bluuebunny/crossref_metadata_2025 huggingface dataset:
Pneumococcal serotype trends, surveillance and risk factors in UK adult pneumonia, 2013–18
Authors: Pick Harry , Daniel Priya , Rodrigo Chamira , Bewick Thomas , Ashton Deborah , Lawrence Hannah , Baskaran Vadsala , Edwards-Pritchard Rochelle C , Sheppard Carmen , Eletu Seyi D , Rose Samuel , Litt David , Fry Norman K , Ladhani Shamez , Chand Meera , Trotter Caroline , McKeever Tricia M , Lim Wei Shen
Published: October 2019

Background

Changes over the last 5 years (2013–18) in the serotypes implicated in adult pneumococcal pneumonia and the patient groups associated with vaccine-type disease are largely unknown.

Methods

We conducted a population-based prospective cohort study of adults admitted to two large university hospitals with community-acquired pneumonia (CAP) between September 2013 and August 2018. Pneumococcal serotypes were identified using a novel 24-valent urinary monoclonal antibody assay and from blood cultures. Trends in incidence rates were compared against national invasive pneumococcal disease (IPD) data. Persons at risk of vaccine-type pneumonia (pneumococcal conjugate vaccine (PCV)13 and pneumococcal polysaccharide vaccine (PPV)23) were determined from multivariate analyses.

Findings

Of 2934 adults hospitalised with CAP, 1075 (36.6%) had pneumococcal pneumonia. The annual incidence of pneumococcal pneumonia increased from 32.2 to 48.2 per 100 000 population (2013–18), predominantly due to increases in PCV13non7-serotype and non-vaccine type (NVT)-serotype pneumonia (annual incidence rate ratio 1.12, 95% CI 1.04 to 1.21 and 1.19, 95% CI 1.10 to 1.28, respectively). Incidence trends were broadly similar to IPD data. PCV13non7 (56.9% serotype 3) and PPV23non13 (44.1% serotype 8) serotypes were identified in 349 (32.5%) and 431 (40.1%) patients with pneumococcal pneumonia, respectively. PCV13-serotype pneumonia (dominated by serotype 3) was more likely in patients in the UK pneumococcal vaccination clinical risk group (adjusted OR (aOR) 1.73, 95% CI 1.31 to 2.28) while PPV23-serotype pneumonia was more likely in patients outside the clinical risk group (aOR 1.54, 95% CI 1.13 to 2.10).

Interpretation

The incidence of pneumococcal CAP is increasing, predominantly due to NVT serotypes and serotype 3. PPV23-serotype pneumonia is more likely in adults outside currently identified clinical risk groups.
The life history and feeding ecology of velvet shell, Velutina velutina (Gastropoda: Velutinidae), a specialist predator of ascidians
Authors: Sargent P.S. , Hamel J.-F. , Mercier A.
Published: October 2019

Velvet shell, Velutina velutina (Müller, 1776), is a specialist predator of ascidians, like other members of the gastropod family Velutinidae. Globally, invasive ascidians have become problematic, ecologically and economically, yet ecological knowledge of velutinids remains limited. This study outlines the life history and feeding ecology of V. velutina in eastern Canada based on laboratory work complemented by field observations. The life history of V. velutina is closely linked with ascidians, which serve as prey and protection for their egg capsules. Egg capsules were embedded within tunics of Aplidium glabrum (Verrill, 1871) and Ascidia callosa Stimpson, 1852, with a preference for the latter. Seasonal behavioural shifts were consistent annually and corresponded with seawater temperature cycles. Feeding dominated during the coldest months (January–May), growth occurred as water temperature increased to the annual maximum (June and July), transitioning to mating during the warmest period (July–August), and egg capsule deposition dominated as water temperature declined (November–January). Larvae hatched between January and July after 2–4 months of development. Velutina velutina preyed on all ascidian species presented during this study, including golden star tunicate, Botryllus schlosseri (Pallas, 1766), and vase tunicate, Ciona intestinalis (Linnaeus, 1767), two non-indigenous species, although solitary species were preferred.
Isotropization and change of complexity by gravitational decoupling
Authors: Casadio R. , Contreras E. , Ovalle J. , Sotomayor A. , Stuchlik Z.
Published: October 2019

