bluuebunny/crossref_metadata_2025 huggingface dataset:
Eutrophication modelling of Amirkabir Reservoir (Iran) using an artificial neural network approach
Authors: Homayoun Aria Shiva , Asadollahfardi Gholamreza , Heidarzadeh Nima
Published: January 2019

The complicated non‐linear relationships between water quality and environmental parameters involved in predicting algal blooms necessitate a new approach, using data‐driven modelling. Accordingly, a multilayer perceptron (MLP) and time delay neural network (TDNN) were used to predict the eutrophication status of two monitoring stations in the Amirkabir Reservoir in Iran. Six scenarios for each monitoring station were performed to select a significant, independent input using 12 years of monthly data. The final inputs were temperature, turbidity, phosphate (PO4), nitrate (NO3), nitrite (NO2), ammonium (NH3), dissolved oxygen (DO) and electrical conductivity (EC). Applying an MLP neural network to the upstream monitoring station with 21–38 neurons in the first and second hidden layers, the minimum mean squared errors (MSE) in training, validating and testing were 0.083, 0.81 and 1.95 cells/100 ml, respectively. Further, when the TDNN network was used with the same neuron numbers in the hidden layer for the similar monitoring station, the minimum MSE values for model training, validating and testing were 0.06, 0.72 and 1.76 cells/100 ml, respectively. For the Beylaghan monitoring station, using the MLP neural network with 29–23 neurons in the first and second hidden layer, the minimum MSE values gained in training, validating and testing were 0.181, 0.58 and 0.95 cells/100 ml, respectively. Using the TDNN network with the same neurons in the hidden layers of the MLP neural network for the station, the minimum MSE values for training, validating and testing were 0.152, 0.43 and 0.84 cells/100mL, respectively. Thus, TDNN exhibited a high accuracy and workability, compared to the MLP. Sensitivity analysis of the Amirkabir Reservoir dataset indicated increasing the value of nitrate is the first factor, followed by turbidity and NH3, having the greatest impacts on eutrophication prediction.
Hard‐Core Toughie: Donald Trump’s Negotiations for the United States Presidency
Authors: Kapoutsis Ilias , Volkema Roger
Published: January 2019

This paper examines the negotiation tactics employed by Donald Trump in his 2016 presidential campaign. Drawing on data from multiple sources (interviews, debates, articles, books), our analysis begins with a brief overview of Trump’s personality and philosophy, which offers a basis for understanding his general negotiating approach. We then highlight six competitive tactics and four principles of persuasion that Trump employs, with specific examples of how he used them during the campaign with his primary negotiating counterparts – the other candidates, the Republican Party, the press corps, and the American electorate. Finally, we discuss some of the implications of his negotiating approach and preferred tactics in dealing with domestic and international issues as president of the United States.
Chanteurs de rue, or street singers in early modern France
Authors: McIlvenna Una
Published: January 2019

The impression one tends to have about the profession of the street singer in early modern France is of one voice struggling to be heard amongst a cacophony of other ambulant sellers crying their goods for sale. This vision is encouraged by the centuries‐old genre of the ‘cris de Paris’, immortalised in verse as early as the thirteenth century. This paper outlines in greater detail the figure of the chanteur de rue in the early modern period, from eye‐witness accounts (more plentiful for the eighteenth century), from pictorial evidence, and from clues within the songs themselves. There is evidence to suggest that different types of songs were performed by different types of singers, with the singer of complaintes (execution songs) adopting a costume and demeanour that distinguished him from the singer of ‘profane songs’. However, French songs in the sixteenth century were often sold in cheaply printed recueils, songbooks on a surprisingly diverse range of topics. This paper therefore examines how a street singer might have performed and sold these often heterogenous texts, and how the authorities tried in vain to control and censor these potentially subversive singers of news.
Frail echoes of singing in the streets. Tracing ballad sellers and their reputation in the Low Countries
Authors: Salman Jeroen
Published: January 2019

This article discusses opposing representations of the Dutch ballad singer as political rebel versus entertainer and performer. It reveals how these representations were shaped, how they interacted in cultural practices and how they changed in the Low Countries in the course of the sixteenth and seventeenth century. The underlying question is the relevancy of these street singers in the process of public opinion formation. The period under scrutiny is highly relevant in the context of Dutch history, because it covers the rise of the reformist movement, the revolt of the Northern provinces against the Spanish King, the establishment of the Dutch Republic and growing importance of the local cultural infrastructure. One of the main conclusions is that from the mid‐fifteenth century onwards and including the seventeenth century, ballads and street singing, entertaining as well as propagandistic, were generally seen as a form propaganda and subversion. Despite the often tolerated and even appreciated entertaining function of ballads, the ballad singer from the Dutch revolt onwards remained a distrusted figure.
From beggar to virtuoso: The street singer in the Netherlandish visual tradition, 1500–1600
Authors: Chriscinda Henry
Published: January 2019

