking down aberrant GFI1 expression restores megakaryocytic differentiation in miR-22 knockout cells. Furthermore, we have characterized hematopoiesis in miR-22 knockout animals and confirmed that megakaryocyte differentiation is similarly impaired in vivo and upon ex vivo megakaryocyte differentiation. Consistently, repression of Gfi1 is incomplete in the megakaryocyte lineage in miR-22 knockout mice and Gfi1 is aberrantly expressed upon forced megakaryocyte differentiation in explanted bone marrow from miR-22 knockout animals. This study identifies a positive role for miR-22 in hematopoiesis, specifically in promoting megakaryocyte differentiation through repression of GFI1, a target antagonistic to this process.
RETRACTED ARTICLE: Investigation of the evaluation system of SMEs’ industrial cluster management performance based on wireless network development
Authors: Lan Jiang , Chengjun Wang , Wei Zhang
Published: January 2019

Today, with the rapid development of mobile Internet technology, the operation of enterprises is basically based on the mobile network platform. Therefore, the study of the evaluation system of SMEs’ industrial cluster management performance based on wireless network development is proposed. After briefly describing the relevant research of industrial cluster performance evaluation, the knowledge innovation of wireless network era is the core of SME industrial cluster management, and a set of industrial cluster management performance evaluation index system has been constructed. Based on this, a comprehensive evaluation method based on neural network algorithm is designed. In a subsequent experiment, it is demonstrated that this method can evaluate the level of cluster management performance.
Effects of fashion vlogger attributes on product attitude and content sharing
Authors: Choi Woojin , Lee Yuri
Published: January 2019

Recently, general people posting vlog on newly shopped fashion and cosmetics items are gaining popularity, and it is growing more common to get consumer reviews or opinion through vlogs. In this paper, we examine the effect of vloggers’ attributes (i.e., attractiveness, expertise, trustworthiness) depending on the types that the vlogs expose certain products in videos. Also we find out how emotional bond between vloggers and viewers affect the relationships of vlogger’s attributes with content sharing intention and attitude towards products. Based on the results of one-way ANOVA, multiple regression analysis, and moderated regression analysis, we could enhance the understanding of vlog and vloggers’ role in retail. Also, we applied para-social interaction to find out how emotional bond between vloggers and viewers affect their perception. This research implies the need of understanding vlog as a form of marketing mix that fashion retailers can utilize.
A quantification of the preferred ease allowance for the men’s formal jacket patterns
Authors: Kim In Hwa , Nam Yun Ja , Han Hyunsook
Published: January 2019

The purpose of this study is to provide a quantitative reference required for the decision of ease allowance to draft men’s formal jacket patterns by quantifying the customers’ actual tendency regarding the preferred fit. The ease allowances of 62 male customers were investigated through the sensory evaluations, once in the initial fitting jackets which were designed using the graded sizing chart of ready-to-wear, and once again in the custom-made jacket customers ordered. The 5-point Likert scale was used for the sensory evaluation and the preferred ease allowance was defined as the ease allowance of respondents who responded “3_Suitable”. The regression equations were developed to estimate preferred ease allowance by inputting body size measurements which showed the highest correlation with the preferred ease allowances. The estimated ease allowance ranges by inputting the 5th to 95th percentile of the body sizes were 5.17–8.25 cm for the chest circumference, 6.90–2.09 cm for chest–waist circumference on the jacket, − 3.82 to 1.34 cm for the chest–hip circumference on the jacket, 1.58–5.86 cm for the upper arm circumference, − 1.80 to 1.95 cm for the bi-shoulder length, and 0.406–0.425 for the ratio of jacket length to stature. The actual tendency of the jacket consumers can be estimated by result of this study, which make the jacket pattern which conforms to current fashion trends can be produced minimizing the potential fit problems.
Geometric seismic attribute estimation using data-adaptive windows
Authors: Lin Tengfei , Zhang Bo , Marfurt Kurt
Published: January 2019

