bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison on optimal torque vectoring strategies in overall performance enhancement of a passenger car
Authors: Jaafari Seyed Mohammad Mehdi , Heidari Shirazi Kourosh
Published: January 2016

In this paper, a comparison is made on different torque vectoring strategies to find the best strategy in terms of improving handling, fuel consumption, stability and ride comfort performances. The torque vectoring differential strategies include superposition clutch, stationary clutch, four-wheel drive and electronic stability control. The torque vectoring differentials are implemented on an eight-DOF vehicle model and controlled using optimized fuzzy-based controllers. The vehicle model assisted with the Pacejka tyre model, an eight-cylinder dynamic model for engine, and a five-speed transmission system. Bee’s Algorithm is employed to optimize the fuzzy controller to ensure each torque vectoring differential works in its best state. The controller actuates the electronic clutches of the torque vectoring differential to minimize the yaw rate error and limiting the side-slip angle in stability region. To estimate side-slip angle and cornering stiffness, a combined observer is designed based on full order observer and recursive least square method. To validate the results, a realistic car model is built in Carsim package. The final model is tested using a co-simulation between Matlab and Carsim. According to the results, the torque vectoring differential shows better handling compared to electronic stability control, while electronic stability control is more effective in improving the stability in critical situation. Among the torque vectoring differential strategies, stationary clutch in handling and four-wheel drive in fuel consumption as well as ride comfort have better operation and more enhancements.
Large amplitude free vibration study of non-uniform plates with in-plane material inhomogeneity
Authors: Kumar Saurabh , Mitra Anirban , Roy Haraprasad
Published: January 2016

Free vibration study of non-uniform plates with in-plane material inhomogeneity is carried out in the present work considering geometric nonlinearity. Inhomogeneous plates where the material properties vary along only x-axis (unidirectional) and along both x- and y-axis (bidirectional) are considered. The analysis is performed for two boundary conditions namely clamped and simply supported at all edges, under the action of a transverse uniformly distributed load. The large amplitude problem is formulated using nonlinear strain–displacement relations along with a variational form of energy method. A two-step solution procedure is utilised where, in the first part the static problem is solved and undetermined coefficients are found, subsequently the dynamic problem is taken up on the basis of previously determined coefficients. Validity of the results is successfully confirmed by comparison with the works of other researchers. The analysis reveals that the amplitude and taper parameter affect the loaded natural frequencies significantly. Three-dimensional mode shapes for linear and nonlinear cases are presented along with their respective contour plots.
Assessing ideal theories
Authors: Wiens David
Published: January 2016

Numerous philosophers allege that the “general theory of second best” poses a challenge to the Target View, which asserts that real-world reform efforts should aim to establish arrangements that conform to the constitutive features of ideally just states of affairs. I demonstrate two claims that are relevant in this context. First, I show that the theory of second best fails to present a compelling challenge to the Target View in general. But, second, the theory of second best requires ideal theorists to undertake certain kinds of causal and comparative analyses that are typically thought to lie outside the remit of conventional ideal theory.
When Framing Matters
Authors: Wagner Michael W. , Gruszczynski Mike
Published: January 2016

This monograph examines how the consistency and content of issue frames used by politicians and journalists from 1975–2008 affect preferences and partisanship. Combining our content analysis of Newsweek’s coverage of abortion and taxes with public opinion data, we show that consistent, partisan-sourced frames affect preferences and partisanship. In general, specific frames affect attitudes but not partisanship when sourced by partisan politicians, and both attitudes and partisanship when sourced by journalists. Policy-oriented liberal frames were associated with more liberal preferences and Democratic partisanship while symbolic conservative frames were associated with more conservative preferences and Republican partisanship.
The Karl Marx Problem in Contemporary New Media Economy
Authors: Kangal Kaan
Published: January 2016

This article focuses on five flaws of Christian Fuchs’ approach of Web 2.0 economy. Here, Fuchs’ views on immaterial production, productivity of labor, commodification of users’ data, underestimation of financial aspects of digital economy, and the violation of Marx’s laws of value production, rate of exploitation, fall tendency of profit rate, and overproduction crisis are put into question. This article defends the thesis Fuchs fails to apply Marxian political economy to the contemporary phenomena of Web 2.0 economy. It is possible to avoid Fuchs’ errors, and another approach is possible to remake Marxism relevant for an analysis of the new media economy.
The Epistemology of the (Televised, Polygamous) Closet
Authors: Weber Brenda R.
Published: January 2016

This article examines the reality television show Sister Wives (2010–), which focuses on the Kody Brown family, members of a religious group called the Apostolic United Brethren (AUB), in turn part of the Fundamentalist Church of Jesus Christ of Latter-day Saints (FLDS). The Browns practice a form of “progressive polygamy” that both they and the show establish as quintessentially egalitarian, American, and normal, though not normative. Sister Wives indicates that the complex structural dynamics of progressive polygamy create individuals who can thrive in a neoliberal milieu where good choices matter more than governments and where being savvy about the image yields currencies that are monetary, cultural, and, ultimately, spiritual. Surprisingly, the kind of flexible labor modeled on Sister Wives and endemic to neoliberalism authorizes itself through the language and idioms of the lesbian, gay, bisexual, and transgender (LGBT) social justice movement. However, while espousing a gay-friendly social justice agenda, the market logics of Sister Wives appropriate LGBT politics in the service of family commercial enterprises.
Effectiveness of Contrasting Approaches to Response-Contingent Learning Among Children With Significant Developmental Delays and Disabilities
Authors: Raab Melinda , Dunst Carl J. , Hamby Deborah W.
Published: January 2016

