bluuebunny/crossref_metadata_2025 huggingface dataset:
Capsules
Authors: Zippel Richard
Published: November 2016

Well organized large systems tend to consist of a large number of small pieces of code each of which captures a single semantic unit. These pieces of code are strung together to form larger semantic phrases, which are in turn components of even larger phrases. The smallest semantic units in a polynomial manipulation system might be the routines that add and multiply the coefficients of the polynomials. These routines are combined (used as subroutines) to form the routines that add and multiply polynomials, which are components in the factoring and greatest common divisor routines.

When a system is built in a top down manner, the larger phrases are formed first and are used to define the semantic components of the smaller phrases. Bottom up software design begins with the small phrases and generates the large phrases. In practice a combination of these two approaches is often used. The manner in which the routines are initially connected is usually simple, but in time the addition of new capabilities and features, and the necessities of performance enhancement generally cause the dependency structure to become quite complex.
The flipped classroom allows for more class time devoted to critical thinking
Authors: DeRuisseau Lara R.
Published: November 2016

The flipped classroom was utilized in a two-semester, high-content science course that enrolled between 50 and 80 students at a small liberal arts college. With the flipped model, students watched ~20-min lectures 2 days/wk outside of class. These videos were recorded via screen capture and included a detailed note outline, PowerPoint slides, and review questions. The traditional format included the same materials, except that lectures were delivered in class each week and spanned the entire period. During the flipped course, the instructor reviewed common misconceptions and asked questions requiring higher-order thinking, and five graded case studies were performed each semester. To determine whether assessments included additional higher-order thinking skills in the flipped vs. traditional model, questions across course formats were compared via Blooms Taxonomy. Application-level questions that required prediction of an outcome in a new scenario comprised 38 ± 3 vs. 12 ± 1% of summative assessment questions (<0.01): flipped vs. traditional. Final letter grades in both formats of the course were compared with major GPA. Students in the flipped model performed better than their GPA predicted, as 85.5% earned a higher grade (vs. 42.2% in the traditional classroom) compared with their major GPA. These data demonstrate that assessments transitioned to more application-level compared with factual knowledge-based questions with this particular flipped model, and students performed better in their final letter grade compared with the traditional lecture format. Although the benefits to a flipped classroom are highlighted, student evaluations did suffer. More detailed studies comparing the traditional and flipped formats are warranted.
Citrulline directly modulates muscle protein synthesis via the PI3K/MAPK/4E-BP1 pathway in a malnourished state: evidence from in vivo, ex vivo, and in vitro studies
Authors: Le Plénier Servane , Goron Arthur , Sotiropoulos Athanassia , Archambault Eliane , Guihenneuc Chantal , Walrand Stéphane , Salles Jérome , Jourdan Marion , Neveux Nathalie , Cynober Luc , Moinard Christophe
Published: November 2016

Citrulline (CIT) is an endogenous amino acid produced by the intestine. Recent literature has consistently shown CIT to be an activator of muscle protein synthesis (MPS). However, the underlying mechanism is still unknown. Our working hypothesis was that CIT might regulate muscle homeostasis directly through the mTORC1/PI3K/MAPK pathways. Because CIT undergoes both interorgan and intraorgan trafficking and metabolism, we combined three approaches: in vivo, ex vivo, and in vitro. Using a model of malnourished aged rats, CIT supplementation activated the phosphorylation of S6K1 and 4E-BP1 in muscle. Interestingly, the increase in S6K1 phosphorylation was positively correlated ( P < 0.05) with plasma CIT concentration. In a model of isolated incubated skeletal muscle from malnourished rats, CIT enhanced MPS (from 30 to 80% CIT vs. Ctrl, P < 0.05), and the CIT effect was abolished in the presence of wortmannin, rapamycin, and PD-98059. In vitro, on myotubes in culture, CIT led to a 2.5-fold increase in S6K1 phosphorylation and a 1.5-fold increase in 4E-BP1 phosphorylation. Both rapamycin and PD-98059 inhibited the CIT effect on S6K1, whereas only LY-294002 inhibited the CIT effect on both S6K1 and 4E-BP1. These findings show that CIT is a signaling agent for muscle homeostasis, suggesting a new role of the intestine in muscle mass control.
Breast Cancer Metastasis to the Stomach That Was Diagnosed after Endoscopic Submucosal Dissection
Authors: Kita Masahide , Furukawa Masashi , Iwamuro Masaya , Hori Keisuke , Kawahara Yoshiro , Taira Naruto , Nogami Tomohiro , Shien Tadahiko , Tanaka Takehiro , Doihara Hiroyoshi , Okada Hiroyuki
Published: November 2016

A 52-year-old woman presented with stage IIB primary breast cancer (cT2N1M0), which was treated using neoadjuvant chemotherapy (epirubicin, cyclophosphamide, and paclitaxel). However, the tumor persisted in patchy areas; therefore, we performed modified radical mastectomy and axillary lymph node dissection. Routine endoscopy at 8 months revealed a depressed lesion on the gastric angle’s greater curvature, and histology revealed signet ring cell proliferation. We performed endoscopic submucosal dissection for gastric cancer, although immunohistochemistry revealed that the tumor was positive for estrogen receptor, mammaglobin, and gross cystic disease fluid protein-15 (E-cadherin-negative). Therefore, we revised the diagnosis to gastric metastasis from the breast cancer.
A Rare Cause of Nasal Obstruction: Metastatic Renal Cell Carcinoma
Authors: Kokenek-Unal Tuba Dilay , Gumuskaya B. , Ocal B. , Alper Murat
Published: November 2016