Geometric seismic attributes such as coherence are routinely used for highlighting geologic features such as faults and channels. Traditionally, we use a single user-defined analysis window of fixed size to calculate attributes for the entire seismic volume. In general, smaller windows produce sharper geologic edges, but they are more sensitive to noise. In contrast, larger windows reduce the effect of random noise, but they might laterally smear faults and channel edges and vertically mix the stratigraphy. The vertical and lateral resolutions of a 3D seismic survey change with depth due to attenuation losses and velocity increase, such that a window size that provides optimal images in the shallower section is often too small for the deeper section. A common workaround to address this problem is to compute the seismic attributes using a suite of fixed windows and then splice the results at the risk of reducing the vertical continuity of the final volume. Our proposed solution is to define laterally and vertical smoothly varying analysis windows. The construction of such tapered windows requires a simple modification of the covariance matrix for eigenstructure-based coherence and a less obvious, but also simple, modification of semblance-based coherence. We determine the values of our algorithm by applying it to a vintage 3D seismic survey acquired offshore Louisiana, USA.
Survival Outcomes of Younger Patients With Mantle Cell Lymphoma Treated in the Rituximab Era
Authors: Gerson James N. , Handorf Elizabeth , Villa Diego , Gerrie Alina S. , Chapani Parv , Li Shaoying , Medeiros L. Jeffrey , Wang Michael I. , Cohen Jonathon B. , Calzada Oscar , Churnetski Michael C. , Hill Brian T. , Sawalha Yazeed , Hernandez-Ilizaliturri Francisco J. , Kothari Shalin , Vose Julie M. , Bast Martin A. , Fenske Timothy S. , Narayana Rao Gari Swapna , Maddocks Kami J. , Bond David , Bachanova Veronika , Kolla Bhaskar , Chavez Julio , Shah Bijal , Lansigan Frederick , Burns Timothy F. , Donovan Alexandra M. , Wagner-Johnston Nina , Messmer Marcus , Mehta Amitkumar , Anderson Jennifer K. , Reddy Nishitha , Kovach Alexandra E. , Landsburg Daniel J. , Glenn Martha , Inwards David J. , Karmali Reem , Kaplan Jason B. , Caimi Paolo F. , Rajguru Saurabh , Evens Andrew , Klein Andreas , Umyarova Elvira , Pulluri Bhargavi , Amengual Jennifer E. , Lue Jennifer K. , Diefenbach Catherine , Fisher Richard I. , Barta Stefan K.
Published: January 2019

PURPOSE

Mantle cell lymphoma (MCL) is a B-cell lymphoma characterized by cyclin D1 expression. Autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy is often used for eligible patients; however, the benefit remains uncertain in the rituximab era. Herein we retrospectively assessed the impact of AHCT consolidation on survival in a large cohort of transplantation-eligible patients age 65 years or younger.

PATIENTS AND METHODS

We retrospectively studied transplantation-eligible adults age 65 years or younger with newly diagnosed MCL treated between 2000 and 2015. The primary objective was to assess for improved progression-free survival (PFS) with AHCT consolidation and secondarily to assess for improved overall survival (OS). Cox multivariable regression analysis and propensity score–weighted (PSW) analysis were performed.

RESULTS

Data were collected from 25 medical centers for 1,254 patients; 1,029 met inclusion criteria. Median follow-up for the cohort was 76 months. Median PFS and OS were 62 and 139 months, respectively. On unadjusted analysis, AHCT was associated with improved PFS (75 v 44 months with v without AHCT, respectively; P < .01) and OS (147 v 115 months with v without AHCT, respectively; P < .05). On multivariable regression analysis, AHCT was associated with improved PFS (hazard ratio [HR], 0.54; 95% CI, 0.44 to 0.66; P < .01) and a trend toward improved OS (HR, 0.77; 95% CI, 0.59 to 1.01; P = .06). After PSW analysis, AHCT remained associated with improved PFS (HR, 0.70; 95% CI, 0.59 to 0.84; P < .05) but not improved OS (HR, 0.87; 95% CI, 0.69 to 1.1; P = .2).

CONCLUSION

In this large cohort of younger, transplantation-eligible patients with MCL, AHCT consolidation after induction was associated with significantly improved PFS but not OS after PSW analysis. Within the limitations of a retrospective analysis, our findings suggest that in younger, fit patients, AHCT consolidation may improve PFS.
HES1 Protein Modulates Human Papillomavirus–Mediated Carcinoma of the Uterine Cervix
Authors: Tripathi Richa , Rath Gayatri , Sharma Vishwas , Hussain Showket , Sharma Shashi , Bharadwaj Mausumi , Mehrotra Ravi
Published: January 2019

PURPOSE

Cervical cancer (CC) is the most common cancer affecting women worldwide. Human papillomavirus (HPV) infection is a major contributing factor for the development of CC. The development of CC occurs progressively from precancer stages to cancerous stages (ie, invasive squamous cell carcinoma [ISCC] and adenocarcinoma [ADC]). ADC is a rare form of CC that develops from the mucinous endocervical epithelium. It is believed that the downstream targets of Notch signaling contribute to the etiology of CC. One such target is HES1, whose role in the modulation of ADC is unknown. The purpose of this study is to determine the role of HES1 protein in HPV-associated ADC subtype of CC and also to compare its expression in histologic subtypes of precancer and ISCC.