Findings from a randomized controlled design study of an ability-based versus needs-based approach to response-contingent learning among children with significant developmental delays and disabilities who did not use instrumental behavior to produce reinforcing consequences are reported. The ability-based intervention and needs-based intervention differed in terms of how child behavior was identified and used to elicit reinforcing consequences as part of response-contingent learning games implemented by the children’s parents. For the ability-based group, behavior that children were capable of producing, but did not yet use intentionally, was identified and used to elicit reinforcing consequences. For the needs-based group, behavior children did not yet produce, but were expected to learn, was identified through a developmental assessment and used to elicit reinforcing consequences. Results showed that the children in the ability-based group had more learning opportunities, acquired more response-contingent behavior, and demonstrated more efficient learning compared with children in the needs-based group.
Aneurysm rupture from blunt abdominal trauma after endovascular repair
Authors: Bahar Ilknur G , Tutun Ufuk , Iscan Zafer , Ayabakan Nurcan , Ozdemir Mustafa
Published: January 2016

We present a case of aneurysm rupture from severe blunt abdominal trauma due to fight in a patient who had endovascular aneurysm repair. The patient presented to the emergency service with computed tomography evidence of an endoleak and a large retroperitoneal hematoma. The contrast abdominal computed tomography demonstrated a type Ib endoleak, increase in the aneurysm diameter and hematoma in the retroperitoneum. The patient has been taken under interventional procedure for endovascular aneurysm repair revision under urgent condition. Type Ib endoleak was treated by placement of a covered iliac extension limb, but a second leakage from graft body was found in control computed tomography images and open surgical conversion was necessary. Operative findings included a type III endoleak from graft body, defect on fabric. It was seen that the aneurysm sac anterior and posterior parts were ruptured. Upon reviewing the literature, we found that it was an interesting case as the first rupture case which had been developed after severe blunt abdominal trauma during the follow-up period of a patient on which endovascular aneurysm repair procedure had been performed and progressed in this manner.
Detecting failed elements on phased array ultrasound transducers using the Edinburgh Pipe Phantom
Authors: Welsh Dan , Inglis Scott , Pye Stephen D
Published: January 2016

Aims

Imaging faults with ultrasound transducers are common. Failed elements on linear and curvilinear array transducers can usually be detected with a simple image uniformity or ‘paperclip’ test. However, this method is less effective for phased array transducers, commonly used in cardiac imaging. The aim of this study was to assess whether the presence of failed elements could be detected through measurement of the resolution integral (R) using the Edinburgh Pipe Phantom.

Methods

A 128-element paediatric phased array transducer was studied. Failed elements were simulated using layered polyvinyl chloride (PVC) tape as an attenuator and measurements of resolution integral were carried out for several widths of attenuator.

Results

All widths of attenuator greater than 0.5 mm resulted in a significant reduction in resolution integral and low contrast penetration measurements compared to baseline (p < 0.05).

Conclusions

Measurements of resolution integral and low contrast penetration both have the potential to be used as straightforward and inexpensive tests to detect failed elements on phased array transducers. Particularly encouraging is the result for low contrast penetration as this is a quick and simple measurement to make and can be performed with many different test objects, thus enabling ‘in-the-field’ checks.
Contrast sonovenography – Is this the answer to complex deep vein thrombosis imaging?
Authors: Smith AGW , Parker P , Byass O , Chiu K
Published: January 2016

Background: Deep vein thrombosis (DVT) is a potentially fatal condition causing significant morbidity and mortality in the patient population. Ultrasound (USS) is the mainstay for detecting DVT. This can sometimes be difficult in hostile limbs due to factors such as large body habitus and oedema. This pilot study investigated contrast-enhanced ultrasound (CEUS) as a viable method to improve visualisation of the venous system of the lower limb. Methods: Patients at high risk for DVT were selected after an initial negative USS. A follow-up scan was performed 1 week later utilising standard B-mode imaging with a curvilinear 3–5 MHz transducer array. After the fundamental scan, intravenous Sonovue™ contrast was administered and visualisation of the proximal limb veins and visualisation gains in distance were mapped onto a proforma. Results: Twelve patients were selected. Visualisation was not improved in the common femoral vein (CFV) but increases in full visualisation were demonstrated in the femoral vein (FV) and popliteal vein (Pop V) from ( n = 8) 67% and ( n = 10) 83–100% in both veins, respectively. Significant gains in visualisation distance were observed in the posterior tibial vein (PTV) ( p = 0.0005) and peroneal vein (Per V) ( p = 0.02) with increased full visualisation of the Per V from ( n = 3) 25% to ( n = 7) 58%. Conclusion: CEUS is a viable and clinically safe method for increasing visualisation of the deep venous system. It has the potential to improve visualisation of the lower limb venous system, reducing follow-up costs and diagnostic uncertainty for patients and the clinician.
The clinical use of contrast-enhanced ultrasound in the kidney
Authors: Tenant Sean C , Gutteridge Catherine M
Published: January 2016