Introduction. Renal cell carcinoma can present with several interesting symptoms, paraneoplastic syndromes, and unusual metastatic sites. Head and neck region is one of the rare locations for renal cell carcinoma metastasis. Case Report. A 50-year-old man was admitted to the hospital with nasal congestion and snoring. Physical examination revealed nasal serous secretion. First taken biopsy was misinterpreted. The symptoms of the patient were not revealed and he was readmitted to the hospital. On radiologic examination, a vascular rich mass in maxillary sinus extending to the nasal cavity was observed. Biopsy was diagnosed as renal cell carcinoma metastasis. Herein, we present a patient with renal cell carcinoma presenting nasal obstruction and snoring as first and recurrent symptom.
In VivoExpression of Reprogramming Factors Increases Hippocampal Neurogenesis and Synaptic Plasticity in Chronic Hypoxic-Ischemic Brain Injury
Authors: Wi Soohyun , Yu Ji Hea , Kim MinGi , Cho Sung-Rae
Published: November 2016

Neurogenesis and synaptic plasticity can be stimulatedin vivoin the brain. In this study, we hypothesized thatin vivoexpression of reprogramming factors such asKlf4,Sox2,Oct4, andc-Mycwould facilitate endogenous neurogenesis and functional recovery. CD-1® mice were induced at 1 week of age by unilaterally carotid artery ligation and exposure to hypoxia. At 6 weeks of age, mice were injected GFP only or both four reprogramming factors and GFP into lateral ventricle. Passive avoidance task and open field test were performed to evaluate neurobehavioral function. Neurogenesis and synaptic activity in the hippocampus were evaluated using immunohistochemistry, qRT-PCR, and/or western blot analyses. Whereas BrdU+GFAP+cells in the subgranular zone of the hippocampus were not significantly different, the numbers of BrdU+βIII-tubulin+and BrdU+NeuN+cells were significantly higher in treatment group than control group. Expressions of synaptophysin and PSD-95 were also higher in treatment group than control group. Importantly, passive avoidance task and open field test showed improvement in long-term memory and decreased anxiety in treatment group. In conclusion,in vivoexpression of reprogramming factors improved behavioral functions in chronic hypoxic-ischemic brain injury. The mechanisms underlying these repair processes included endogenous neurogenesis and synaptic plasticity in the hippocampus.
Dynamic Relay Satellite Scheduling Based on ABC-TOPSIS Algorithm
Authors: Zhuang Shufeng , Yin Zhendong , Wu Zhilu , Chen Xiaoguang
Published: November 2016

Tracking and Data Relay Satellite System (TDRSS) is a space-based telemetry, tracking, and command system, which represents a research field of the international communication. The issue of the dynamic relay satellite scheduling, which focuses on assigning time resource to user tasks, has been an important concern in the TDRSS system. In this paper, the focus of study is on the dynamic relay satellite scheduling, whose detailed process consists of two steps: the initial relay satellite scheduling and the selection of dynamic scheduling schemes. To solve the dynamic scheduling problem, a new scheduling algorithm ABC-TOPSIS is proposed, which combines artificial bee colony (ABC) and technique for order preference by similarity to ideal solution (TOPSIS). The artificial bee colony algorithm is performed to solve the initial relay satellite scheduling. In addition, the technique for order preference by similarity to ideal solution is adopted for the selection of dynamic scheduling schemes. Plenty of simulation results are presented. The simulation results demonstrate that the proposed method provides better performance in solving the dynamic relay satellite scheduling problem in the TDRSS system.
Straightforward Proofs of Ostrowski Inequality and Some Related Results
Authors: Farid Ghulam
Published: November 2016

We give proofs of some known results in very simple and antique way. Also we find some general bounds of a nonnegative difference of the Hadamard inequality and an Ostrowski-Grüss type inequality is proved.
Postinsertional Cable Movements of Cochlear Implant Electrodes and Their Effects on Intracochlear Pressure
Authors: Todt I. , Karimi D. , Luger J. , Ernst A. , Mittmann P.
Published: November 2016

Introduction.To achieve a functional atraumatic cochlear implantation, intracochlear pressure changes during the procedure should be minimized. Postinsertional cable movements are assumed to induce intracochlear pressure changes. The aim of this study was to observe intracochlear pressure changes due to postinsertional cable movements.Materials and Methods.Intracochlear pressure changes were recorded in a cochlear model with a micro-pressure sensor positioned in the apical region of the cochlea model to follow the maximum amplitude and pressure gain velocity in intracochlear pressure. A temporal bone mastoid cavity was attached to the model to simulate cable positioning. The compared conditions were (1) touching the unsealed electrode, (2) touching the sealed electrode, (3) cable storage with an unfixed cable, and (4) cable storage with a fixed cable.Results.We found statistically significant differences in the occurrence of maximum amplitude and pressure gain velocity in intracochlear pressure changes under the compared conditions. Comparing the cable storage conditions, a cable fixed mode offers significantly lower maximum pressure amplitude and pressure gain velocity than the nonfixed mode.Conclusion.Postinsertional cable movement led to a significant pressure transfer into the cochlea. Before positioning the electrode cable in the mastoid cavity, fixation of the cable is recommended.
Protection against Corrosion of Aluminum Alloy in Marine Environment by Lawsonia inermis
Authors: Hajar H. M. , Zulkifli F. , Mohd Sabri M. G. , Wan Nik W. B.
Published: November 2016