We employ the gravitational decoupling approach for static and spherically symmetric systems to develop a simple and powerful method in order to (a) continuously isotropize any anisotropic solution of the Einstein field equations, and (b) generate new solutions for self-gravitating distributions with the same or vanishing complexity factor. A few working examples are given for illustrative purposes.
Quantum entanglement in physical and cognitive systems: A conceptual analysis and a general representation
Authors: Aerts D. , Aerts Arguëlles J. , Beltran L. , Geriente S. , Sassoli de Bianchi M. , Sozzo S. , Veloz T.
Published: October 2019

We provide a general description of the phenomenon of entanglement in bipartite systems, as it manifests in micro and macro physical systems, as well as in human cognitive processes. We do so by observing that when genuine coincidence measurements are considered, the violation of the ‘marginal laws’, in addition to the Bell-CHSH inequality, is also to be expected. The situation can be described in the quantum formalism by considering the presence of entanglement not only at the level of the states, but also at the level of the measurements. However, at the “local” level of a specific joint measurement, a description where entanglement is only incorporated in the state remains always possible, by adopting a fine-tuned tensor product representation. But contextual tensor product representations should only be considered when there are good reasons to describe the outcome-states as (non-entangled) product states. This will not in general be true, hence, the entanglement resource will have to generally be allocated both in the states and in the measurements. In view of the numerous violations of the marginal laws observed in physics’ laboratories, it remains unclear to date if entanglement in micro-physical systems is to be understood only as an ‘entanglement of the states’, or also as an ‘entanglement of the measurements’. But even if measurements would also be entangled, the corresponding violation of the marginal laws (also called ‘no-signaling conditions’) would not for this imply that a superluminal communication would be possible.
Robust Optimization of Industrial Process Operation Parameters Based on Data‐Driven Model and Parameter Fluctuation Analysis
Authors: Li Taifu , Liao Zhiqiang
Published: October 2019

The fluctuation of industrial process operation parameters will severely influence the production process. How to find the robust optimal process operation parameters is an effective method to address this problem. In this paper, a scheme based on data‐driven model and variable fluctuation analysis is proposed to obtain the robust optimal operation parameters of industrial process. The data‐driven modelling method: multivariate Gaussian process regression (MGPR) based on Bayesian statistical learning theory can map the process operation parameters to objective performance with the flexibility in nonparameter inferring and the self‐adaptiveness to determinate hyperparameters. According to the minimum variance criterion, the parameter fluctuation analysis can be performed through multiobjective evolutionary algorithm based on the MGPR model. To analyze the robustness influence of a single parameter, cross validation is applied to evaluate the model output with 2% fluctuation. After that, the robust optimal process operation parameters can be obtained and applied to guide the production. The effectiveness and reliability of the proposed method have been verified with the hydrogen cyanide production process and compared with other model methods and single objective optimization method.
To Evaluate the Effect of Chronic Obstructive Pulmonary Disease on Retinal and Choroidal Thicknesses Measured by Optical Coherence Tomography
Authors: Alim Sait , Demir Helin Deniz , Yilmaz Ayşe , Demir Selim , Güneş Alper
Published: October 2019

Purpose. To evaluate the retinal and choroidal thicknesses in patients with chronic obstructive pulmonary disease using optical coherence tomography. Methods. The study included 26 patients with chronic obstructive pulmonary disease (COPD) and 26 age-matched healthy control groups. Detailed ocular examinations were performed on all participants. Cirrus EDI-OCT (enhanced depth imaging-optical coherence tomography) was used for choroidal thickness measurements with frame enhancement software. The subfoveal area was used for choroidal thickness measurements. Results. The patients with the chronic obstructive pulmonary disease had an average 239.13 ± 57.77 μm subfoveal choroidal thickness, and the control group had an average 285.02 ± 25 μm subfoveal choroidal thickness. The subfoveal choroidal thickness measurements revealed a statistically significant difference between patients and the control group (p<0.05). There were no statistically significant differences between patients and control group regarding mean macular thickness, central macular thickness, and GCIPL (ganglion cell-inner plexiform layer) thickness. Also, there was no statistically significant difference between patients and control group regarding mean, superior, nasal, inferior, and temporal RNFL (retinal nerve fiber layer) thicknesses. Conclusion. Chronic hypoxemia seems to cause decreased choroidal thickness in patients with chronic obstructive pulmonary disease.
Efficacy of the Antibody–Drug Conjugate W0101 in Preclinical Models of IGF-1 Receptor Overexpressing Solid Tumors
Authors: Akla Barbara , Broussas Matthieu , Loukili Noureddine , Robert Alain , Beau-Larvor Charlotte , Malissard Martine , Boute Nicolas , Champion Thierry , Haeuw Jean-Francois , Beck Alain , Perez Michel , Dreyfus Cyrille , Pavlyuk Mariya , Chetaille Eric , Corvaia Nathalie
Published: October 2019