Traditional B-Mode and Doppler sonography have been the stalwart of renal tract imaging for many years, and indeed, are in daily use in most centres as the modality of choice for the initial assessment of renal pathology. However, traditional ultrasound scanning can be limited in its ability to accurately characterise renal pathology, and can be inaccurate at determining benign from malignant lesions. Contrast-enhanced ultrasound conveys many benefits, being safe (especially in patients with renal dysfunction), does not require the use of ionising radiation, is quick and relatively cheap and can help to establish whether a focal renal lesion is sinister. Furthermore, it is our experience that contrast-enhanced ultrasound is not a difficult technique to master for the experienced ultrasound practitioner. In this article, we discuss the technique, interpretation and value of contrast-enhanced ultrasound in renal imaging, and describe how we use it in our practice.
A review of the efficacy and safety of mirodenafil in the management of erectile dysfunction
Authors: Cho Min Chul , Paick Jae-Seung
Published: January 2016

Erectile dysfunction (ED) is a common disorder that can jeopardize quality of life and the partnership of patients and their sexual partners. The advent of oral phosphodiesterase type 5 inhibitors (PDE5Is) has revolutionized a treatment for ED, and they are recognized as the first-line therapy for ED, regardless of its etiology. Mirodenafil, a second-generation PDE5I, has biochemical profiles such as high affinity for PDE5 and high selectivity for PDE5 over other PDE isoforms, compared to other existing PDE5Is such as sildenafil, vardenafil and tadalafil. Available evidence has suggested that doses of 50 and 100 mg mirodenafil effectively improve ED [with improvements in the erectile function domain of the International Index of Erectile Function (IIEF-EF) scores, positive responses to questions 2 of the Sexual Encounter Profiles (SEP2) and questions 3 of the Sexual Encounter Profiles (SEP3): 7.6–11.6 points, 27.72–38.98% and 44.20–67.33%, respectively] in a broad range of patient populations with ED of a variety of underlying etiologies, severities and ages, without any serious treatment-related adverse effects. In the treatment of diabetic ED, a traditionally difficult-to-treat population, 100 mg mirodenafil has been reported to offer favorable efficacy (with improvements in the IIEF-EF scores, and positive responses to the SEP2 and the SEP3: 9.3 points, 36.1% and 61.8%, respectively) and tolerability (mild adverse effects of less than 19.6%), which are comparable with results from clinical studies on other PDE5Is. Mirodenafil appears to be effective, safe and well tolerated in men with both ED and hypertension or lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) who are taking concomitant antihypertensive medications or α1-blockers. Furthermore, recent evidence has indicated that mirodenafil may be a potential option for chronic dosing in the treatment of ED despite its short half-life ( T1/2). Most of the available clinical studies have reported that adverse effects (up to 53.7%) caused by 50 and 100 mg mirodenafil are mild or moderate in severity, with headache (1.8–14.8%) and flushing (6.7–24.1%) being the most common. Due to the pharmacodynamic profiles of mirodenafil, its tolerability is expected to be somewhat better than those of the other PDE5Is. However, further well designed studies with larger cohorts of different ethnicities, flexible dosing schedules and long-term follow up are necessary to confirm the favorable efficacy and tolerability profiles of mirodenafil for the treatment of ED.
An update on the use of transdermal oxybutynin in the management of overactive bladder disorder
Authors: Cohn Joshua A. , Brown Elizabeth T. , Reynolds W. Stuart , Kaufman Melissa R. , Milam Douglas F. , Dmochowski Roger R.
Published: January 2016

Antimuscarinic medications are used to treat nonneurogenic overactive bladder refractory to nonpharmacologic therapy. Side effects such as dry mouth, constipation, blurred vision, dizziness, and impaired cognition limit the tolerability of therapy and are largely responsible for high discontinuation rates. Oxybutynin is a potent muscarinic receptor antagonist whose primary metabolite after first-pass hepatic metabolism is considered largely responsible for its associated anticholinergic side effects. Transdermal administration of medications bypasses hepatic processing. Specifically with oxybutynin, whose low molecular weight permits transdermal administration, bioavailability of the parent drug with oral administration is less than 10%, whereas with transdermal delivery is a minimum of 80%. The result has been an improved side effect profile in multiple clinical trials with maintained efficacy relative to placebo; however, the drug may still be discontinued by patients due to anticholinergic side effects and application site reactions. Transdermal oxybutynin is available as a patch that is changed every 3–4 days, a gel available in individual sachets, or via a metered-dose pump that is applied daily. The transdermal patch was briefly available as an over-the-counter medication for adult women, although at this time all transdermal formulations are available by prescription only.
#ec: Findings and implications from a quantitative content analysis of tweets about emergency contraception
Authors: Gurman Tilly A , Clark Tiffany
Published: January 2016