The corrosion performance of aluminum alloy 5083 (AA5083) was investigated in the splash zone area simulated in salt spray cabinet at ambient temperature. Three paint formulations were prepared in accordance with different percentages of henna extract. FTIR method was used to determine the constituent of henna while weight loss and electrochemical method were applied to investigate the inhibition behaviour. The findings show that corrosion rate of aluminum alloy decreased with the increases of henna extract in the coating formulation. The rise of charge transfer resistance (Rct) value has contributed to the greater protection of the coated aluminum. The decrease in double layer capacitance value (Cdl) is another indicator that a better protective barrier has been formed in the presence of henna in the coating matrix.
Structural Comparison between the Right and Left Atrial Appendages Using Multidetector Computed Tomography
Authors: Shinoda Koichi , Hayashi Shogo , Fukuoka Daisuke , Torii Ryo , Watanabe Tsuneo , Nakano Takashi
Published: November 2016

The three-dimensional (3D) structures of the right atrial appendage (RAA) and left atrial appendage (LAA) were compared to clarify why thrombus formation less frequently occurs in RAA than in LAA. Morphological differences between RAA and LAA of 34 formalin-preserved cadaver hearts were investigated. Molds of RAA and LAA specimens were made and the neck areas, volumes of the atrial appendages (AA), and amount of pectinate muscles (PMs) were analyzed using multidetector computed tomography. In RAA, most PMs were connected to one another and formed a “dendritic” appearance and the inner surface area was smaller than in LAA. RAA had smaller volumes and larger neck areas than LAA. The ratios of the neck area/volume were larger and the amounts of PMs were smaller in RAA than in LAA. The volumes, neck areas, and amount of PMs of RAA were significantly correlated with those of LAA. According to the 3D structure, RAA appears to be suited for a more favorable blood flow, which may explain why the thrombus formation is less common in RAA than in LAA. Examining not only LAA but also RAA by transesophageal echocardiography may be useful in high-risk patients of thrombus formation in LAA because the volume, neck area, and amount of PMs of LAA reflect the shape of RAA.
Serum Levels of Soluble ST2 and IL-10 Are Associated with Disease Severity in Patients with IgA Nephropathy
Authors: Zhang Zhihui , Wang Haifeng , Zhang Li , Crew Rebecca , Zhang Nan , Liu Xiaolei , Jiang Yanfang
Published: November 2016

Background. The IL-33/ST2 axis is involved in humoral immune responses. Method. The concentrations of sera IL-33 and sST2 in 74 patients and 34 healthy controls (HC) were measured by ELISA. Clinical and laboratory data were examined. The potential association between sera IL-33 and sST2 and the clinical parameters in IgAN patients were analyzed. Results. No difference was discovered in IL-33 concentrations between IgAN patients and HCs; however, the sST2 were significantly higher in each stage of IgAN progression than in the HC. The concentration of sST2 was positively correlated with IL-33 levels in IgAN patients. Higher levels of sera IL-2, IL-4, IL-10, IL-17A, and IFN-γ were detected in patients compared to the HC. The concentration of serum sST2 was positively correlated with the levels of IL-10 in IgAN patients. Furthermore, serum sST2 was negatively correlated with the values of eGFR and serum calcium. Serum sST2 was positively correlated with 24-hour urinary protein, serum phosphorus, and serum IgA; however, serum IL-33 was not associated with these. Following treatment, serum sST2 was significantly decreased, while sera IL-4 and IL-10 were significantly increased. Conclusions. Increased sST2 and IL-10 but not IL-33 may be involved in the pathogenic process of IgAN.
NEMO-Binding Domain Peptide Attenuates Lipopolysaccharide-Induced Acute Lung Injury by Inhibiting the NF-κB Signaling Pathway
Authors: Huang Jianhua , Li Li , Yuan Weifeng , Zheng Linxin , Guo Zhenhui , Huang Wenjie
Published: November 2016

The aim of the present study is to investigate the protective effects and relevant mechanisms exerted by NEMO-binding domain peptide (NBD) against lipopolysaccharide- (LPS-) induced acute lung injury (ALI) in mice. The ALI model was induced by intratracheally administered atomized LPS (5 mg/kg) to BABL/c mice. Half an hour before LPS administration, we treated the mice with increasing concentrations of intratracheally administered NBD or saline aerosol. Two hours after LPS administration, each group of mice was sacrificed. We observed that NBD pretreatment significantly attenuated LPS-induced lung histopathological injury in a dose-dependent manner. Western blotting established that NBD pretreatment obviously attenuated LPS-induced IκB-αand NF-κBp65 activation and NOX1, NOX2, and NOX4 overexpression. Furthermore, NBD pretreatment increased SOD and T-AOC activity and decreased MDA levels in lung tissue. In addition, NBD also inhibited TNF-αand IL-1βsecretion in BALF after LPS challenge. In conclusion, NBD protects against LPS-induced ALI in mice.
Hyperprogressive Disease Is a New Pattern of Progression in Cancer Patients Treated by Anti-PD-1/PD-L1
Authors: Champiat Stéphane , Dercle Laurent , Ammari Samy , Massard Christophe , Hollebecque Antoine , Postel-Vinay Sophie , Chaput Nathalie , Eggermont Alexander , Marabelle Aurélien , Soria Jean-Charles , Ferté Charles
Published: November 2016

Purpose: While immune checkpoint inhibitors are disrupting the management of patients with cancer, anecdotal occurrences of rapid progression (i.e., hyperprogressive disease or HPD) under these agents have been described, suggesting potentially deleterious effects of these drugs. The prevalence, the natural history, and the predictive factors of HPD in patients with cancer treated by anti-PD-1/PD-L1 remain unknown.