The insulin-like growth factor type 1 receptor (IGF-1R) is important in tumorigenesis, and its overexpression occurs in numerous tumor tissues. To date, therapeutic approaches based on mAbs and tyrosine kinase inhibitors targeting IGF-1R have only shown clinical benefit in specific patient populations. We report a unique IGF-1R–targeted antibody–drug conjugate (ADC), W0101, designed to deliver a highly potent cytotoxic auristatin derivative selectively to IGF-1R overexpressing tumor cells. The mAb (hz208F2-4) used to prepare the ADC was selected for its specific binding properties to IGF-1R compared with the insulin receptor, and for its internalization properties. Conjugation of a novel auristatin derivative drug linker to hz208F2-4 did not alter its binding and internalization properties. W0101 induced receptor-dependent cell cytotoxicity in vitro when applied to various cell lines overexpressing IGF-1R, but it did not affect normal cells. Efficacy studies were conducted in several mouse models expressing different levels of IGF-1R to determine the sensitivity of the tumors to W0101. W0101 induced potent tumor regression in certain mouse models. Interestingly, the potency of W0101 correlated with the expression level of IGF-1R evaluated by IHC. In an MCF-7 breast cancer model with high-level IGF-1R expression, a single injection of W0101 3 mg/kg led to strong inhibition of tumor growth. W0101 provides a potential new therapeutic option for patients overexpressing IGF-1R. A first-in-human trial of W0101 is currently ongoing to address clinical safety.
Influence of Pre-Existing Mild Cognitive Impairment and Dementia on Post-Stroke Mortality. The Dijon Stroke Registry
Authors: Graber Mathilde , Garnier Lucie , Mohr Sophie , Delpont Benoit , Blanc-Labarre Christelle , Vergely Catherine , Giroud Maurice , Béjot Yannick
Published: October 2019

Objective: We assessed the association between pre-stroke cognitive status and 90-day case-fatality. Methods: Patients with ischemic stroke (IS) or spontaneous intracerebral hemorrhage (ICH) were prospectively identified among residents of Dijon, France, between 2013 and 2015, using a population-based registry. Association between pre-stroke cognitive status and case-fatality at 90 days was evaluated using Cox regression. Results: Seven hundred sixty-two patients were identified, and information about pre-stroke cognitive status was obtained for 716 (92.6%) of them, including 603 IS (84.2%) and 113 ICH (15.8%). Before stroke, 99 (13.8%) patients had mild cognitive impairment (MCI) and 98 (13.7%) had dementia. Patients with cognitive impairment were older, had a higher prevalence of several risk factors, more severe stroke, more frequent ICH, and less admission to stroke unit. Case-fatality rate at 90 days was 11.7% in patients without cognitive impairment, 32.3% in MCI patients, and 55.1% in patients with dementia. In multivariable analyses, pre-existing MCI (hazard ratio [HR] 2.22, 95% CI 1.21–4.05, p = 0.009) and dementia (HR 4.35, 95% CI 2.49–7.61, p < 0.001) were both associated with 90-day case-fatality. Conclusion: Pre-stroke MCI and dementia were both associated with increased mortality. These associations were not fully explained by baseline characteristics, pre-stroke dependency, stroke severity or patient management, and underlying reasons need to be investigated.
Fetal Cardiac Intervention in Critical Aortic Stenosis with Severe Mitral Regurgitation, Severe Left Atrial Enlargement, and Restrictive Foramen Ovale
Authors: Mallmann Michael R. , Herberg Ulrike , Gottschalk Ingo , Strizek Brigitte , Hellmund Astrid , Geipel Annegret , Breuer Johannes , Gembruch Ulrich , Berg Christoph
Published: October 2019