Twitter, a popular social media, helps users around the world quickly share and receive information. The way in which Twitter frames health issues – especially controversial issues like emergency contraception (EC) – can influence public opinion. The current study analyzed all English-language EC-related tweets from March 2011 ( n = 3535). Variables measured user characteristics (e.g. gender), content (e.g. news, humor), Twitter-specific strategy (e.g. retweet), and certain time periods (e.g. weekends). The analysis applied chi-square and regression analyses to the variables. Tweets most frequently focused on content related to news (27.27%), accessing EC (27.27%), and humor (25.63%). Among tweets that were shared, however, the most common content included humor, followed by personal/vicarious experience. Although only 5.54% of shared tweets mentioned promiscuity, this content category had the strongest odds for being shared (OR = 1.51; p = 0.031). The tweet content with lowest odds of being shared were side effects (OR = 0.24; p < 0.001), drug safety (OR = 0.44; p < 0.001), and news (OR = 0.44; p < 0.001). Tweets with the greatest odds of having been sent on a weekend sought advice (OR = 1.94; p = 0.012), addressed personal or vicarious experience (OR = 1.91; p < 0.001), or contained humor (OR = 1.56; p < 0.001). Similar patterns occurred in tweets sent around St. Patrick’s Day. Only a few differences were found in the ways in which male and female individuals discussed EC on Twitter. In particular, when compared to males, females mentioned birth control ( p = 0.002), EC side effects ( p = 0.024), and issues related to responsibility ( p = 0.003) more often than expected. Study findings offer timely and practical suggestions for public health professionals wanting to communicate about EC via Twitter.
Yoga as an Alternative and Complimentary Therapy for Cardiovascular Disease
Authors: Haider Taj , Sharma Manoj , Branscum Paul
Published: January 2016

Cardiovascular disease is a leading cause of disability and death worldwide. Yoga, a mind-body exercise, utilizes breathing techniques with low-impact physical activity that may be an alternative treatment for cardiovascular disease. The purpose of this systematic review was to examine yoga interventions for patients at-risk for and/or suffering from cardiovascular disease. The inclusion criteria for interventions were ( a) published in the English language between 2005 and 2015; ( b) indexed in MEDLINE/PubMed, CINAHL, or Alt HealthWatch; ( c) employed a quantitative design; and ( d) applied a yoga intervention. Twelve interventions met the inclusion criteria, of which, all documented significant improvements in one or more factors associated with cardiovascular disease. Limitations to the studies in this review included a lack of studies adhering to the inclusion criteria, small sample sizes, and high attrition rates. Despite the limitations, this review demonstrates the clear potential yoga has as an alternative and complementary means to improve cardiovascular disease risk.
U.S. State Education Agencies’ Use of Twitter
Authors: Wang Yinying
Published: January 2016

This study examined how Twitter was used by all U.S. state education agencies (SEAs) for public engagement in education. Drawing on the ecological model of communication, this study analyzed the latest 71,913 tweets from 40 SEAs that had official Twitter accounts. The results of correlation analysis indicate no significant relationship between the SEAs’ presence on Twitter and the SEAs’ targeted Twitter users, denoting that the SEAs’ well-intentioned efforts in communicating with stakeholders and the public by using Twitter might fall short of the public’s preferable medium for receiving information. In addition, the results of content analysis suggest that the SEAs primarily used Twitter for one-way asymmetrical information broadcasting, leaving Twitter’s two-way symmetrical communication functionality largely untapped. Findings are discussed with respect to the implications for educational organizations’ effective use of Twitter through the public’s increased participation and collaboration.
Our Scripted Sexuality
Authors: Seabrook Rita C. , Ward L. Monique , Reed Lauren , Manago Adriana , Giaccardi Soraya , Lippman Julia R.
Published: January 2016

The heterosexual script describes the set of complementary but unequal roles for women and men to follow in their romantic and sexual interactions. The heterosexual script is comprised of the sexual double standard (men want sex and women set sexual limits), courtship strategies (men attract women with power and women attract men through beauty and sexiness), and commitment strategies (men avoid commitment and women prioritize relationships). Despite evidence that women and men are aware of this script, and it is prominent in the media, there is no existing measure of endorsement of the heterosexual script. In Studies 1 and 2, we develop and validate a measure of endorsement of the heterosexual script. In Study 3, we demonstrate that television consumption predicts stronger endorsement of the heterosexual script. We discuss the implications of endorsement of the heterosexual script for sexual health and provide suggestions for future research using this scale.
Rhetorical Tactics to Influence Responsibility Judgments: Account Giving in Banks Presidents’ Letters During the Financial Market Crisis
Authors: Brühl Rolf , Kury Max
Published: January 2016

This content analysis investigates bank presidents’ letters in the aftermath of the financial market crisis (2007/2008). We posit that managers use accounts as a rhetorical device in order to influence responsibility judgments of stakeholders. Therefore, we draw on attribution theory, self-presentational theories and research on account giving to develop our hypotheses. From our model of responsibility judgment, we infer how banks will react to their financial performance after the financial market crisis (2007/2008). We test this with a sample built from 91 U.S. and European banks, which were all severely hit by this crisis. Our results indicate that bank managers use accounts as linguistic devices to influence the responsibility judgments of stakeholders: Refusals and to relativize are used to influence their situational perception, concessions and excuses target on locus and controllability perceptions, and initiatives and outlooks affect stability perceptions.
Navigating the Problem Space of Academic Work
Authors: Hora Matthew T.
Published: January 2016