Experimental Design: Medical records from all patients (N = 218) prospectively treated in Gustave Roussy by anti-PD-1/PD-L1 within phase I clinical trials were analyzed. The tumor growth rate (TGR) prior (“REFERENCE”; REF) and upon (“EXPERIMENTAL”; EXP) anti-PD-1/PD-L1 therapy was compared to identify patients with accelerated tumor growth. Associations between TGR, clinicopathologic characteristics, and overall survival (OS) were computed.

Results: HPD was defined as a RECIST progression at the first evaluation and as a ≥2-fold increase of the TGR between the REF and the EXP periods. Of 131 evaluable patients, 12 patients (9%) were considered as having HPD. HPD was not associated with higher tumor burden at baseline, nor with any specific tumor type. At progression, patients with HPD had a lower rate of new lesions than patients with disease progression without HPD (P < 0.05). HPD is associated with a higher age (P < 0.05) and a worse outcome (overall survival). Interestingly, REF TGR (before treatment) was inversely correlated with response to anti-PD-1/PD-L1 (P < 0.05) therapy.

Conclusions: A novel aggressive pattern of hyperprogression exists in a fraction of patients treated with anti-PD-1/PD-L1. This observation raises some concerns about treating elderly patients (>65 years old) with anti-PD-1/PD-L1 monotherapy and suggests further study of this phenomenon. Clin Cancer Res; 23(8); 1920–8. ©2016 AACR.

See related commentary by Sharon, p. 1879
PD-1 Suppresses Development of Humoral Responses That Protect against Tn-Bearing Tumors
Authors: Haro Marcela A. , Littrell Chad A. , Yin Zhaojun , Huang Xuefei , Haas Karen M.
Published: November 2016

Tn is a carbohydrate antigen uniquely exposed on tumor mucins and, thus, an ideal target for immunotherapy. However, it has been difficult to elicit protective antibody responses against Tn antigen and other tumor-associated carbohydrate antigens. Our study demonstrates this can be attributed to PD-1 immuno-inhibition. Our data show a major role for PD-1 in suppressing mucin- and Tn-specific B-cell activation, expansion, and antibody production important for protection against Tn-bearing tumor cells. These Tn/mucin-specific B cells belong to the innate-like B-1b cell subset typically responsible for T cell–independent antibody responses. Interestingly, PD-1–mediated regulation is B cell–intrinsic and CD4+ cells play a key role in supporting Tn/mucin-specific B-cell antibody production in the context of PD-1 deficiency. Mucin-reactive antibodies produced in the absence of PD-1 inhibition largely belong to the IgM subclass and elicit potent antitumor effects via a complement-dependent mechanism. The identification of this role for PD-1 in regulating B cell–dependent antitumor immunity to Tn antigen highlights an opportunity to develop new therapeutic strategies targeting tumor-associated carbohydrate antigens. Cancer Immunol Res; 4(12); 1027–37. ©2016 AACR.
Longer Left Ventricular Electric Delay Reduces Mitral Regurgitation After Cardiac Resynchronization Therapy
Authors: Chatterjee Neal A. , Gold Michael R. , Waggoner Alan D. , Picard Michael H. , Stein Kenneth M. , Yu Yinghong , Meyer Timothy E. , Wold Nicholas , Ellenbogen Kenneth A. , Singh Jagmeet P.
Published: November 2016

Background—

Mitral regurgitation (MR) is associated with worse survival in those undergoing cardiac resynchronization therapy (CRT). Left ventricular (LV) lead position in CRT may ameliorate mechanisms of MR. We examine the association between a longer LV electric delay (QLV) at the LV stimulation site and MR reduction after CRT.

Methods and Results—

QLV was assessed retrospectively in 426 patients enrolled in the SMART-AV study (SmartDelay Determined AV Optimization: A Comparison to Other AV Delay Methods Used in CRT). QLV was defined as the time from QRS onset to the first large peak of the LV electrogram. Linear regression and logistic regression were used to assess the association between baseline QLV and MR reduction at 6 months (absolute change in vena contracta width and odds of ≥1 grade reduction in MR). At baseline, there was no difference in MR grade, LV dyssynchrony, or LV volumes in those with QLV above versus below the median (95 ms). After multivariable adjustment, increasing QLV was an independent predictor of MR reduction at 6 months as reflected by an increased odds of MR response (odds ratio: 1.13 [1.03–1.25]/10 ms increase QLV;
P
=0.02) and a decrease in vena contracta width (
P
<0.001). At 3 months, longer QLV (≥median) was associated with significant decrease in LV end-systolic volume (ΔLV end-systolic volume −28.2±38.9 versus −4.9±33.8 mL,
P
<0.001). Adjustment for 3-month ΔLV end-systolic volume attenuated the association between QLV and 6-month MR reduction.

Conclusions—

In patients undergoing CRT, longer QLV was an independent predictor of MR reduction at 6 months and associated with interval 3-month LV reverse remodeling. These findings provide a mechanistic basis for using an electric-targeting LV lead strategy at the time of CRT implant.
Methodology Considerations in Phase Mapping of Human Cardiac Arrhythmias
Authors: Vijayakumar Ramya , Vasireddi Sunil K. , Cuculich Phillip S. , Faddis Mitchell N. , Rudy Yoram
Published: November 2016

Background—

Phase analysis of cardiac arrhythmias, particularly atrial fibrillation, has gained interest because of the ability to detect organized stable drivers (rotors) and target them for therapy. However, the lack of methodology details in publications on the topic has resulted in ongoing debate over the phase mapping technique. By comparing phase maps and activation maps, we examined advantages and limitations of phase mapping.