Objective: To assess the intrauterine course and outcome of fetal cardiac intervention (FCI) in fetuses with critical aortic stenosis (CAS), severe mitral regurgitation (MR), severe left atrial dilatation (LAD), and restrictive foramen ovale (RFO) or intact atrial septum. Methods: All fetuses with a prenatal diagnosis of CAS, severe MR, severe LAD, and RFO were retrospectively collected in one tertiary center for fetal medicine over a period of 10 years. Video recordings, pre- and postnatal charts were reviewed for cardiac and extracardiac anomalies, intrauterine course, and postnatal outcome. Results: Nineteen fetuses with CAS, severe MR, severe LAD, and RFO were diagnosed in the study period. In 5 cases, FCI was not considered as the parents either opted for expectative management or for termination. In the remaining 14 fetuses, 21 FCI were performed: 14 balloon valvuloplasties, 2 atrioseptostomies, and 5 fetal atrial stent insertions. Seven of 14 fetuses (50%) had fetal hydrops, 5 of 14 fetuses (36%) presented with intact atrial septum. Procedure-related death occurred in 5 fetuses after aortic valvuloplasty or concomitant atrioseptostomy but in none after fetal atrial stenting. Due to progressive hydrops, two terminations of pregnancy were performed. Among the 7 live births, 3 died in the neonatal period. The remaining 4 received single ventricle palliation, 2 following fetal aortic valvuloplasty and 2 after fetal atrial stent insertion. Conclusions: CAS with severe MR, severe LAD, and RFO has a high overall mortality even in cases undergoing intrauterine intervention. Parameters that accurately predict the intrauterine and postnatal outcome have yet to be defined.
Vowel-to-Vowel Coarticulation in Spanish Nonwords
Authors: Conklin Jenna T. , Dmitrieva Olga
Published: October 2019

The present study examined vowel-to-vowel (VV) coarticulation in backness affecting mid vowels /e/ and /o/ in 36 Spanish nonwords produced by 20 native speakers of Spanish, aged 19–50 years (mean = 30.7; SD = 8.2). Examination of second formant frequency showed substantial carryover coarticulation throughout the data set, while anticipatory coarticulation was minimal and of shorter duration. Furthermore, the effect of stress on vowel-to-vowel coarticulation was investigated and found to vary by direction. In the anticipatory direction, small coarticulatory changes were relatively stable regardless of stress, particularly for target /e/, while in the carryover direction, a hierarchy of stress emerged wherein the greatest coarticulation occurred between stressed triggers and unstressed targets, less coarticulation was observed between unstressed triggers and unstressed targets, and the least coarticulation occurred between unstressed triggers with stressed targets. The results of the study augment and refine previously available knowledge about vowel-to-vowel coarticulation in Spanish and expand cross-linguistic understanding of the effect of stress on the magnitude and direction of vowel-to-vowel coarticulation.
Breast Cancer Statistics in the European Union: Incidence and Survival across European Countries
Authors: Dafni Urania , Tsourti Zoi , Alatsathianos Ioannis
Published: October 2019

The current status and time trends in breast cancer incidence and survival in the 28 European Union countries (EU-28) is presented here. Rates reported are age adjusted and standardized (ASR). A high incidence and high survival rates were observed in the Northern and Western European countries, with the exception of the Baltic countries. The higher incidence is partly attributed to the higher prevalence of lifestyle risk factors, while the higher survival is attributed to better access to beneficial treatments and general health care. Most of the countries in Southern Europe or the former Eastern Bloc have not yet reached the high GDP per capita status (2017 purchasing power parity; PPP) of the earlier established Western democracies. The breast cancer incidence and survival are associated with the PPP level (both higher for the higher PPP category; 2017 PPP above USD 40,000). Overall, a trend toward higher survival rates was observed throughout this first period of the 21st century, with the incidence for most countries either stabilizing at the 2010 levels or decreasing further.
Dog Ownership and Survival After a Major Cardiovascular Event
Authors: Mubanga Mwenya , Byberg Liisa , Egenvall Agneta , Ingelsson Erik , Fall Tove
Published: October 2019