Despite an increasing focus on the quality of teaching in postsecondary institutions, little research exists that examines how faculty actually plan their courses in real-world settings. In this study the idea of the “problem space” from cognitive science is used to examine how faculty construct mental representations for the task of planning undergraduate courses. Using data from free lists and retrospective interviews, I report the factors that most shape the planning space and subsequent strategies and curricular artifacts used by a group of 58 faculty. Results indicate the primacy of fixed affordances, such as workload constraints, course content, and class size, and that these constraints contribute to the routine maintenance of preexisting lecture notes and PowerPoint slides. I recommend that educational leaders consider these cultural practices when designing instructional reforms and enact policies that require faculty to engage in brief, postclass reflection that results in minor updates to these artifacts.
Bioconductor’s EnrichmentBrowser: seamless navigation through combined results of set- & network-based enrichment analysis
Authors: Geistlinger Ludwig , Csaba Gergely , Zimmer Ralf
Published: January 2016

Background

Enrichment analysis of gene expression data is essential to find functional groups of genes whose interplay can explain experimental observations. Numerous methods have been published that either ignore (set-based) or incorporate (network-based) known interactions between genes. However, the often subtle benefits and disadvantages of the individual methods are confusing for most biological end users and there is currently no convenient way to combine methods for an enhanced result interpretation.

Results

We present the package as an easily applicable software that enables (1) the application of the most frequently used set-based and network-based enrichment methods, (2) their straightforward combination, and (3) a detailed and interactive visualization and exploration of the results. The package is available from the Bioconductor repository and implements additional support for standardized expression data preprocessing, differential expression analysis, and definition of suitable input gene sets and networks.

Conclusion

The package implements essential functionality for the enrichment analysis of gene expression data. It combines the advantages of set-based and network-based enrichment analysis in order to derive high-confidence gene sets and biological pathways that are differentially regulated in the expression data under investigation. Besides, the package facilitates the visualization and exploration of such sets and pathways.
Panel Testing for Familial Breast Cancer: Calibrating the Tension Between Research and Clinical Care
Authors: Thompson Ella R. , Rowley Simone M. , Li Na , McInerny Simone , Devereux Lisa , Wong-Brown Michelle W. , Trainer Alison H. , Mitchell Gillian , Scott Rodney J. , James Paul A. , Campbell Ian G.
Published: January 2016

Purpose

Gene panel sequencing is revolutionizing germline risk assessment for hereditary breast cancer. Despite scant evidence supporting the role of many of these genes in breast cancer predisposition, results are often reported to families as the definitive explanation for their family history. We assessed the frequency of mutations in 18 genes included in hereditary breast cancer panels among index cases from families with breast cancer and matched population controls.

Patients and Methods

Cases (n = 2,000) were predominantly breast cancer-affected women referred to specialized Familial Cancer Centers on the basis of a strong family history of breast cancer and BRCA1 and BRCA2 wild type. Controls (n = 1,997) were cancer-free women from the LifePool study. Sequencing data were filtered for known pathogenic or novel loss-of-function mutations.

Results

Excluding 19 mutations identified in BRCA1 and BRCA2 among the cases and controls, a total of 78 cases (3.9%) and 33 controls (1.6%) were found to carry potentially actionable mutations. A significant excess of mutations was only observed for PALB2 (26 cases, four controls) and TP53 (five cases, zero controls), whereas no mutations were identified in STK11. Among the remaining genes, loss-of-function mutations were rare, with similar frequency between cases and controls.

Conclusion

The frequency of mutations in most breast cancer panel genes among individuals selected for possible hereditary breast cancer is low and, in many cases, similar or even lower than that observed among cancer-free population controls. Although multigene panels can significantly aid in cancer risk management and expedite clinical translation of new genes, they equally have the potential to provide clinical misinformation and harm at the individual level if the data are not interpreted cautiously.
Effectiveness of Adjuvant Chemotherapy for Locally Advanced Bladder Cancer
Authors: Galsky Matthew D. , Stensland Kristian D. , Moshier Erin , Sfakianos John P. , McBride Russell B. , Tsao Che-Kai , Casey Martin , Boffetta Paolo , Oh William K. , Mazumdar Madhu , Wisnivesky Juan P.
Published: January 2016

Purpose

Given that randomized trials exploring adjuvant chemotherapy for bladder cancer have been underpowered and/or terminated prematurely, yielding inconsistent results and creating an evidence gap, we sought to compare the effectiveness of cystectomy versus cystectomy plus adjuvant chemotherapy in real-world patients.

Patients and Methods

We conducted an observational study to compare the effectiveness of adjuvant chemotherapy versus observation postcystectomy in patients with pathologic T3-4 and/or pathologic node-positive bladder cancer using the National Cancer Data Base. We compared overall survival using propensity score (–adjusted, –stratified, –weighted, and –matched) analyses based on patient-, facility-, and tumor-level characteristics. A sensitivity analysis was performed to examine the impact of performance status.