PATIENTS AND METHODS

A total of 148 patients (30 with precancers, 98 with ISCC, and 20 with ADC) and 40 normal control participants were analyzed for the expression of HES1 via immunohistochemistry, with results validated by immunoblotting.

RESULTS

The comparison between HPV-16 and HES1 expression was significant in precancer (cervical intraepithelial neoplasia grades 1 to 3; P = .013), ISCC (International Federation of Gynecology and Obstetrics stages I to IV; P = .001), and ADC ( P = .007). An overall significant mean difference was observed between HES1, JAG1, and Notch-3 proteins in precancer ( P = .001), ISCC ( P = .001), and ADC ( P = .001). Pairwise comparisons between HES1 and JAG1 and HES1 and Notch-3 were also found to be significant.

CONCLUSION

This study showed that among all HPV-16–positive precancers, the major HES1 positivity signal arises from cervical intraepithelial neoplasia grades 2 and 3 that develops into ISCC. Moreover, HPV-16–positive ADC also showed an association with HES1. The HES1, JAG1, and Notch-3 proteins showed their synergistic role in modulating HPV associated ADC along with histologic subtypes of precancer and ISCC of CC.
Hemodialysis Internal jugular vein versus Subclavian vein Catheters: Complications, patients’ comfort, tolerance and cost-effectiveness
Authors: Shafique Muhammad Nadeem , Akhtar Syed Hassan , Mahnoor Miss , Hussain Mujahid
Published: January 2019

Objective: To compare hemodialysis (HD) internal jugular vein (IJV) versus subclavian vein (SCV) catheters in terms of procedural complications, patients’ comfort, tolerance and cost effectiveness.

Methods: Sixty six consecutive eligible adult patients planned for hemodialysis @ 3 sessions/ week for maximum 42 days in a private hospital at Sialkot, Pakistan were documented between March 2017 and April 2018. A group, IJV or SCV catheter was allotted to alternate subjects. The catheters were inserted as per practice guidelines. Record of catheter-related complications (CRCs) was computerized. Similarly, patients’ uncomfortability and expenditures on management of CRCs were recorded.

Results: Of 66 cases, 62 (93.9%, 31/group) successfully completed the study. Baseline information showed male predominance (n = 47, 75.8%), age (M = 47, range 24-75 years) or catheter stay time (M = 40 days). The rate of vein damage or artery puncture was found higher in IJV than SCV group [(13.9 vs. 6.5%) or (9.7 vs. 3.2%), respectively] during catheterization. The difference also existed in late CRCs such as bacterial infection (32.3 vs. 16.1%), or device dysfunctioning (9.7 vs. 3.2%) with an exception of mechanical kinking. All the patients of IJV or SCV group with missed (19.4 vs. 6.5%) or shortened HD sessions (22.6 vs. 12.9%) reported CRCs-based discomfort as a cause of the regularity. Moreover, the participants of IJV group consumed 69% of the total expenditures on CRCs management.

Conclusion: SCV is a better site for HD catheterization as it has comparatively lesser likelihood of complications, patients’ feel comfortable and it is also cost-effective.than IJV.

How to cite this:Shafique MN, Akhtar SH, Mahnoor M, Hussain M. Hemodialysis Internal jugular vein versus Subclavian vein Catheters: Complications, patients’ comfort, tolerance and cost-effectiveness. Pak J Med Sci. 2019;35(1):124-128. doi: https://doi.org/10.12669/pjms.35.1.249

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Climate change, migration and health systems resilience: Need for interdisciplinary research
Authors: Ridde Valéry , Benmarhnia Tarik , Bonnet Emmanuel , Bottger Carol , Cloos Patrick , Dagenais Christian , De Allegri Manuela , Nebot Ariadna , Queuille Ludovic , Sarker Malabika
Published: January 2019

Climate change is one of today's major challenges, among the causes of population movements and international migration. Climate migrants impact health systems and how they respond and adapt to their needs and patterns. But to date, the resilience of health systems in the context of climate change has been little explored.