Background:

Dog ownership is associated with increased physical activity levels and increased social support, both of which could improve the outcome after a major cardiovascular event. Dog ownership may be particularly important in single-occupancy households where ownership provides substitutive companionship and motivation for physical activity.

Methods and Results:

We used the Swedish National Patient Register to identify all patients aged 40 to 85 presenting with an acute myocardial infarction (n=181 696; 5.7% dog ownership) or ischemic stroke (n=154 617; 4.8% dog ownership) between January 1, 2001 and December 31, 2012. Individual information was linked across registers for cause of death, sociodemographic, and dog ownership data. We evaluated all-cause mortality and risk of recurrent hospitalization for the same cause until December 31, 2012. Models were adjusted for socioeconomic, health, and demographic factors at study inclusion such as age, marital status, the presence of children in the home, area of residence, and income, as well as all registered comorbidities and hospitalization for cardiovascular disease in the past 5 years. Dog owners had a lower risk of death after hospitalization for acute myocardial infarction during the full follow-up period of 804 137 person-years, with an adjusted hazard ratio (HR) of 0.67 (95% CI, 0.61 to 0.75) for those who lived alone, and HR of 0.85 (95% CI, 0.80 to 0.90) for those living with a partner or a child. Similarly, after an ischemic stroke, dog owners were at lower risk of death during the full follow-up of 638 219 person-years adjusted HR of 0.73 (95% CI, 0.66 to 0.80) for those who lived alone and HR of 0.88 (95% CI, 0.83 to 0.93) for those living with a partner or a child. We further found an association of dog ownership with reduced risk of hospitalization for recurrent myocardial infarction (HR, 0.93; 95% CI, 0.87 to 0.99).

Conclusions:

We found evidence of an association of dog ownership with a better outcome after a major cardiovascular event. Although our models are adjusted for many potential confounders, there are also unmeasured confounders such as smoking that prevent us from drawing conclusions regarding a possible causal effect.
Role of Nitric Oxide Carried by Hemoglobin in Cardiovascular Physiology
Authors: Premont Richard T. , Reynolds James D. , Zhang Rongli , Stamler Jonathan S.
Published: October 2019

A continuous supply of oxygen is essential for the survival of multicellular organisms. The understanding of how this supply is regulated in the microvasculature has evolved from viewing erythrocytes (red blood cells [RBCs]) as passive carriers of oxygen to recognizing the complex interplay between Hb (hemoglobin) and oxygen, carbon dioxide, and nitric oxide—the three-gas respiratory cycle—that insures adequate oxygen and nutrient delivery to meet local metabolic demand. In this context, it is blood flow and not blood oxygen content that is the main driver of tissue oxygenation by RBCs. Herein, we review the lines of experimentation that led to this understanding of RBC function; from the foundational understanding of allosteric regulation of oxygen binding in Hb in the stereochemical model of Perutz, to blood flow autoregulation (hypoxic vasodilation governing oxygen delivery) observed by Guyton, to current understanding that centers on S-nitrosylation of Hb (ie, S-nitrosohemoglobin; SNO-Hb) as a purveyor of oxygen-dependent vasodilatory activity. Notably, hypoxic vasodilation is recapitulated by native S-nitrosothiol (SNO)–replete RBCs and by SNO-Hb itself, whereby SNO is released from Hb and RBCs during deoxygenation, in proportion to the degree of Hb deoxygenation, to regulate vessels directly. In addition, we discuss how dysregulation of this system through genetic mutation in Hb or through disease is a common factor in oxygenation pathologies resulting from microcirculatory impairment, including sickle cell disease, ischemic heart disease, and heart failure. We then conclude by identifying potential therapeutic interventions to correct deficits in RBC-mediated vasodilation to improve oxygen delivery—steps toward effective microvasculature-targeted therapies. To the extent that diseases of the heart, lungs, and blood are associated with impaired tissue oxygenation, the development of new therapies based on the three-gas respiratory system have the potential to improve the well-being of millions of patients.
Establishment of a new genus for Nudina xizangensis Fang, 2000 (Lepidoptera, Erebidae, Arctiinae, Lithosiini)
Authors: HUANG SI-YAO , TAN SHUN-YUN , WANG MIN , FAN XIAO-LING
Published: October 2019