Results

A total of 5,653 patients met study inclusion criteria; 23% received adjuvant chemotherapy postcystectomy. Chemotherapy-treated patients were younger and more likely to have private insurance, live in areas with a higher median income and higher percentage of high school–educated residents, and have lymph node involvement and positive surgical margins (P < .05 for all comparisons). Stratified analyses adjusted for propensity score demonstrated an improvement in overall survival with adjuvant chemotherapy (hazard ratio, 0.70; 95% CI, 0.64 to 0.76), and similar results were achieved with propensity score matching and weighting. The association between adjuvant chemotherapy and improved survival was consistent in subset analyses and was robust to the effects of poor performance status.

Conclusion

In this observational study, adjuvant chemotherapy was associated with improved survival in patients with locally advanced bladder cancer. Although neoadjuvant chemotherapy remains the preferred approach based on level I evidence, these data lend further support for the use of adjuvant chemotherapy in patients with locally advanced bladder cancer postcystectomy who did not receive chemotherapy preoperatively.
Chemotherapy for Muscle-Invasive Bladder Cancer: Better Late Than Never?
Authors: Sonpavde Guru , Gordetsky Jennifer B. , Lockhart Mark E. , Nix Jeffrey W.
Published: January 2016

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.

A 64-year-old man with a history of cigarette smoking but no significant comorbidities presented with hematuria and dysuria. Computed tomography scans demonstrated a mass and thickening of the bladder wall and no evidence of metastasis. His laboratory evaluation showed normal blood cell counts and comprehensive metabolic panel with a calculated creatinine clearance of more than 60 mL per minute. A transurethral resection of the bladder tumor and biopsy identified transitional cell carcinoma or urothelial carcinoma invading the muscularis propria of the bladder. On the basis of the bladder-confined mass on computed tomography scan, the tumor was assigned a clinical stage of cT2N0. The patient was advised to undergo neoadjuvant chemotherapy followed by radical cystectomy (RC). The patient had multiple concerns regarding neoadjuvant chemotherapy, particularly toxicities, especially the possibility of chronic neurologic and renal toxicities, and the potential harm from delay of RC, especially if the bladder cancer was resistant to chemotherapy. After a discussion of approximately 1 hour, he elected to proceed with upfront RC and extended lymph node dissection in conjunction with construction of a neobladder. Pathology revealed pathologic extravesical urothelial carcinoma, with disease in one of 25 lymph nodes removed (ypT3N1). Four weeks after RC, he returned to discuss further management with the medical oncologist. He exhibited an Eastern Cooperative Oncology Group performance status of 0, normal blood cell counts, and a calculated creatinine clearance of more than 60 mL per minute.
Trends in the Aggressiveness of End-of-Life Cancer Care in the State of Qatar
Authors: Hassan Azza A. , Mohsen Hassan , Allam Ayman A. , Haddad Pascale
Published: January 2016

Purpose

Quality of end-of-life (EOL) care is a key component of excellence in cancer care, and monitoring indicators for quality of EOL cancer care is crucial to providing excellent care. The aim of the current study is to describe the relative aggressiveness of EOL cancer care in the state of Qatar and to compare it with international figures.

Methods

We analyzed all deaths from cancer in Qatar between January 1, 2009 and December 31, 2013. A total of 784 eligible patients were studied to assess aggressiveness of cancer care at EOL.

Results

The average number of intensive care unit admissions per person decreased from 0.44 to 0.22 (P < .001) over the period of study. In addition, patients spent fewer days in the intensive care unit (2.79 to 1.82 days; P = .006) and made fewer visits to the emergency department (1.00 to 0.52 visits; P < .001) in the last 30 days of life. Fewer patients had at least one aggressive treatment measure at EOL during the 5-year period (82.3% to 71.0%; P = .038). The mean composite score for aggressiveness of EOL care decreased from 2.24 to 1.92 (P < .01).

Conclusion

The aggressiveness of EOL cancer care has significantly decreased over time in Qatar; however, despite this decrease, the rate is still higher than that reported internationally. The integration of community palliative care services in Qatar may further decrease the aggressiveness of cancer care at EOL.
Icam5 Expression Exhibits Sex Differences in the Neonatal Pituitary and Is Regulated by Estradiol and Bisphenol A
Authors: Eckstrum Kirsten S. , Weis Karen E. , Baur Nicholas G. , Yoshihara Yoshihiro , Raetzman Lori T.
Published: January 2016