Methods and Results—

Seven subjects were enrolled. We generated phase maps and activation maps from electrocardiographic imaging–reconstructed epicardial unipolar electrograms. For ventricular signals, phase was computed with (1) pseudoempirical mode decomposition detrending and (2) a novel Moving Average (MVG) detrending approach. For atrial fibrillation signals, MVG was modified to incorporate dynamic cycle length (DCL) changes (MVG-DCL). Phase maps were visually analyzed to study phase singularity points and rotors. Results show that phase is sensitive to cycle length choice, a limitation that was addressed by the MVG-DCL algorithm. MVG-DCL was optimal for atrial fibrillation analysis. Phase maps helped to highlight high-curvature wavefronts and rotors. However, for some activation patterns, phase generated nonrotational singularity points and false rotors.

Conclusions—

Phase mapping computes singularity points and visually highlights rotors. As such, it can help to provide a clearer picture of the spatiotemporal activation characteristics during atrial fibrillation. However, it is advisable to incorporate electrogram characteristics and the time-domain activation sequence in the analysis, to prevent misinterpretation and false rotor detection. Therefore, for mapping complex arrhythmias, a combined time-domain activation and phase mapping with variable cycle length seems to be the most reliable method.
Magnetic Resonance Imaging of Cardiac Strain Pattern Following Transplantation of Human Tissue Engineered Heart Muscles
Authors: Qin Xulei , Riegler Johannes , Tiburcy Malte , Zhao Xin , Chour Tony , Ndoye Babacar , Nguyen Michael , Adams Jackson , Ameen Mohamed , Denney Thomas S. , Yang Phillip C. , Nguyen Patricia , Zimmermann Wolfram H. , Wu Joseph C.
Published: November 2016

Background—

The use of tissue engineering approaches in combination with exogenously produced cardiomyocytes offers the potential to restore contractile function after myocardial injury. However, current techniques assessing changes in global cardiac performance after such treatments are plagued by relatively low detection ability. Since the treatment is locally performed, this detection could be improved by myocardial strain imaging that measures regional contractility.

Methods and Results—

Tissue engineered heart muscles (EHMs) were generated by casting human embryonic stem cell–derived cardiomyocytes with collagen in preformed molds. EHMs were transplanted (n=12) to cover infarct and border zones of recipient rat hearts 1 month after ischemia reperfusion injury. A control group (n=10) received only sham placement of sutures without EHMs. To assess the efficacy of EHMs, magnetic resonance imaging and ultrasound-based strain imaging were performed before and 4 weeks after transplantation. In addition to strain imaging, global cardiac performance was estimated from cardiac magnetic resonance imaging. Although no significant differences were found for global changes in left ventricular ejection fraction (control −9.6±1.3% versus EHM −6.2±1.9%;
P
=0.17), regional myocardial strain from tagged magnetic resonance imaging was able to detect preserved systolic function in EHM-treated animals compared with control (control 4.4±1.0% versus EHM 1.0±0.6%;
P
=0.04). However, ultrasound-based strain failed to detect any significant change (control 2.1±3.0% versus EHM 6.3±2.9%;
P
=0.46).

Conclusions—

This study highlights the feasibility of using cardiac strain from tagged magnetic resonance imaging to assess functional changes in rat models following localized regenerative therapies, which may not be detected by conventional measures of global systolic performance.
Association Between Physician Teamwork and Health System Outcomes After Coronary Artery Bypass Grafting
Authors: Hollingsworth John M. , Funk Russell J. , Garrison Spencer A. , Owen-Smith Jason , Kaufman Samuel A. , Pagani Francis D. , Nallamothu Brahmajee K.
Published: November 2016

Background—

Patients undergoing coronary artery bypass grafting (CABG) must often see multiple providers dispersed across many care locations. To test whether teamwork (assessed with the bipartite clustering coefficient) among these physicians is a determinant of surgical outcomes, we examined national Medicare data from patients undergoing CABG.

Methods and Results—

Among Medicare beneficiaries who underwent CABG between 2008 and 2011, we mapped relationships between all physicians who treated them during their surgical episodes, including both surgeons and nonsurgeons. After aggregating across CABG episodes in a year to construct the physician social networks serving each health system, we then assessed the level of physician teamwork in these networks with the bipartite clustering coefficient. Finally, we fit a series of multivariable regression models to evaluate associations between a health system’s teamwork level and its 60-day surgical outcomes. We observed substantial variation in the level of teamwork between health systems performing CABG (SD for the bipartite clustering coefficient was 0.09). Although health systems with high and low teamwork levels treated beneficiaries with comparable comorbidity scores, these health systems differed over several sociocultural and healthcare capacity factors (eg, physician staff size and surgical caseload). After controlling for these differences, health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality.

Conclusions—

Health systems with physicians who tend to work together in tightly-knit groups during CABG episodes realize better surgical outcomes. As such, delivery system reforms focused on building teamwork may have positive effects on surgical care.
Early Detection of Heart Failure Using Electronic Health Records
Authors: Ng Kenney , Steinhubl Steven R. , deFilippi Christopher , Dey Sanjoy , Stewart Walter F.
Published: November 2016

Background—

Using electronic health records data to predict events and onset of diseases is increasingly common. Relatively little is known, although, about the tradeoffs between data requirements and model utility.