The little known species Nudina xizangensis Fang, 2000 is rediscovered from its type locality, Beibeng, Motuo County, Southeast Xizang, with genitalia of both sexes illustrated for the first time. Based on its unique genitalia structure, a new lichen moth genus, Paranudina Huang & Wang gen. nov., is described with N. xizangensis as the type species. Adults and genitalia of Paranudina xizangensis (Fang, 2000) comb. nov. and Nudina artaxidia (Butler, 1881) are compared and illustrated.
A stacked structure comprising 3-dimensional nitrogen-doped graphene, silicon microchannel plate, and TiO2 for high-performance anode in lithium-ion battery
Authors: Miao Fengjuan , Miao Rui , Yu Zang , Shi Cuiping , Zhu Lei , Chu Paul K.
Published: October 2019

A hybrid electrode composed of silicon microchannel plates (Si MCPs) coated with nitrogen-doped graphene and TiO2 is prepared and used as the anode in a lithium-ion battery. The materials are characterized systematically by scanning electron microscopy, Raman scattering spectroscopy,
X-ray photoelectron spectroscopy, and electrochemical techniques. The unique porous and ordered nanostructure of the TiO2/N-graphene/Si-MCP nanocomposite provides short paths for diffusion of Li ions and immobilized active sites, whereas N-doped graphene facilitates fast charge
transportation. The synergetic effects result in high reversible specific capacities and stability. Owing to the compatibility with semiconductor processing and devices, the concept and technique have large potential in large-scale fabrication of high-performance anodes of lithium-ion batteries,
especially those integrated into microelectronic chips.
An investigation of the mechanism and benefits of ultrasonic vibration-assisted drilling of hard brittle materials such as Hotan jade
Authors: Wang Tianqi , Han Xiaolan , Liu Zhanfeng , Qiu Yuanying
Published: October 2019

The ultrasonic vibration-assisted drilling process and the surface micro characteristics of Hotan jade were evaluated in detail. Because of the special physical properties of Hotan jade, traditional machining methods have great limitations. In consequence, it is difficult to achieve
the required precision and surface quality. In this study, the physical properties of Hotan jade were considered and its unique cutting and machinability characteristics were evaluated for comparison purposes. The design principles of UV drilling and the important components of such a system
were examined. The material removal mechanism of UV drilling was evaluated in detail. Finally, comparative tests using UV drilling and traditional drilling were carried on Hotan jade. The test results were evident from the degree of tool wear, degree of reaming, the extent of damage at the
entrance to the drilled hole, the outlet burr and the roughness of the hole surface. The results of the machining trials confirmed that UV drilling not only was an easier process, but the straightness of the hole could be guaranteed, and the machined quality and drilling efficiency usually
were better than was the case using traditional machining.
Synthesis and morphology control of nano-scaled magnesium hydroxide and its influence on the mechanical property and flame retardancy of polyvinyl alcohol
Authors: Wang Xiaodong , Yu Mingqing , Li Lei , Fan Xu
Published: October 2019

Nano-scaled magnesium hydroxide with the special appearance was synthesized by a water precipitation reaction at room temperature. The effects of surfactant, reaction time, reactant concentration on the morphology of nano-scaled magnesium hydroxide were investigated. The nanocomposite
film was prepared by adding nano-sized magnesium hydroxide to polyvinyl alcohol. The mechanical property and flame retardancy of PVA nanocomposites were tested. The results showed that the mechanical properties and flame retardancy of the composite film were improved by adding nano-powders.
Augmentation of ferromagnetism in CuO–Al2O3 nanocomposite synthesized via solution combustion method
Authors: Alam Mir Waqas , Dar Farooq Ahmad , Mohmed Fida , Aljaafari Abdullah , Saber Osama
Published: October 2019