The purpose of this article is to show the importance of studying, from an interdisciplinary perspective, the relationships between climate change, migration, and the resilience of health systems.

Resilience is an old concept, notably in the field of psychology, and is increasingly applied to the study of health systems. Yet, no research has analysed the resilience of health systems in the context of climate change. While universal health coverage is a major international goal, little research has to date focused on the existing links between climate, migration, health systems and resilience.

We propose an interdisciplinary approach relying on the concept of health system resilience to study adaptive and transformative strategies to articulate climate change, migration and health systems.
Factors associated with self-medication in users of drugstores and pharmacies in Peru: an analysis of the National Survey on User Satisfaction of Health Services, ENSUSALUD 2015
Authors: Urrunaga-Pastor Diego , Benites-Zapata Vicente A. , Mezones-Holguín Edward
Published: January 2019

Background: Irresponsible self-medication is a problem for health systems in developing countries. We aimed to estimate the frequency of self-medication and associated factors in users of drugstores and pharmacies in Peru.

Methods: We performed a secondary data analysis of the 2015 National Survey on User Satisfaction of Health Services (ENSUSALUD), a two-stage probabilistic sample of all regions of Peru. Non self-medication (NSM), responsible self-medication (RSM) and irresponsible self-medication (ISM) were defined as the outcome categories. Demographic, social, cultural and health system variables were included as covariates. We calculated relative prevalence ratios (RPR) with their 95% confidence intervals (95%CI) using crude and adjusted multinomial logistic regression models for complex samples with NSM as the referent category.

Results: 2582 participants were included. The average age was 41.4 years and the frequencies of NSM, RSM and ISM were 25.2%, 23.8% and 51.0%; respectively. The factors associated with RSM were male gender (RPR: 1.35; 95%CI: 1.06-1.72), being between 40 and 59 years old (RPR: 0.53; 95%IC: 0.39-0.72), being 60 or older (RPR: 0.39; 95%IC: 0.25-0.59), not having health insurance (RPR: 1.89; 95%CI: 1.31-2.71) and living in the Highlands region (RPR: 2.27; 95%CI: 1.23-4.21). The factors associated with ISM were male gender (RPR: 1.41; 95%CI: 1.16-1.72), being between 40 and 59 years old (RPR: 0.68; 95%IC: 0.53-0.88), being 60 or older (RPR: 0.65; 95%IC: 0.48-0.88) and not having health insurance (RPR: 2.03; 95%CI: 1.46-2.83).

Conclusion: Around half of the population practiced ISM, which was associated with demographic and health system factors. These outcomes are the preliminary evidence that could contribute to the development of health policies in Peru.
ПЕЙЗАЖНЫЙ ЖАНР В СИСТЕМЕ ПРОФЕССИОНАЛЬНОГО ХУДОЖЕСТВЕННО-ПЕДАГОГИЧЕСКОГО ОБРАЗОВАНИЯ
Authors: Paramonov Aleksey Grigorevich , Bashkatov Ivan Aleksandrovich , Alekseeva Svetlana Olegovna
Published: January 2019

Введение. Живопись является одной из ведущих специальных дисциплин. Жанр пейзажного изображения служит прекрасной платформой для экспериментов в живописи. В процессе пленэрной работы студентами приобретаются наибольшее количество профессиональных навыков в освоении живописного изображения. Выход на природу, любование ею непременно наполняет живопись сердечной теплотой и обаянием, что переходит и в практику изображения натюрморта, портрета, а также в построение сложной композиции, включая и живопись в условиях учебной аудитории. Преобразования, происходящие в системе художественно-педагогического образования, приводят к сокращению часов, отводимых на пленэрную работу, минимизируя контакт студента с преподавателем. В связи с этим возрастает значение самостоятельной работы студентов.Цель: поднять проблему снижения качества обучения при сокращении контактной работы студентов с преподавателем в процессе пленэрной практики. Наметить пути сохранения эффективности обучения, подчеркнуть значение пейзажного жанра в системе профессионального художественно-педагогического образования.Материалы и методы. Анализ учебно-методической и специальной литературы по проблеме пленэрной живописи, анализ государственных образовательных стандартов, учебных планов и программ, обобщение педагогического опыта обучения пленэрной живописи, сравнительный статистический анализ художественной, учебно-творческой и педагогической деятельности студентов.Результаты исследования, обсуждения. Представленные рекомендации для работы в условиях пленэра позволят более эффективно и рационально организовать эти занятия, более продуманно и осознанно подходить к их выполнению, что стимулирует самостоятельную работу студентов и позволяет добиться более качественного результата в выполнении пленэрных заданий.Заключение. Проблема проведения занятий в условиях пленэра в настоящее время не получила достаточной разработанности и всё ещё нуждается в существенных коррективах в связи с преобразованиями системы образования.
ПРОБЛЕМЫ ПРОФЕССИОНАЛЬНОГО САМООПРЕДЕЛЕНИЯ ИНВАЛИДОВ И ЛИЦ С ОГРАНИЧЕННЫМИ ВОЗМОЖНОСТЯМИ ЗДОРОВЬЯ
Authors: Bystrova Natalya Vasilyevna , Konyaeva Elena Alexandrovna , Tsyplakova Svetlana Anatolyevna
Published: January 2019