Methods and Results—

We examined the performance of machine learning models trained to detect prediagnostic heart failure in primary care patients using longitudinal electronic health records data. Model performance was assessed in relation to data requirements defined by the prediction window length (time before clinical diagnosis), the observation window length (duration of observation before prediction window), the number of different data domains (data diversity), the number of patient records in the training data set (data quantity), and the density of patient encounters (data density). A total of 1684 incident heart failure cases and 13 525 sex, age-category, and clinic matched controls were used for modeling. Model performance improved as (1) the prediction window length decreases, especially when <2 years; (2) the observation window length increases but then levels off after 2 years; (3) the training data set size increases but then levels off after 4000 patients; (4) more diverse data types are used, but, in order, the combination of diagnosis, medication order, and hospitalization data was most important; and (5) data were confined to patients who had ≥10 phone or face-to-face encounters in 2 years.

Conclusions—

These empirical findings suggest possible guidelines for the minimum amount and type of data needed to train effective disease onset predictive models using longitudinal electronic health records data.
Insulin Resistance Is a Risk Factor for Silent Lacunar Infarction
Authors: Lee Ji Eun , Shin Dong Wook , Yun Jae Moon , Kim Sang Hyuck , Nam You-Seon , Cho BeLong , Lim Jae-Sung , Jeong Han-Yeong , Kwon Hyung-Min , Park Jin-Ho
Published: November 2016

Background and Purpose—

This study aims to investigate the association between insulin resistance (IR) and silent lacunar infarction (SLI) in healthy adults.

Methods—

We recruited 2326 healthy Korean adults who took health checkups, including a brain magnetic resonance imaging. SLI was defined as an infarction measuring 0.3 to 1.5 cm in diameter that was localized in the territory of perforating branches of cerebral arteries, as seen in the brain magnetic resonance imaging. The homeostasis model assessment–estimated insulin resistance index was used for IR estimation, and the cutoff value for its diagnosis for Koreans was 2.56.

Results—

The mean age of the study population was 56.2 years (range, 40–79 years), and 1279 subjects (55.0%) were male. The prevalence of SLI and IR was 8.1% and 18.1%, respectively. In multivariate logistic analysis, after adjusting for traditional SLI-associated risk factors, IR was positively associated with the prevalence of SLI (adjusted odds ratio, 1.69; 95% confidence interval, 1.16–2.46). The proportion of subjects with multiple SLI lesions (≥2) was also higher in the IR (+) group than that in the IR (−) group (4.3% versus 1.7%;
P
<0.001). In ordered logistic regression, IR was positively associated with an increase in SLI severity (adjusted odds ratio, 1.76; 95% confidence interval, 1.21–2.56).

Conclusions—

IR is an independent risk factor of SLI presence and its severity in Koreans. Whether improvement of IR might prevent SLI occurrence needs to be addressed by clinical trials.
Poetics of Praise: Love and Authority in al-ḤājjʿUmar Tāl’s Safīnat al-saʿāda li-ahl ḍuʿf wa-l-najāda
Authors: Syed Amir
Published: November 2016

In this article, I provide one example of how a careful engagement with poetry can enrich our understanding of West African history. In 1852, al-ḤājjʿUmar Fūtī Tāl (d.1864) completed his panegyric of the Prophet Muḥammad—Safīnat al-saʿāda li-ahl ḍuʿf wa-l-najāda or The Vessel of Happiness and Assistance for the Weak. Through an analysis of Safīnat al-saʿāda, I explain Tāl’s creative use of two older poems that were widespread in West Africa—al-ʿIshrīniyyāt—The Twenties—of ʿAbd al-Raḥmān al-Fāzāzī (d. 1230), and its takhmīs (pentastich) by Abū Bakr ibn Muhīb (n.d.). Though Safīnat al-saʿāda was primarily meant for devotion, it also reflected Tāl’s scholarly prestige and claims he made about his religious authority. In the long prose introduction to the poem, Tāl claimed that he was a vicegerent of the Prophet, and therefore had authority to guide and lead the Muslims of West Africa. His composition of Safīnat al-saʿāda was partly meant to prove this point.
Untangling the Amorimia rigida complex, a puzzling group of lianescent Malpighiaceae from Eastern Brazil
Authors: DE ALMEIDA RAFAEL FELIPE , VAN DEN BERG CÁSSIO , AMORIM ANDRÉ MÁRCIO ARAUJO
Published: November 2016

A proposal for the resolution of the Amorimia rigida complex is presented, including a new combination, three new species, and the redescription of A. rigida and A. velutina. The newly described and the re-established taxa are endemic to Eastern Brazil, and can be differentiated from A. rigida s.s. by details in the leaves, indumenta, floral, and fruit morphology. This study includes morphological descriptions for all taxa, along with an identification key, illustrations, a distribution map, conservation assessments, comments on ecology, nomenclature, and taxonomy, and a table comparing all species belonging to this complex.
Description of a new Tiporus Watts, 1985 from northern Queensland, Australia (Coleoptera: Dytiscidae, Hydroporinae)
Authors: HENDRICH LARS , BALKE MICHAEL , WATTS CHRIS H.S.
Published: November 2016

Tiporus queenslandicus sp. n. is described from NE Queensland. The new species is similar to T. undecimmaculatus (Clark, 1862) and T. giuliani (Watts, 1978) from the Northern Territory and north-western Australia but well characterized by its larger size, more elongate habitus, and form of median lobe and parameres. Tiporus queenslandicus sp. n. is a lotic species being collected from rest pools of intermittent creeks and rivers with a sandy bottom. Important species-defining characters (habitus, median lobe, paramere, protibia of male) are illustrated. Together with T. queenslandicus sp. n. the genus comprises now 13 species.
The Goblin spider genus Xestaspis in Sri Lanka (Araneae: Oonopidae)
Authors: RANASINGHE U. G. S. L. , BENJAMIN SURESH. P.
Published: November 2016