The finite size effect of CuO nanoparticles and their effect on the magnetic behavior of a CuO–Al2O3 nanocomposite synthesized via a solution combustion method are discussed here. It is observed that the introduction of CuO nanoparticles of ∼20 nm in
size on the surfaces of Al2O3 nanosheets strongly influences the magnetic moment of the nanocomposite. The X-ray diffraction pattern reveals the presence of a CuO phase in the CuO–Al2O3 nanocomposite. Electron microscopy imaging shows the presence
of CuO nanoparticles distributed over the surfaces of Al2O3 nanosheets. Magnetic measurements performed at 5 and 300 K revealed a strong enhancement in the saturation magnetization of the CuO–Al2O3 nanocomposite at both temperatures. This increase
is due to the formation of CuO nanoparticles on the surfaces of the Al2O3 nanosheets. These CuO nanoparticles show a ferromagnetic nature due to the uncompensated surface Cu2+ spins of the copper ions. The presence of the Cu2+ state in the CuO nanoparticles
in the CuO–Al2O3 nanocomposite was confirmed by X-ray photoelectron spectroscopy (XPS) measurements.
North Atlantic Integrated Water Vapor Transport—From 850 to 2100 CE: Impacts on Western European Rainfall
Authors: Sousa Pedro M. , Ramos Alexandre M. , Raible Christoph C. , Messmer M. , Tomé Ricardo , Pinto Joaquim G. , Trigo Ricardo M.
Published: October 2019

Moisture transport over the northeastern Atlantic Ocean is an important process governing precipitation distribution and variability over western Europe. To assess its long-term variability, the vertically integrated horizontal water vapor transport (IVT) from a long-term climate simulation spanning the period 850–2100 CE was used. Results show a steady increase in moisture transport toward western Europe since the late-nineteenth century that is projected to expand during the twenty-first century under the RCP8.5 scenario. The projected IVT for 2070–99 significantly exceeds the range given by interannual–interdecadal variability of the last millennium. Changes in IVT are in line with significant increases in tropospheric moisture content, driven by the concurrent rise in surface temperatures associated with the anthropogenic climate trend. On regional scales, recent and projected precipitation changes over the British Isles follow the global positive IVT trend, whereas a robust precipitation decrease over Iberia is identified in the twenty-first century, particularly during autumn. This indicates a possible extension of stable and dry summer conditions and a decoupling between moisture availability and dynamical forcing. The investigation of circulation features reveals a mean poleward shift of moisture corridors and associated atmospheric rivers. In particular, in Iberia, a significant increase in the frequency of dry weather types is observed, accompanied by a decrease in the frequency of wet types. An opposite response is observed over the British Isles. These changes imply a stronger meridional north–south dipole in terms of pressure and precipitation distributions, enhancing the transport toward central Europe rather than to Iberia.
An Investigation of Large Along-Track Errors in Extratropical Transitioning North Atlantic Tropical Cyclones in the ECMWF Ensemble
Authors: Leonardo Nicholas M. , Colle Brian A.
Published: October 2019

The synoptic evolution and mechanisms for the largest medium-range (72–120 h) along-track errors of tropical cyclones (TC) are investigated. The mean along-track errors (ATEs) of the 51-member European Centre for Medium-Range Weather Forecasts (ECMWF) ensemble are evaluated for 393 forecasts (85 TCs) during the 2008 to 2016 North Atlantic seasons. The 27 unique forecasts within the upper quintile of most negative ATEs (i.e., slow bias greater than 500 km by 72 h) are inherently fast-moving TCs that undergo extratropical transition as they recurve and interact with a 300-hPa upstream trough and a downstream ridge. Both the trough and ridge are underamplified by only 5–10 m ~60 h before the time of largest ATE. The height errors then grow rapidly due to underpredicted 300–200-hPa potential vorticity advection by both the nondivergent wind and the irrotational wind from the TC’s outflow. Both wind components are underpredicted and result in weak biases in the trough’s developing potential vorticity gradient and associated jet streak. The underamplification of the upstream trough is exacerbated by underpredicted 700-hPa cold advection extending from beneath the trough into the TC at 48–36 h before the largest ATE. Standardized differences are consistent with the mean errors and reveal that weaker divergent outflow is driven by underpredicted near-TC precipitation, which corresponds to underpredicted 700-hPa moisture fluxes near the TC at ~108 h before the largest ATE. The ensemble member ATEs at 72–120 h generally show little correlation with their ATEs before 36 h, suggesting that initial position uncertainty is not the primary source of ATE variability later in the forecast.
Contrast, Commonality, and a Call for Clarity: A Review of the Use of Core Practices in Teacher Education
Authors: Grosser-Clarkson Dana , Neel Michael A.
Published: October 2019