This essay surveys the iconography of street singers and musicians in sixteenth‐century Netherlandish painting. It examines the visual and social status of itinerant performers as they move between different roles in the urban marketplace: from sympathetic beggar deserving of charity to diabolical trickster and charlatan, to successful entrepreneur operating within a new market system. The representation of this marginal type extends from grotesque and comic portrayals in late medieval manuscript illuminations and the hallucinatory Hellscapes of Hieronymous Bosch and his followers, to sympathetic depictions as objects of charity in altarpieces of The Seven Works of Mercy, to more ambivalent figurations of pedlars hawking printed wares in serial paintings of biblical narratives in the marketplace by Antwerp‐based artists Pieter Aertsen and Joachim Beuckelaer. The portrait of the street singer that emerges in the highly urbanized Low Countries reflects the burgermoraal (bourgeois morality) of patrons and artists and their attitudes on the social role of the marketplace, the status of consumer capitalism versus civic charity, and most importantly the acceptance of marginal and itinerant individuals who operate outside the norms and regulations of cities and societies.
The ‘Fascinating’ World of the Evil EyeBeware the Evil Eye: The Evil Eye in the Bible and the Ancient World. Volume 1: Introduction, Mesopotamia, and Egypt, John H.Elliott, James Clarke & Co., 2016 (ISBN 978‐0‐227‐17568‐2), xxii + 209 pp., pb £16Beware the Evil Eye: The Evil Eye in the Bible and the Ancient World. Volume 2: Greece and Rome, John H.Elliott, James Clarke & Co., 2016 (ISBN 978‐0‐227‐17613‐9), xxxvi + 334 pp., pb £27.50Beware the Evil Eye: The Evil Eye in the Bible and the Ancient World. Volume 3: The Bible and Related Sources, John H.Elliott, James Clarke & Co., 2017 (ISBN 978‐0‐227‐17667‐2), xxx + 354 pp., pb £32Beware the Evil Eye: The Evil Eye in the Bible and the Ancient World. Volume 4: Postbiblical Israel and Early Christianity through Late Antiquity, John H.Elliott, Wipf and Stock, 2017 (ISBN 978‐1‐4982‐3072‐8), xxvi + 220 pp., pb $29
Authors: Askin Lindsey A.
Published: January 2019

The Evil Eye is a pervasive folkloric belief in the eye as an active organ. Historically, the belief and its related protective practices have been much maligned by modern Western attitudes. Origins of the belief, as best as can be traced, are pinned to ancient Mesopotamia and Egypt. From there, the belief radiated outwards until it was pervasive throughout the ancient Near East and Mediterranean world including, as Elliott argues, ancient Judaism and early Christianity. Conceptualizations of the Evil Eye and related beliefs and protective practices have been found as far as Brazil, Tibet, and Australia and are still expressed in Western society. Elliott's four‐volume work on the Evil Eye in antiquity is a contextual reception history that draws together both textual sources and material culture of this fascinating belief across the ancient world.
Asymmetric effects of financial development on export price and quality across countries
Authors: Choi ByeongHwa , Lugovskyy Volodymyr
Published: January 2019

We derive two novel predictions: financial development has a more pronounced effect on quality in countries with greater labor productivity, and its effect on export prices is U‐shaped in labor productivity. We confirm our predictions empirically and show that the negative effect of financial development on export prices is greatest in middle‐productivity countries, while its positive effect on quality is strongest in the most productive countries. Our findings contribute to the literature on the poverty trap: we argue that improving the quality of financial institutions alone is unlikely to boost quality or lower prices of the poorest countries.
Critical Thinking and Problem-Solving Skills of Visually Impaired Female National Judo Team Athletes
Authors: Demiral Sengul
Published: January 2019

A high level of critical thinking and problem-solving skills in visually impaired female national judo team athletes is an important factor in increasing their performance and for their high performance. The aim of this study was to examine critical thinking and problem-solving skills of visually impaired female national judo team athletes. The sample of the study was composed of visually impaired female athletes (n=15) in 2015 national team. A Personal Information Form, the California Critical Thinking Disposition Inventory and the Problem Solving Inventory were used as data collection tools. The data obtained in this study were analyzed using SPSS 17 software. Evaluation of the data analysis revealed that there was no statistically significant difference among groups in total Problem Solving Inventory and Critical Thinking Disposition Inventory scores in terms of age group or age of starting judo (p>0.05). There was no statistically significant relationship between total problem-solving and total critical thinking disposition scores of athletes (p>0.05). As a result, judo coaches are thought to play an important role in the development of strategies for increasing athletes’ problem-solving and critical thinking skills and in the development of their sporting performance, particularly in the development of high performance.
Strength, Jump Heights and Physical Characteristics of Young Male Basketball Players by Their Positions
Authors: Adıgüzel Niyazi Sıdkı
Published: January 2019

The aim of the study is to compare isokinetic leg strengths and jump performances of basketball players playing at different positions. A total of 34 basketball players (guards (n=13), forwards (n=13) and centers (n=7)) from 17 teams of Turkish Basketball Development League participated in the study. The isokinetic strength tests were performed for the dominant limb at two different angular speeds (60°s-1 and 180°s-1) and the extensor and flexor peak torques (EPT and FPT) were recorded. The strengths produced according to weight were taken as relative EPT and FPT. Jump tests were performed in three categories: free jump, 120° squat jump and active jump. Multivariate variance analysis (ANOVA) was used to compare players' scores in strength and jump tests by their positions. In the comparison of the positions, the guards were shorter and slimmer than the forwards and centers (p <0.05), and they were found to have less BMI values than the centers. The absolute strength values obtained with knee extension peak torques for both angular velocities were higher in the centers than the guards (p <0.05). There was no statistically significant difference in the relative strength values. Moreover, no statistically significant difference was found between the groups for other parameters and all jump parameters (p> 0.05). Consequently, it can be stated that there are physical differences among high-level young basketball players by their positions and absolute quadriceps strengths of the centers may be higher than of the guards.
An integral formulation for the global error of Lie Trotter splitting scheme
Authors: Seydaoğlu Muaz
Published: January 2019