Endocrine-disrupting chemicals are prevalent in the environment and can impair reproductive success by affecting the hypothalamic-pituitary-gonadal axis. The developing pituitary gland is sensitive to exposure to endocrine-disrupting chemicals, such as bisphenol A (BPA), and sex-specific effects can occur. However, effects on the critical window of neonatal pituitary gland development in mice have not been explored. Therefore, this study determined baseline gene expression in male and female pituitaries and consequences of environmental exposure to 17β-estradiol (E2) and BPA on transcription of genes exhibiting sex differences during the neonatal period. Through microarray and quantitative RT-PCR analysis of pituitaries at postnatal day (PND)1, 3 genes were differentially expressed between males and females: Lhb, Fshb, and intracellular adhesion molecule-5 (Icam5). To see whether E2 and BPA exposure regulates these genes, pituitaries were cultured at PND1 with 10−8M E2 or 4.4 × 10−6M BPA. E2 decreased expression of Lhb, Fshb, and Icam5 mRNA in females but only significantly decreased expression of Icam5 in males. BPA decreased expression of Icam5 similarly to E2, but it did not affect Lhb or Fshb. Importantly, in vivo exposure to 50-μg/kg · d E2 from PND0 to PND7 decreased expression of Lhb, Fshb, and Icam5 mRNA in both males and females, whereas 50-mg/kg · d BPA exposure during the same time frame decreased expression of Icam5 in females only. Overall, we have uncovered that genes differentially expressed between the sexes can be regulated in part by hormonal and chemical signals in vivo and directly at the pituitary and can be regulated in a sex-specific manner.
The Urine Iodine to Creatinine as an Optimal Index of Iodine During Pregnancy in an Iodine Adequate Area in China
Authors: Li Chenyan , Peng Shiqiao , Zhang Xiaomei , Xie Xiaochen , Wang Danyang , Mao Jinyuan , Teng Xiaochun , Shan Zhongyan , Teng Weiping
Published: January 2016

Context:

Iodine nutrition is a global event, especially for pregnant women.

Objective:

To develop applicable index of iodine intake for population during pregnancy.

Design, Setting, and Participants:

From 2012 to 2014, pregnant women at less than 8 weeks of gestation (n = 222) and reproductive-age women (n = 827) participated in this study. The pregnant women were evaluated at follow-up visits at 8, 12, 16, 20, 28, and 36 weeks of gestation and 3 and 6 months postpartum.

Main Outcome Measures:

Twenty-four-hour urine samples were collected at weeks 8 of gestation. Urine iodine (UI) and creatinine (Cr) and serum thyroglobulin were measured in all of the subjects. Circulatory iodine was measured using inductively coupled plasma-mass spectrometry at 8, 20, and 36 weeks of gestation and 6 months postpartum.

Results:

The median UI concentration decreased from 183.6 to 104.2 μg/L during pregnancy. The serum iodine (SI) changes were similar to the UI to creatinine ratio (UI/Cr). The SI level was lowest at the eighth week of gestation (60.5 μg/L), which rose significantly until 20 weeks (106.5 μg/L) and then began to decline (36 wk, 84.7 μg/L). The 24-hour UI excretion measurement was regarded as the gold standard. The area under the receiver-operating characteristic curve for UI/Cr was 0.92 for iodine deficiency diagnoses and 0.78 for SI. The area for SI was 0.82 for excessive iodine diagnoses and 0.75 for UI/Cr. The areas under these curves were significantly different (P < .001). The areas under the receiver-operating characteristic curve for UI were 0.61 (P = .11) and 0.65 (P = .08) for iodine deficiency and excessive iodine diagnoses, respectively. Additionally, for thyroglobulin, these values were 0.54 (P = .53) and 0.53 (P = .74), respectively.

Conclusions:

Iodine intake, as assessed by spot UI concentration in pregnant women, is inaccurate and increases the prevalence of iodine deficiency. The UI/Cr better reflects the 24-hour iodine excretion and circulating iodine levels during pregnancy and the postpartum period.
Early and Sustained Changes in Bone Metabolism After Severe Burn Injury
Authors: Muschitz Gabriela Katharina , Schwabegger Elisabeth , Kocijan Roland , Baierl Andreas , Moussalli Hervé , Fochtmann Alexandra , Nickl Stefanie , Tinhofer Ines , Haschka Judith , Resch Heinrich , Rath Thomas , Pietschmann Peter , Muschitz Christian
Published: January 2016

Context:

Severe burn injury causes a massive stress response, consecutively heightened serum levels of acute phase proteins, cortisol, and catecholamines with accompanying disturbance in calcium metabolism.

Objective:

Evaluation of early and prolonged changes of serum bone turnover markers (BTMs) and regulators of bone metabolism.

Design:

Longitudinal observational design.

Setting:

University clinic.

Patients:

A total of 32 male patients with a median age of 40.5 years and a median burned total body surface area of 40% (83% patients with full thickness burn injury).

Interventions:

None.

Main Outcome Measures:

Comparison of changes of BTM/regulators of bone metabolism in the early (d 2–7) and prolonged (d 7–56) phases after trauma.

Results:

All investigated BTM/regulators significantly changed. During the early phase, pronounced increases were observed for serum type 1 collagen cross-linked C-telopeptide, intact N-terminal propeptide of type I procollagen, sclerostin, Dickkopf-1, bone-specific alkaline phosphatase, fibroblast growth factor 23, and intact parathyroid hormone levels, whereas 25-hydroxyvitamin D, albumin, serum, and ionized calcium levels decreased. Changes of osteoprotegerin, osteocalcin, and phosphate were less pronounced but remained significant. In the prolonged phase, changes of intact N-terminal propeptide of type I procollagen were most pronounced, followed by elevated sclerostin, osteocalcin, bone-specific alkaline phosphatase, and lesser changes for albumin levels. Calcium and ionized calcium levels tardily increased and remained within the limit of normal. In contrast, levels of intact parathyroid hormone, fibroblast growth factor 23, C-reactive protein, and to a lesser extent serum type 1 collagen cross-linked C-telopeptide and phosphate levels declined significantly during this phase of investigation.