Three new species of the genus Xestaspis Simon, 1884: X. nuwaraeliya sp. nov., X. padaviya sp. nov. and X. pophami sp. nov. are described based on both sexes. Xestaspis kandy Eichenberger, 2012 is illustrated based on new material. A key and a distribution map for Sri Lankan Xestaspis is provided. Phylogenetic placement of Sri Lankan Xestaspis spp. obtained by the analysis of 43 morphological characters is presented and discussed. In all our analysis Gamasomorpha species appear paraphyletic suggesting that Xestaspis is most probably a junior synonym of Gamasomorpha. Thus, forming monophyletic group of oriental hard bodied oonopids.
Three new and a known species of the genus Proleptonchus Lordello, 1955 (Nematoda: Leptonchidae) with a diagnostic compendium of the genus
Authors: AHAD SUMAYA , AHMAD WASIM
Published: November 2016

This paper deals with the description of three new and one known species of the genus Proleptonchus Lordello, 1955. Proleptonchus kazirangus n. sp. from Kaziranga National Park, India is characterized by having 1.08–1.45 mm long body; cap-like, offset, lip region; 7–8 µm long odontostyle and 10–12 µm long odontophore; short, pear-shaped pharyngeal bulb offset by a constriction, occupying about 18–21% of total neck length; female genital system mono-prodelphic; pars dilatata uteri with distinctly sclerotized central lumen containing refringent apophyses; posterior uterine sac 78–112 µm long, with sac-like structure representing a rudimentary oviduct; transverse vulva, short, rounded-conoid tail and males with 31–33 µm long spicules, lateral guiding pieces and seven, regularly spaced ventromedian supplements. P. prerectus n. sp. from Japan is characterized by having 1.18–1.43 mm long body; lip region cap-like, offset by a slight constriction; odontostyle 8 µm, odontophore 9–10 µm; short cylindroid basal bulb offset by a constriction, occupying about 16–20% of total neck length; female genital system mono-prodelphic; pars dilatata uteri with sclerotized refringent apophyses; posterior uterine sac small, 27–36 µm; transverse vulva; a prerectal chamber and short, rounded-hemispheroid tail. P. japonicus n. sp. also from Japan is characterized by having 0.91–1.04 mm long body; lip region cap-like, set off by a slight constriction; odontostyle 5 µm and odontophore 10–11 µm long; pharynx consists of a very slender, non-muscular anterior part, separated from pyriform basal bulb by a constriction, with thickened lumen in posterior region, occupying about 18–20% of total neck length; female genital system mono-prodelphic; posterior uterine sac small, 20–24 µm long; transverse vulva and short, rounded-conoid tail. P. shamimi Bajaj & Bhatti, 1980 is redescribed and its relationship with closely related species is discussed. A diagnostic compendium of all the valid species of Proleptonchus is also provided.
Four new species of Chinaia Bruner & Metcalf (Hemiptera: Cicadellidae: Neocoelidiinae) from the Neotropical Region
Authors: MARQUES ANA PAULA COELHO , ALE-ROCHA ROSALY
Published: November 2016

Four new species of Chinaia Bruner & Metcalf, Chinaia bicornis sp. nov., Chinaia longicauda sp. nov., Chinaia modesta sp. nov., and Chinaia peruviana sp. nov. are described and illustrated. The new species can be distinguished from the other species of the genus by characters of the male genitalia, especially the morphology of the pygofer and aedeagus. A generic diagnosis and a complete description, together with illustrations and pictures of the new species, are provided.
A new genus and a new species in the sea cucumber subfamily Colochirinae (Echinodermata: Holothuroidea: Dendrochirotida: Cucumariidae) in the Mediterranean Sea
Authors: MJOBO SIFISO , THANDAR AHMED S.
Published: November 2016

A new genus Hemiocnus is here erected to accommodate the Mediterranean dendrochirotid sea cucumber Cladodactyla syracusana Grube, currently classified, with some doubt, in the cucumariid genus Pseudocnella. At the same time a new cucumariid species, Hemiocnus rubrobrunneus, is described from some Tunisian material, misidentified as Pseudocnella syracusana (Grube), received from the United States National Museum. The new genus appears most closely related to Pseudocnella than to any other genus within the Colochirinae. Although its body wall ossicles resemble those of Pseudocnella spp. it differs in that the two ventral-most tentacles are reduced and in the presence of rosettes in the tentacles. P. syracusana also cannot be classified in Ocnus because of the presence of multi-layered, fir-cone shaped plates in the body wall, often with one end denticulate; such ossicles are lacking in the type species of the latter genus. The new species, Hemiocnus rubrobrunneus, on the other hand, shows some resemblance to H. syracusanus in its characteristic buttons and incomplete baskets, differing in its softer body wall, lack of fir-cone-shaped plates and in the presence of rosettes and complete baskets in the body wall. There are also some resemblances of the new species to the Mediterranean species of Ocnus viz. O. brunneus, O. planci and O. lacteus, but the soft nature of the body wall, shallow quadrilocular instead of deep trilocular baskets, and the presence of large knobbed plates in the anal region precludes its inclusion in this genus.
Dynamical and Thermodynamical Impacts of High- and Low-Frequency Atmospheric Eddies on the Initial Melt of Arctic Sea Ice
Authors: Hegyi Bradley M. , Deng Yi
Published: November 2016