An ordinary differential equation (ODE) can be split into simpler sub equations and each  of the  sub equations is  solved subsequently by a numerical method. Such a procedure  involves splitting error and numerical error caused by the time stepping methods applied to sub equations.  The aim of the paper is to present  an integral formula for the global error expansion of a splitting  procedure combined with any  numerical  ODE solver.
Application of an Intermittency Model for Laminar, Transitional, and Turbulent Internal Flows
Authors: Abraham J. P. , Sparrow E. M. , Gorman J. M. , Zhao Yu , Minkowycz W. J.
Published: January 2019

A turbulent transition model has been applied to fluid flow problems that can be laminar, turbulent, transitional, or any combination. The model is based on a single additional transport equation for turbulence intermittency. While the original model was developed for external flows, a slight modification in model constants has enabled it to be used for internal flows. It has been successfully applied to such flows for Reynolds numbers that ranged from 100 to 100,000 in circular tubes, parallel plate channels, and circular tubes with an abrupt change in diameters. The model is shown to predict fully developed friction factors for the entire range of Reynolds numbers as well as velocity profiles for both laminar and turbulent regimes.
Flow Over the Tip Region of a Flexible Cantilever Wing With the Effect of Angle of Attack
Authors: Hu Ye , Liu Xiaohui , Shyy Wei , Qiu Huihe
Published: January 2019

The investigation focused on the conversions of flow structures with a change in angle of attack (AOA) for a flexible cantilever wing, which experienced a self-excited vibration. Stereoscopic particle imaging velocimetry (Stereo-PIV) was utilized to measure the velocity field in the wing-tip region as AOA varied from 0 deg to 12 deg. At the Reynolds number (Re) of 3 × 104, instability waves shedding from the wing were amplified as they propagated and developed into Karman Vortex Street in the far downstream region at low AOAs (AOA = 4 deg and 6 deg). As AOA increased to 8 deg with the wing model was still steady, the Karman Vortex Street no longer existed. The wing started to vibrate at AOA = 10 deg owing to the self-excited vibration, and the Karman Vortex Street appeared again. The inception location of the Karman Vortex Street moved further upstream than in the cases at AOA = 4 deg and 6 deg. A new vortex structure, secondary vortex-pairs, appears outside the main wing-tip vortex (WTV).
The Gut Microbiota Is Associated with Clearance of Clostridium difficile Infection Independent of Adaptive Immunity
Authors: Leslie Jhansi L. , Vendrov Kimberly C. , Jenior Matthew L. , Young Vincent B.
Published: January 2019

Clostridium difficile
infection is a major cause of morbidity and mortality in hospitalized patients in the United States. Currently, the role of the adaptive immune response in modulating levels of
C. difficile
colonization is unresolved. This work suggests that the indigenous gut microbiota is a main factor that promotes clearance of
C. difficile
from the GI tract. Our results show that clearance of
C. difficile
can occur without contributions from the adaptive immune response. This study also has implications for the design of preclinical studies testing the efficacy of vaccines on clearance of bacterial pathogens, as inherent differences in the baseline community structure of animals may bias findings.
Utilizing DNA metabarcoding to characterize the diet of marine-phase Arctic lamprey (Lethenteron camtschaticum) in the eastern Bering Sea
Authors: Shink Katie G. , Sutton Trent M. , Murphy James M. , López J. Andrés
Published: January 2019

To understand the marine feeding ecology of Arctic lamprey (Lethenteron camtschaticum) in the eastern Bering Sea, visual observations and DNA metabarcoding of gut contents (N = 250) were used to characterize Arctic lamprey diet composition in 2014 and 2015. Differences among individual diets were evaluated by collection year, capture site, and fish size. Hard structures and tissues were observed during visual examinations of gut contents, and 10 ray-finned fish taxa were identified by DNA metabarcoding. The most frequently observed taxa included capelin (Mallotus villosus), Pacific herring (Clupea pallasii), Pacific sand lance (Ammodytes hexapterus), and gadids. Six taxa were reported for the first time as prey for Arctic lamprey. Individual diets differed between collection years, among capture sites, and among size classes; however, both collection year and size class explained only a small portion of diet variability (R2 = 0.01 and 0.04, respectively) relative to capture site (R2 = 0.49). These study results indicate that Arctic lamprey is a flesh-feeding species and highlight the value of DNA metabarcoding to characterize the diet of a poorly understood lamprey species.
Product of continuous fractional wave packet transforms
Authors: Prasad Akhilesh , Kumar Praveen , Kumar Tanuj
Published: January 2019

In this paper, we investigated the fractional Fourier transform (FrFT) of the continuous fractional wave packet transform and studied some properties of continuous fractional wave packet transform. The product of continuous fractional wave packet transforms (CFrWPTs) is defined. Parseval’s relation and an inversion formula for product of CFrWPT are obtained. An example is also given.
Severe Influenza A(H1N1) Virus Infection Complicated by Myositis, Refractory Rhabdomyolysis, and Compartment Syndrome
Authors: Odio Camila D. , Mandimika Charisse , Jabuonski Thiago A. , Malinis Maricar
Published: January 2019