Conclusions:

Ongoing changes of BTM and regulators of bone metabolism suggest alterations in bone metabolism with a likely adverse influence on bone quality and structure in male patients with severe burn injuries.
Inexpressible Ignorance
Authors: Dasgupta Shamik
Published: January 2016

Sometimes, ignorance is inexpressible. Lewis recognized this when he argued, in “Ramseyan Humility,” that we cannot know which property occupies which causal role. This peculiar state of ignorance arises in a number of other domains too, including ignorance about our position in space and the identities of individuals. In these cases, one does not know something, and yet one cannot give voice to one's ignorance in a certain way. But what does the ignorance in these cases consist in? This essay argues that many standard models of ignorance cannot account for the phenomenon of inexpressible ignorance. It then develops an alternative model that does better, on which the ignorance consists in a failure to identify something by way of its nature or essence.
Expectations of Paternalism: Welfare, Corporate Responsibility, and HIV at South Africa's Mines
Authors: Rajak Dinah
Published: January 2016

This article focuses on HIV/AIDS management at Anglo American, the world's third-biggest mining company, the largest private-sector employer in South Africa and across the continent, and the first company to provide antiretroviral therapy (ART) “free of charge” to its workforce in a context of little or no access to state health care. Through the lens of HIV management, the article considers what happens when human care and welfare is refracted through the prism of corporate managerialism, shareholder value, and, more immediately, the relationship between workers and capital. It suggests that, as welfare is conflated with the maintenance of human capital, care becomes a conduit for corporate control and containment giving new force to old paternalistic regimes in the postapartheid workplace. Here the discourse of shareholder value and (human) capital efficiency is fused with moralities of social responsibility in this new dispensation of corporate compassion. The result is the emergence of a vanguard of ART recipients, employees who depend on their corporate employers not only for their livelihood but for their very survival and thus are divided from society outside the workplace and from their own dependents. Their liminality comes to embody the disjuncture between corporate responsibility and state welfare.
Self-Defense as a Revolutionary Practice in Rojava, or How to Unmake the State
Authors: Üstündağ Nazan
Published: January 2016

This intervention concerns the ways in which law and violence are being reorganized in Rojava. Based on observations and interviews I conducted in the Jazira canton of Rojava, I argue that, through democratic autonomy, the Rojava revolution poses a challenge to the politics of sovereignty and biopolitics. While democratic autonomy involves the institutionalization of radical democracy, radical democracy needs to be defended against attacks of capital, state, and patriarchy. The question of how such defense can be organized without reproducing the “magic” of the state and law at an everyday level is crucial for the revolution. I address the debates and practices in Rojava developing around this question and conclude that, rather than speaking about a model in Rojava, we should speak of a movement residing in the dialectic between state-ness and society.
Cellular structural biology as revealed by cryo-electron tomography
Authors: Irobalieva Rossitza N. , Martins Bruno , Medalia Ohad
Published: January 2016

Understanding the function of cellular machines requires a thorough analysis of the structural elements that underline their function. Electron microscopy (EM) has been pivotal in providing information about cellular ultrastructure, as well as macromolecular organization. Biological materials can be physically fixed by vitrification and imaged with cryo-electron tomography (cryo-ET) in a close-to-native condition. Using this technique, one can acquire three-dimensional (3D) information about the macromolecular architecture of cells, depict unique cellular states and reconstruct molecular networks. Technical advances over the last few years, such as improved sample preparation and electron detection methods, have been instrumental in obtaining data with unprecedented structural details. This presents an exciting opportunity to explore the molecular architecture of both individual cells and multicellular organisms at nanometer to subnanometer resolution. In this Commentary, we focus on the recent developments and in situ applications of cryo-ET to cell and structural biology.
Nonsense-mediated mRNA decay in humans at a glance
Authors: Kurosaki Tatsuaki , Maquat Lynne E.
Published: January 2016

Nonsense-mediated mRNA decay (NMD) is an mRNA quality-control mechanism that typifies all eukaryotes examined to date. NMD surveys newly synthesized mRNAs and degrades those that harbor a premature termination codon (PTC), thereby preventing the production of truncated proteins that could result in disease in humans. This is evident from dominantly inherited diseases that are due to PTC-containing mRNAs that escape NMD. Although many cellular NMD targets derive from mistakes made during, for example, pre-mRNA splicing and, possibly, transcription initiation, NMD also targets ∼10% of normal physiological mRNAs so as to promote an appropriate cellular response to changing environmental milieus, including those that induce apoptosis, maturation or differentiation. Over the past ∼35 years, a central goal in the NMD field has been to understand how cells discriminate mRNAs that are targeted by NMD from those that are not. In this Cell Science at a Glance and the accompanying poster, we review progress made towards this goal, focusing on human studies and the role of the key NMD factor up-frameshift protein 1 (UPF1).