The role of high-frequency and low-frequency eddies in the melt onset of Arctic sea ice is investigated through an examination of eddy effects on lower-tropospheric (1000–500 hPa) meridional heat transport into the Arctic and local surface downwelling shortwave and longwave radiation. Total and eddy components of the meridional heat transport into the Arctic from 1979 to 2012 are calculated from reanalysis data, and surface radiation data are acquired from the NASA Clouds and the Earth’s Radiant Energy System (CERES) project dataset. There is a significant positive correlation between the mean initial melt date and the September sea ice minimum extent, with each quantity characterized by a negative trend. Spatially, the earlier mean melt onset date is primarily found in a region bounded by 90°E and 130°W. The decline in this region is steplike and not associated with an increase in meridional heat transport but with an earlier appearance of above-freezing temperatures in the troposphere. In most years, discrete short-duration episodes of melt onset over a large area occur. In an investigation of two of these melt episodes, a positive total meridional heat transport is associated with the peak melt, with the product of high-frequency eddy wind and mean temperature fields being the most important contributor. Additionally, there is a key positive anomaly in surface downwelling longwave radiation immediately preceding the peak melt that is associated with increased cloud cover and precipitable water. These results suggest the importance of carefully considering and properly representing atmospheric eddies when modeling the melt onset of Arctic sea ice.
Comments on “Characterizing ENSO Coupled Variability and Its Impact on North American Seasonal Precipitation and Temperature”
Authors: Harrison D. E. , Chiodi Andrew M.
Published: November 2016

El Niño and La Niña seasonal weather anomaly associations provide a useful basis for winter forecasting over the North American regions where they are sufficiently strong in amplitude and consistent in character from one event to another. When the associations during La Niña are different than El Niño, however, the obvious quasi-linear-statistical approach to modeling them has serious shortcomings. The linear approach of L’Heureux et al. is critiqued here based on observed land surface temperature and tropospheric circulation associations over North America. The La Niña associations are quite different in pattern from their El Niño counterparts. The El Niño associations dominate the statistics. This causes the linear approach to produce results that are inconsistent with the observed La Niña–averaged associations. Further, nearly all the useful North American associations have been contributed by the subset of El Niño and La Niña years that are identifiable by an outgoing longwave radiation (OLR) El Niño index and a distinct OLR La Niña index. The remaining “non-OLR events” exhibit winter weather anomalies with large event-to-event variability and contribute very little statistical utility to the composites. The result is that the linear analysis framework is sufficiently unable to fit the observations as to question its utility for studying La Niña and El Niño seasonal temperature and atmospheric circulation relationships. An OLR-event based approach that treats La Niña and El Niño separately is significantly more consistent with, and offers an improved statistical model for, the observed relationships.
Connecting Atmospheric Blocking to European Temperature Extremes in Spring
Authors: Brunner Lukas , Hegerl Gabriele C. , Steiner Andrea K.
Published: November 2016

Atmospheric blocking is an important contributor to European temperature variability. It can trigger cold and warm spells, which is of specific relevance in spring because vegetation is particularly vulnerable to extreme temperatures in the growing season. The spring season is investigated as a transition period from predominant connections of blocking with cold spells in winter to predominant connections of blocking with warm spells in summer. Extreme temperatures are termed cold or warm spells if temperature stays outside the 10th to 90th percentile range for at least six consecutive days. Cold and warm spells in Europe over 1979–2014 are analyzed in observations from the European daily high-resolution gridded dataset (E-OBS) and the connection to blocking is examined in geopotential height fields from ERA-Interim. A highly significant link between blocking and cold and warm spells is found that changes during spring. Blocking over the northeastern Atlantic and Scandinavia is correlated with the occurrence of cold spells in Europe, particularly early in spring, whereas blocking over central Europe is associated with warmer conditions, particularly from March onward. The location of the block also impacts the spatial distribution of temperature extremes. More than 80% of cold spells in southeastern Europe occur during blocking whereas warm spells are correlated with blocking mainly in northern Europe. Over the analysis period, substantial interannual variability is found but also a decrease in cold spells and an increase in warm spells. The long-term change to a warmer climate holds the potential for even higher vulnerability to spring cold extremes.
Performance of Emerging Technologies for Measuring Solid and Liquid Precipitation in Cold Climate as Compared to the Traditional Manual Gauges
Authors: Boudala Faisal S. , Isaac George A. , Filman Peter , Crawford Robert , Hudak David , Anderson Martha
Published: November 2016

Precipitation amount, type, and snow depth ) have been analyzed using data collected during the 4Wing Cold Lake Research Project in northeastern Alberta, Canada. The instruments used include the Vaisala present weather detector PWD22 and present weather sensor (FS)11P, the OTT Pluvio2 automatic catchment-type gauge, the manual standard Canadian Nipher (CN) and Type B rain gauges, and a snow ruler. Both the PWD22 and FS11P performed well at detecting snow, rain, and drizzle events as compared to the human observer. The sensors predicted a higher frequency of ice pellet cases than the human observer. Segregation of precipitation phase using temperature alone appeared unrealistic at near-freezing temperatures. All the sensors agreed well at measuring liquid precipitation, but the Pluvio2 gauge with a single Alter shield underestimated the snowfall amount by 40%, mostly due to wind effects. After correcting the CN gauge catch efficiency (CE) due to wind effects, the CE of the Pluvio2 relative to the CN gauge was found dependent on wind speed (ws). Using these data, a new transfer function (TF) for the Pluvio2 as a function of ws has been developed. The new TF was used to correct the Pluvio2 gauge, and the corrected data agreed well with the PWD22 measurements. Using the and corrected CN data, snow density ratios ( were derived, varying from 4.2 to 35 with a mean value of 12.2. The mean value derived in this study is higher than the 10:1 ratio usually assumed for converting to snow water equivalent in Canada. On average increases with increasing temperature and the 10:1 ratio appears to be more appropriate for warmer temperatures.