Myositis is a rare and morbid complication of influenza infection that can rapidly progress to rhabdomyolysis with acute renal failure. Here, we describe a 35-year-old obese woman with severe influenza A(H1N1) virus infection complicated by myositis, refractory rhabdomyolysis, and compartment syndrome.
Combination of Fresh Frozen Plasma and Cryosupernatant Plasma for Therapeutic Plasma Exchange in Thrombotic Thrombocytopenic Purpura: A Single Institution Experience
Authors: Lin Qiuyan , Fan Liping , Huang Haobo , Zeng Feng , Fu Danhui , Wei Shijin
Published: January 2019

Purpose. To evaluate the impact of a combination of fresh frozen plasma (FFP) and cryosupernatant plasma (CP) as a replacement fluid in therapeutic plasma exchange (TPE) on early therapeutic response and long-term survival of patients with thrombotic thrombocytopenic purpura (TTP). Materials and Methods. A total of 44 patients with suspected TTP were screened by Bentley and PLASMIC scores. Twenty-seven patients treated with TPE using the FFP and CP combination as the replacement fluid were enrolled and divided into two groups: 11 patients who received TPE with CP-dominant replacement fluid (FFP/CP<1) and 16 patients who received TPE with FFP-dominant replacement fluid (FFP/CP>1). Results. There were no significant differences in the demographic and clinicopathological characteristics between the two groups except for the international normalized ratio (INR). The number of TPE procedures was lower, and time to achieve complete response was shorter in the CP-dominant group than in the FFP-dominant group. There were no significant differences in overall survival between the two groups. Conclusion. The CP-dominant replacement fluid was superior to the FFP-dominant replacement fluid in early response to TPE in patients with TTP, but did not impact the patients’ overall survival.
SPH‐Based Analysis on the Lateral Response of Pipe Culverts in the Flowing Process of Liquefied Sand
Authors: Wang Zhanbin , Yu Xin , Zhang Weijie , Zhang Fei , Zhou Yundong , Gao Yufeng
Published: January 2019

This study proposes a solid‐fluid‐coupled Smoothed Particle Hydrodynamics model to investigate the behavior of pipe in the liquefied sand after failure. In this model, the liquefied soil is simulated as a Bingham fluid material combined with the equivalent Newtonian viscosity. Then the pipe culvert is treated as an elastic solid material, and the culvert‐soil interaction is assumed as the solid‐fluid coupling force. Verification has been conducted through a dam‐break model to demonstrate the accuracy of simulating the flow behavior of liquefied sand. At the same time, the applicability of the SPH simulation in the two‐phase‐coupled force has been checked compared with previous researches. After that, parametric studies are performed on the lateral force and movement of pipe culverts in the flowing sand. The derived results demonstrate that the culvert size and buried depth are the significant factors when estimating the maximum lateral force of culvert‐soil system, while the slope angle severely affects the run‐out distance of culvert and the velocity of flowing sand.
Neuroprotective Effect of Echinacoside in Subacute Mouse Model of Parkinson’s Disease
Authors: Liang Yan , Chen Chang , Xia Baomei , Wu Wei , Tang Juanjuan , Chen Qing , Tang Lili , Yang Hui , Zhang Zhennian , Lu Yan , Yang Ye , Zhao Yang
Published: January 2019

Objective. To study the protective effect of Echinacoside for 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induced dopaminergic (DA) neurons injury in the subacute mouse model of Parkinson’s disease (PD) and to explore its mechanism of action. Methods. We chose 10 weeks of healthy wild type C57BL/6 male mice, hypodermic MPTP 30 mg/kg/day, five days, to prepare PD subacute mouse model. Behavior indexes of open field test and pole test were applied to examine the function of ECH to PD subacute mice model of PD sample action. The effects of ECH on dopaminergic neurons and astrocyte were examined using Immunohistochemistry including tyrosine hydroxylase (TH) and glial fibrillary acidic protein (GFAP) expression. The total numbers of TH-positive neurons and GFAP-positive cells in the substantia nigra pars compacts (SNpc) and ventral tegmental area (VTA) were obtained stereologically using the optical fractionator method. Enzyme-linked immunosorbent assay (ELISA) method was used to detect the inflammatory cytokines in the serum, including TNF-α (Ttumor necrosis factor alpha) and IFN-γ (interferon gamma). Protein expressions of ionized calcium binding adaptor molecule 1 (IBA-1), TNF-α, Cleaved caspase-3, glial derived neurotrophic factor (GDNF), and phosphorylated and total extracellular signal-regulated kinase (p-ERK and ERK) in the anatomical region of substantia nigra (SN) were tested by protein immunoblot method (i.e., Western blotting). Results. ECH reversed the reduction of total distance in open field test in MPTP-induced PD model mice (P < 0.01), shortened the return time and total time of PD subacute model mice in pole test (P < 0.01, P < 0.05), significantly reversed the reduction of TH positive neurons induced by MPTP (P < 0.05), and reduced the activation of astrocytes (P < 0.05). Meanwhile, ECH significantly inhibited the expression of IBA-1, Cleaved caspase-3, and TNF-α in midbrain of MPTP model mice (P < 0.05, P < 0.05, and P < 0.05) and upregulated the expression of GDNF (P < 0.05). And ECH lowered the level of TNF-α and IFN-γ in serum (P < 0.05, P < 0.05). Conclusion. ECH has protective effects on the MPTP subacute model mice, its mechanism may be through inhibiting activation of microglia and astrocytes, reducing inflammatory reaction and promoting the secretion of neurotrophic factors, and eventually resulting in the reduction of the DA neurons apoptosis.
Anti-inflammatory Role of Carotenoids in Endothelial Cells Derived from Umbilical Cord of Women Affected by Gestational Diabetes Mellitus
Authors: Ucci Mariangela , Di Tomo Pamela , Tritschler Federica , Cordone Vincenzo G. P. , Lanuti Paola , Bologna Giuseppina , Di Silvestre Sara , Di Pietro Natalia , Pipino Caterina , Mandatori Domitilla , Formoso Gloria , Pandolfi Assunta
Published: January 2019