Актуальность статьи определяется наличием значительного числа детей-инвалидов и лиц с ОВЗ в Российской Федерации, а также необходимостью разработки и внедрения в практику образовательных организаций новых подходов и образовательных технологий, повышающих эффективность профессионального обучения.Целью статьи является анализ проблем возникающих в процессе профессионального самоопределения у инвалидов и лиц с ОВЗ.Метод или методология проведения работы. Основу исследования образуют методы педагогического и психологического исследований, принципы профессионально-педагогического образования, а также проектный, компетентностный и системный подходы к организации процесса обучения лиц с ОВЗ.Результаты. Результаты работы заключаются в том, что определено, что инвалиды и лица с ОВЗ нуждаются в специальной образовательной поддержке, выражающейся в погружении в общую образовательную среду, предполагающую отсутствие барьеров и препятствий для их полноценной деятельности, с возможным включением различных форм специального образования. Одним из приоритетов государственной политики в социальной сфере является повышение доступности профессионального образования для инвалидов. Материалы статьи могут быть адаптированы ко всем уровням профессиональной подготовки по различным направлениям и специальностям.Область применения результатов. Результаты исследования могут быть применены в сфере профессионального образования.
СТРУКТУРНАЯ ОЦЕНКА ОБРАЗОВАТЕЛЬНОЙ ПОЛИТИКИ И ПОЛИТИКИ МЯГКОЙ СИЛЫ КОРОЛЕВСТВА САУДОВСКАЯ АРАВИЯ
Authors: Zhitnov Evgeny Aleksandrovich
Published: January 2019

Целью статьи выступает исследование внутреннего и внешнеполитического образовательного курса Королевства Саудовская Аравия. Раскрытие интеллектуального потенциала КСА используя методологию идеолого-образовательной логистики в международном аспекте и определение возможного влияния политики мягкой силы, как на территории Ближнего Востока и арабского мира, так и на международной арене.Метод или методология проведения работы. Основу исследования составляют теории образовательного инжиниринга, политико-образовательные концепции, теории государственно-образовательного управления, экономики, истории, социологии, религиоведения, а также ряд других теорий включающих формулу междисциплинарности.Результатом исследования явилось то, что автор сумел определить инструментарий политики мягкой силы КСА. Основой исследования было изучение образовательной системы КСА, а модель образовательной логистики позволила определить, как внутренний, так и внешний потенциал государственно-образовательной траектории развития реализуемой правительством КСА в международном аспекте.Область применения результатов. Итоги исследовательской деятельности могут быть использованы в работах педагогической, внешнеполитической, сравнительно-прогностической деятельностей, а также в работах, которые требуют определения успешности государственно-образовательной политики в международном аспекте.
ПОДГОТОВКА ВОКАЛИСТОВ-ИСПОЛНИТЕЛЕЙ: ИСТОРИЧЕСКИЙ АСПЕКТ
Authors: Kurulenko Eleonora Aleksandrovna , Plaksina Kseniya Gennadyevna
Published: January 2019