Diabetes is associated with vascular inflammation, endothelial dysfunction, and oxidative stress, promoting the development of cardiovascular diseases (CVD). Several studies showed that a carotenoid-rich diet is associated to a reduced cardiovascular risk in healthy and diabetic subjects, although the mechanisms of action are still unknown. Here, the potential role of β-carotene (BC) and lycopene (Lyc) in human endothelial cells isolated from human umbilical cord vein (HUVECs) of women with gestational diabetes (GD) and respective controls (C) has been investigated. Results showed that BC and Lyc reduced the tumor necrosis factor alpha- (TNF-α-) stimulated monocyte-endothelium interaction (adhesion assay), membrane exposure (flow cytometry), and total expression levels (Western blot) of VCAM-1 and ICAM-1 in both cell types. Moreover, the treatment with BC and Lyc reduced the TNF-α-induced nuclear translocation of NF-κB (image flow cytometry) by preserving bioavailability of nitric oxide (NO, flow cytometry, and cGMP EIA kit assay), a key vasoactive molecule. Notably, BC and Lyc pretreatment significantly reduced peroxynitrite levels (flow cytometry), contributing to the redox balance protection. These results suggest a new mechanism of action of carotenoids which exert vascular protective action in diabetic condition, thus reinforcing the importance of a carotenoid-rich diet in the prevention of diabetes cardiovascular complications.
The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy
Authors: Meng Xiangjun , Bao Juan , Mi Qiwu , Fang Shaowei
Published: January 2019

Objective. This study investigated the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy, so as to prevent the occurrence of bleeding and improve the surgical effect. Patients and Methods. The data of 396 patients who underwent percutaneous nephrolithotomy by an experienced surgeon between May 2014 and December 2017 were retrospectively analyzed. To identify the risk factors for bleeding during percutaneous nephrolithotomy, each group was stratified according to the decrease in median hemoglobin. Age, gender, body mass index, stone size, operation time, stone type, degree of hydronephrosis, number of accesses, puncture guidance, underlying disease (diabetes; hypertension), and previous surgical history were evaluated. Univariate analysis was performed to calculate the potential factors. In order to determine the independence of each factor, we finally selected stone size, staghorn stone, degree of hydronephrosis, and operation time. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Results. A total of 396 patients were successfully treated with percutaneous nephrolithotomy. The univariate analysis demonstrated that the potential risk factors for bleeding during percutaneous nephrolithotomy included stone size, type of stone, operative time, and degree of hydronephrosis. According to the previous studies, stone size, staghorn stone, degree of hydronephrosis, and operation time were ultimately selected. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during percutaneous nephrolithotomy. According to the outcome of logistic regression analysis, stone size, staghorn stone, operation time, and degree of hydronephrosis were the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Conclusions. Percutaneous nephrolithotomy is an effective method for the treatment of upper urinary calculi with few complications. According to the results achieved by an experienced surgeon, the size of stone, staghorn stone, operation time, and degree of hydronephrosis were associated with the bleeding during minimally invasive percutaneous nephrolithotomy.
Predicting Long-Term Mortality after Acute Coronary Syndrome Using Machine Learning Techniques and Hematological Markers
Authors: Pieszko Konrad , Hiczkiewicz Jarosław , Budzianowski Paweł , Budzianowski Jan , Rzeźniczak Janusz , Pieszko Karolina , Burchardt Paweł
Published: January 2019

Introduction. Hematological indices including red cell distribution width and neutrophil to lymphocyte ratio are proven to be associated with outcomes of acute coronary syndrome. The usefulness of machine learning techniques in predicting mortality after acute coronary syndrome based on such features has not been studied before. Objective. We aim to create an alternative risk assessment tool, which is based on easily obtainable features, including hematological indices and inflammation markers. Patients and Methods. We obtained the study data from the electronic medical records of 5053 patients hospitalized with acute coronary syndrome during a 5-year period. The time of follow-up ranged from 12 to 72 months. A machine learning classifier was trained to predict death during hospitalization and within 180 and 365 days from admission. Our method was compared with the Global Registry of Acute Coronary Events (GRACE) Score 2.0 on a test dataset. Results. For in-hospital mortality, our model achieved a c-statistic of 0.89 while the GRACE score 2.0 achieved 0.90. For six-month mortality, the results of our model and the GRACE score on the test set were 0.77 and 0.73, respectively. Red cell distribution width (HR 1.23; 95% CL 1.16-1.30; P<0.001) and neutrophil to lymphocyte ratio (HR 1.08; 95% CL 1.05-1.10; P<0.001) showed independent association with all-cause mortality in multivariable Cox regression. Conclusions. Hematological markers, such as neutrophil count and red cell distribution width have a strong association with all-cause mortality after acute coronary syndrome. A machine-learned model which uses the abovementioned parameters can provide long-term predictions of accuracy comparable or superior to well-validated risk scores.
Biomarkers of Inflammation, Fibrosis, and Acute Kidney Injury in Patients with Heart Failure with and without Left Ventricular Assist Device Implantation
Authors: Grosman-Rimon Liza , Hui Sarah Genevieve , Freedman Danit , Elbaz-Greener Gabby , Cherney David , Rao Vivek
Published: January 2019

Background/Aims: Renal dysfunction or renal failure is a common complication in left ventricular assist device (LVAD) recipients and is associated with reduced survival. To date, serum creatinine and glomerular filtration rate (GFR) are used for the evaluation of kidney function. However, serum creatinine and GFR have limitations. The objective of our study is to assess the levels of kidney biomarkers in LVAD recipients compared to heart failure patients and healthy controls and to examine their association with conventional clinical biomarkers. Methods: The biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), plasminogen activator inhibitor-1 (PAI-1), and adiponectin were assessed in 51 participants: 19 heart failure patients, 16 LVAD recipients, and 16 healthy controls. Linear regressions were performed to assess whether demographic and clinical variables predict the levels of biomarkers that are associated with acute kidney injury and the risk of chronic kidney disease. Results: The levels of NGAL and adiponectin were higher in LVAD recipients and patients with heart failure as compared with healthy controls. The levels of PAI-1 and KIM-1 were not elevated in LVAD recipients. The results of linear regression analysis indicated that when controlling for the effect of CRP and BNP, 40.1% of the variance in NGAL levels can be explained by GFR (R2 = 0.401, F = 5.56, p = 0.005), while CRP can explain 35.3% of the variance in adiponectin levels (R2 = 0.353, F = 4.55, p = 0.01), when controlling for the effect of BNP and GFR. Conclusions: The levels of NGAL and adiponectin were augmented in LVAD recipients, suggesting that renal functions were not restored with circulatory support. Larger studies should assess the predictability of these biomarkers of renal dysfunction in LVAD recipients.
Transient Receptor Potential Ankyrin 1 Enhances Ovalbumin-Induced Acute Allergic Inflammation in Murine Models
Authors: Moilanen Lauri J. , Hämäläinen Mari , Ilmarinen Pinja , Kankaanranta Hannu , Nieminen Riina M. , Moilanen Eeva , Lehtimäki Lauri
Published: January 2019

Background: Transient receptor potential ankyrin 1 (TRPA1) is an ion channel known to mediate nociception and neurogenic inflammation, and to be activated by reactive oxygen and nitrogen species (ROS and RNS) produced at the sites of inflammation. Because neurogenic inflammation as well as the release of ROS and RNS are typical features of early stages of allergic responses, we hypothesized that TRPA1 may be involved in triggering and/or amplifying allergic inflammation. Objective: This study aims at exploring the role of TRPA1 ion channel in acute ovalbumin-induced allergic inflammation in applicable murine models. Methods: The effects of pharmacological blockade and genetic deletion of TRPA1 in ovalbumin-induced allergic conjunctivitis and acute paw inflammation were studied in mice sensitized to ovalbumin. Results: Ovalbumin-induced allergic conjunctivitis was milder in TRPA1-deficient mice and alleviated in wild-type mice treated with the TRPA1 antagonist TCS 5861528. Subcutaneous challenge with ovalbumin caused a significant paw edema and interleukin (IL)-4 production in sensitized mice; these responses were attenuated in animals treated with the TRPA1 antagonist and in TRPA1-deficient mice. Interestingly, blockade of the major secondary effector of TRPA1, substance P, also resulted in attenuated ovalbumin-induced paw edema and IL-4 production. However, the splenocytes’ responses to ovalbumin were similar in cells from wild-type and TRPA1-deficient mice sensitized to ovalbumin. Conclusion: These results introduce a novel concept that TRPA1 mediates early events in allergic inflammation, but does not seem to affect allergic sensitization, and could therefore be a novel drug target to treat conditions associated with allergic inflammation.
Effects of Peritoneal Dialysis on Clinical Factors and Functional Performance
Authors: Chang Wenxiu , Liu Ying , Cheng Ben-Chung , Zhang Wenyu , Wu Chien-Hsing , Wang Xichao , Han Yingying  , Tu Yangke , Chen Jin-Bor
Published: January 2019

Background: We investigated the longitudinal trend of functional performance in peritoneal dialysis (PD) patients over 1 year after PD commencement and its related clinical parameters. Methods: One hundred and ninety-six PD patients were enrolled in this study. Karnofsky Performance Status Scale(KPSS) scores were used to assess functional performance. Patients were stratified into 3 groups according to the changes in KPSS from baseline to 1 year. A logistic regression analysis was performed to examine the associations of clinical parameters with KPSS changes. Results: Patients with KPSS declined showed older age and higher serum albumin concentration reduction within 1 year than those in KPSS improved and stable changes. Age was the significant risk factor for KPSS decline, while male and diabetes were significantly associated with non-declined KPSS by multivariable logistic regression analysis. Conclusion: The main determinants of KPSS trend were age, sex, and diabetes in new PD patients.
Longitudinal Experience with Remote Monitoring for Automated Peritoneal Dialysis Patients
Authors: Milan Manani Sabrina , Rosner Mitchell H. , Virzì Grazia Maria , Giuliani Anna , Berti Sonia , Crepaldi Carlo , Ronco Claudio
Published: January 2019