Музыкальная педагогика имеет глубокие исторические традиции и является динамически развивающейся отраслью знаний. Исторический контекст позволяет увидеть все особенности и сложности «нелегкого исторического пути» профессиональной подготовки вокалиста, предусмотреть в этой подготовке формы и методы, накопленные столетиями существования музыкального искусства.Цель данного исследования заключается в нахождении места истокам и детерминантам подготовки вокалистов в их современной профессиональной подготовке к сценическому исполнению.Результаты. В статье показана эволюция вокальной педагогики, которая проходила в условиях поиска баланса между эмоционально-художественной и виртуозно-технической составляющими вокального искусства, что ярко проявляется в генезисе разных музыкальных стилей. Рассматриваются основные направления современной музыкальной педагогики вокала: общетеоретические основы обучения вокалистов-исполнителей; содержание профессиональной подготовки вокалистов; педагогические средства профессиональной подготовки вокалистов; психологическая подготовка вокалистов. Русская вокальная школа в истории развития педагогики вокала предстает как школа наиболее ориентированная на поиск единства и гармонизации музыкально-технического и эмоционально-образного аспектов исполнения.Практическая значимость. Авторская методика формирования способностей к джазовой импровизации, подготовленная на основании исторического анализа и опытно-экспериментальной работы, может использоваться при подготовке будущих специалистов для социокультурной сферы в других вузах творческого профиля.
ОСТЕОСИНТЕЗ НИЖНЕЧЕЛЮСТНЫХ ПЕРЕЛОМОВ С ИСПОЛЬЗОВАНИЕМ КОНСТРУКЦИЙ ИЗ НИКЕЛИДА ТИТАНА
Authors: Radkevich Andrey Anatolevich , Gyunter Viktor Eduardovich , Sinyuk Ilya Vasilevich , Levenets Anatoliy Aleksandrovich , Stynke Georgiy Mikhaylovich , Mamedov Rasim Khaligovich , Podgorny Vasily Yuryevich , Gantimurov Alexander Alekseevich , Zhuravleva Tatyana Borisovna
Published: January 2019

Цель. Разработка новой медицинской технологии хирургического лечения больных с переломами нижней челюсти с использованием материалов с памятью формы.Материалы и методы. С использованием фиксирующих конструкций из никелида титана с памятью формы, разработанных в НИИ медицинских материалов и имплантатов с памятью формы, выполнено оперативное лечение более 2000 больных, лиц обоего пола, в возрасте от 13 до 80 лет, с переломами нижней челюсти различного характера и локализации из внутриротового или внеротового доступов без иммобилизации нижней челюсти и комбинации с другими способами остеосинтеза.Результаты. Применение фиксирующих конструкций с термомеханической памятью в хирургическом лечении различных типов переломов нижней челюсти позволило получить удовлетворительные результаты у 95,5% больных. В остальных 4,5% случаях возникли осложнения в виде нагноения костной раны, травматического остеомиелита, что связано с поздними обращениями и/или угнетением репаративной функции, замедленная консолидация, в основном у лиц старшего и пожилого возраста, в результате трофических нарушений.Заключение. Благодаря биосовместимости никелида титана с тканями организма остеосинтез переломов нижней челюсти с использованием скоб из данного материала позволяет свести до минимума все виды осложнений, присущие этому типу вмешательств.
Work Package Sizing and Project Performance
Authors: Li Chung-Lun , Hall Nicholas G.
Published: January 2019

In organizing a project’s tasks into manageable work packages (i.e., forming a work breakdown structure), trade-offs arise. Defining smaller work packages increases project complexity and workload, and reduces economies of scale, whereas defining larger work packages reduces concurrent processing and adversely affects cash flow. In “Work Package Sizing and Project Performance,” C.-L. Li and N.G. Hall study this trade-off by developing and analyzing an optimization model for work package formation. The model minimizes total project cost, subject to a deadline constraint on project makespan. From a study of this model, the authors demonstrate the value of deliberately varying work package sizes within a project, in contrast with typical project management practice. This research enables more precise planning of work packages to improve performance, documents the value of integrating the planning of work packages and schedules, and provides insights that guide resource allocation decisions.
Load Balancing in the Nondegenerate Slowdown Regime
Authors: Gupta Varun , Walton Neil
Published: January 2019

The exact study of control policies for queueing systems, such as prioritizing queues or load-balancing among servers, is often notoriously intractable. The usual path to study these questions is an asymptotic analysis where either the system load is increased to its capacity or the size of the queueing system is increased (called many servers regime) at the same time as its load is increased. In the paper “Load Balancing in the Nondegenerate Slowdown Regime,” authors V. Gupta and N. Walton argue that the traditional asymptotic regimes are insufficient for studying the properties of the most classical load-balancing policy, join the shortest queue (JSQ), where arriving jobs join the server with the fewest number of jobs. By studying load-balancing policies in the novel nondegenerate slowdown asymptotic regime, the authors conclude that JSQ achieves performance close to the ideal centralized policy. Further, the work proposes a simpler load-balancing policy, called idle one first, which achieves the same performance as JSQ but at a much smaller communication overhead between the servers and the load balancer.