Background: Peritoneal dialysis (PD) is an ideal model for testing remote monitoring (RM). In this study, we evaluated the RM application longitudinally in stable patients undergoing automated PD (APD). Methods: This was an observational study, comparing outcomes in patients with (current patients) and without (historical data) exposure of RM. We analyzed cost-effectiveness of RM-APD measuring the number of night alarms, number of hospital visits, direct and indirect costs. Results: Changes in APD prescription were almost double in the case group (RM) compared to the control group (p = 0.0005). The need for in-person visits and nocturnal alarms was significantly less in RM-APD than in traditional APD (p = 0.01 and p = 0.002, respectively). The distance traveled by patients in the case of RM-APD was reduced by 1,134 km with a time saving of 1,554 min for patients. The overall cost reduction for the PD center in terms of time/nurse and time/physician was 2,647 and 3,673 min, respectively. All these advantages were obtained in the presence of an improved technique survival with a significant reduction of dropouts. All patients found that it is easy to use the RM system and were satisfied with the high level of interaction with the care team and with the possibility of timely resolving technical problems. Conclusion: These data confirm the long-term benefits of RM applied to APD. RM-APD is cost-effective; it allows early detection and resolution of problems, improved treatment compliance, reduction of patient’s access to hospital center for technical and clinical complications with consequent savings, and improved patient’s quality of life.
Sixth Cranial Nerve Palsy and Craniocervical Junction Instability due to Metastatic Urothelial Bladder Carcinoma
Authors: Nasi Davide , Dobran Mauro , di Somma Lucia , Santinelli Alfredo , Iacoangeli Maurizio
Published: January 2019

Metastases involving the clivus and craniocervical junction (CCJ) are extremely rare. Skull base involvement can result in cranial nerve palsies, while an extensive CCJ involvement can lead to spinal instability. We describe an unusual case of clival and CCJ metastases presenting with VI cranial nerve palsy and neck pain secondary to CCJ instability from metastatic bladder urothelial carcinoma. The patient was first treated with an endoscopic endonasal approach to the clivus for decompression of the VI cranial nerve and then with occipitocervical fixation and fusion to treat CCJ instability. At the 6-month follow-up, the patient experienced complete recovery of VI cranial nerve palsy. To the best of our knowledge, the simultaneous involvement of the clivus and the CCJ due to metastatic bladder carcinoma has never been reported in the literature. Another peculiarity of this case was the presence of both VI cranial nerve deficit and spinal instability. For this reason, the choice of treatment and timing were challenging. In fact, in case of no neurological deficit and spinal stability, palliative chemo- and radiotherapy are usually indicated. In our patient, the presence of progressive diplopia due to VI cranial nerve palsy required an emergent surgical decompression. In this scenario, the extended endoscopic endonasal approach was chosen as a minimally invasive approach to decompress the VI cranial nerve. Posterior occipitocervical stabilization is highly effective in avoiding patient’s neck pain and spinal instability, representing the approach of choice.
Effects of Multidisciplinary Team Care Based on 5E’s Renal Rehabilitation for Peritoneal Dialysis Patients in Guangxi Zhuang Autonomous Region of China: A Randomized Controlled Trial
Authors: Luo Yixin , Huang Yanlin , Chen Xiuyu  , Meng Gang  , Zhang Yongsheng 
Published: January 2019

Background: The number of patients with peritoneal dialysis (PD) in China has been increasing year after year, but there are still some challenge in the management of PD patients, and the efficient and effective method has yet to be developed. Multidisciplinary team (MDT) is to create a standardized, individualized, and continuous integrated treatment program for the patients, to ensure the best efficacy and improve patient outcomes. 5E’s renal rehabilitation was originally developed by the Life Options Rehabilitation Advisory Council in 1997 to achieve better management of PD patients. However, there is still no relevant study combining these 2 methods and applying to PD patients so far. Methods: A randomized controlled trial was undertaken in the nephrology department of the First Affiliated Hospital of Guangxi Medical University. We recruited 146 patients according to inclusion and exclusion criteria and divided them into study group (n = 73) and control group (n = 73) using SPSS random number. The control group received routine care and follow-up, while the study group received MDT care based on 5E’s renal rehabilitation. The self-management scale for PD patients and the incidence of dialysis-related peritonitis were compared before discharge and 12 months after discharge. Results: T tests showed that there were no significant differences between the 2 groups in the 5 subscales of Self-management Scale for PD patients at the baseline measures (p > 0.05). However, after 12 months of intervention, the study group gained higher scores in the 5 subscales while the control group declined. And the study group improved statistically significant compared with the control group on “Solution bag replacement (t = 3.103, p = 0.002),” “Troubleshooting during operation (t = 3.978, p ≤ 0.001),” “Diet management (t = 3.201, p = 0.002),”and “Emotion management and return to social life (t = 3.552, p = 0.001)” subscales. Moreover, the peritonitis occurrence rate of the study group (1/68.1 patient month) was statistically significantly lower than that of control group (1/29.4 patient month; p = 0.047). Conclusions: MDT care based on 5E’s renal rehabilitation is beneficial for patients undergoing PD and helpful to improve self-management ability and reduce the incidence of peritonitis.
Abstract 10: Higher Soluble CD14 Level is a Risk Factor for Ischemic Stroke in Black but Not White Participants of the Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study
Authors: Olson Nels C , Koh Insu , Reiner Alex P , Judd Suzanne E , Irvin Marguerite R , Howard George , Zakai Neil A , Cushman Mary
Published: January 2019

Introduction:
CD14 is a co-receptor for bacterial lipopolysaccharide and promotes an inflammatory response. CD14 is expressed on the surface of several innate immune cell subpopulations and also circulates in blood as a soluble form (sCD14). Despite its potential role in cardiovascular disease risk, prospective studies evaluating sCD14 with ischemic stroke outcomes are limited, especially among those of non-European ancestry. We examined the associations between sCD14 levels with incident ischemic stroke risk in REGARDS.

Methods:
REGARDS recruited 30,239 participants across the contiguous U.S. in 2003-07. By design, 55% of participants were female, 41% were black, and 56% lived in the southeast. With 5.8 years follow up, baseline plasma sCD14 was measured by ELISA in 548 incident cases of ischemic stroke and in a stroke-free cohort random sample (
n
=1,039). Cox proportional hazards models were used to estimate the hazard ratio (HR) of incident ischemic stroke adjusted for Framingham stroke risk factors. We tested for a sCD14-by-race interaction.

Results:
Soluble CD14 levels were higher with older age, in women, and lower among blacks. Each 1-standard deviation (SD) higher sCD14 (447 ng/mL) was associated with an increased risk of incident ischemic stroke following adjustment for demographic variables (HR: 1.22; 95% confidence interval (CI): 1.07, 1.40) and stroke risk factors (HR: 1.19; 95% CI: 1.01, 1.40). In analyses stratified by race, the association of sCD14 with stroke was stronger in blacks (HR: 1.42; 95% CI: 1.12, 1.80) and not present in whites (HR: 1.02; 95% CI: 0.82, 1.27) (sCD14 x race interaction p-value = 0.04).

Conclusions:
These results show that higher sCD14 is associated with risk of ischemic stroke in blacks but not whites, and thus may be a risk factor unique to blacks.
Abstract 102: Predictors of the Development of White Matter Hyperintensities Over a 20-Year Period: A Secondary Analysis of the ARIC Study
Authors: Ruff Jerdan , Meyer Chelsea , Alexander Matthew , de Havenon Adam
Published: January 2019

Introduction:
White matter hyperintensities on MRI (WMH) are associated with cognitive impairment and disability. Prior reports have shown associations between various risk factors and WMH.

Hypothesis:
Composite risk stratification will accurately predict WMH burden on MRI performed over 20 years later in the Atherosclerosis Risk in the Community (ARIC) study.

Methods:
We included demographic data from Study Visit 1 (1987-1989) and brain MRI volumetric data (cm^3) from Visit 5 (2011-2013). The primary outcome is quartiles of WMH as a percentage of intrapatient total brain volume. Using Student’s t-test and the chi-squared test we compared demographics between WMH quartile 4 and quartiles 1-3. We also fit a multivariate logistic regression model to WMH quartile 4 versus 1-3.

Results:
Inclusion criteria were met by 1,748 patients, aged 52.7±5.2 years and 41% male. Patient age, black race, cigarette smoking, diabetes mellitus, and family history of stroke were all associated with a larger WMH burden. This association persisted in the multivariate model (Table 2), and is an accurate predictor of WMH development (Figure 3, AUC 0.67).

Conclusion:
These historical and demographic data could be used to develop a clinical score to predict patients at risk for a larger WMH burden, more than 20 years later. This unique cohort provides important data for the study of WMH, which can take decades to develop.
Abstract 106: NLRP3 Inflammasome Inhibition With MCC950 Improves Diabetes-Mediated Cognitive Impairment and Vasoneuronal Remodeling After Ischemia
Authors: Ward Rebecca , Li Weiguo , Abdul Yasir , Jackson LaDonya , Dong Guangkuo , Jamil Sarah , Filosa Jessica , Fagan Susan C , Ergul Adviye
Published: January 2019

Diabetes increases the risk and worsens the progression of cognitive impairment via the greater occurrence of small vessel disease and stroke. While NLRP3 inflammasome signaling has been implicated in the development of neurodegenerative diseases, little is known about the impact of NLRP3 activation on functional and structural interaction within the neurovascular unit (NVU) in diabetes. Endothelial cells are at the center of NVU and produce trophic factors such as BDNF contributing to neuronal survival, known as vasotrophic coupling. Therefore, the goals of this study were to determine the role of NLRP3 activation: 1) on hippocampal NVU remodeling and cognitive outcome after stroke in diabetes, and 2) on vasotrophic uncoupling between endothelial cells and hippocampal neurons after hypoxic injury in diabetes-mimicking conditions. Control and high-fat diet/STZ induced diabetic male rats were treated with saline or MCC950 (3mg/kg), a small molecule inhibitor of NLRP3, after reperfusion following a 90-min MCAO. Cognition was assessed. Neuronal death, blood-brain barrier (BBB) permeability and glial remodeling was measured on Day 14 after stroke. BDNF was measured in endothelial and hippocampal cell cultures under hypoxic and diabetes-mimicking condition with and without NLRP3 inhibition. Diabetes increased neuronal degeneration, BBB permeability, disrupted AQP4 polarity, impaired cognitive function and increased NLRP3 activation after ischemia. Inhibition with MCC950 improved cognitive function and NVU indices after stroke in diabetic animals and prevented hypoxia-mediated decrease in BDNF secretion. These results are the first to provide essential data showing MCC950 has the potential to become a therapeutic to prevent neurovascular remodeling and worsened cognitive decline in diabetic patients following stroke.