In recent years, substantial resources have been invested in researching and describing the enactment of “core practices” of teaching in teacher education. This review of the literature examined more than 40 articles published between 2008 and August 2018 in an effort to determine how teacher educators are supporting teacher candidates to learn about and enact core practices of teaching. The review of the literature presented here demonstrates two distinct approaches that teacher educators use to introduce and prepare teacher candidates to enact core practices: a predesigned enactment approach and an open-design enactment approach. Our goal in identifying these two approaches is to illuminate the role and actions of teacher educators in core-practice work and to demonstrate that the decisions teacher educators make in core-practice work are complex and nuanced, and require further description than heretofore available.
Karl Marx, Le Capital
Authors: Outhwaite William , Smith Kenneth
Published: October 2019

This paper discusses the first French edition of Capital volume 1, revised by Marx, analyzed by Kevin Anderson (1983) in this journal and subsequent work, and partially incorporated into the new German edition by Thomas Kuczynski (2017), based largely on the second German edition. We argue that both Marx and Anderson are too generous (and Engels too negative) in their respective assessments of the translation and that it has found its appropriate place in the now definitive German version which will, we hope, be translated into other languages.
Connections to neighborhood storytellers and community-oriented emotional disclosure on Twitter during an emergency event
Authors: An Zheng , Mendiola-Smith Luana
Published: October 2019

From a communication infrastructure theory perspective, this study examined local residents’ connections to neighborhood storytellers and its association with community-oriented emotional disclosure, a specific form of neighborhood storytelling, during an emergency event. A sample of 1676 local residents and their Twitter activities were obtained from Twitter’s streaming application programming interface (API) during a 2-hour window after the event. A connection was established when the focal user retweeted, commented on, or replied to another user. The results show that scope of connections to residents, community organizations, and mainstream media positively predicted community-oriented disclosure of negative emotions. Scope of connections to residents positively predicted community-oriented disclosure of positive emotions. Scope of connections to local media did not predict community-oriented emotional disclosure.
Moxetumomab pasudotox for hairy cell leukemia: preclinical development to FDA approval
Authors: Lin Adam Yuh , Dinner Shira Naomi
Published: October 2019

Moxetumomab pasudotox (MP) is an immunotoxin that recently received US Food and Drug Administration (FDA) approval for the treatment of hairy cell leukemia (HCL) that has failed at least 2 prior lines of therapy, including a purine analog. MP is a recombinant immunotoxin that consists of an anti-CD22 immunoglobulin variable domain genetically joined to Pseudomonas exotoxin (PE38). Unlike most antibody-drug conjugates, which use a chemical linker, recombinant DNA techniques are used to produce MP. MP and its predecessor, BL22, were initially developed to treat non-Hodgkin lymphoma, acute lymphoblastic leukemia, and HCL. However, MP was found to be particularly effective in HCL due to the high level of CD22 cell-surface expression. The recent pivotal phase 3 trial of MP in relapsed/refractory HCL demonstrated a durable complete remission rate of 30%, and 85% of complete responders achieved minimal residual disease negativity, which is associated with improved disease-free survival outcomes in HCL. In addition to an exceptional depth of response, MP appears to be less immunosuppressive than purine analogs. MP is generally well tolerated but has unique toxicities, including capillary leak syndrome and hemolytic uremic syndrome, which are poorly understood. This review will encompass the preclinical and clinical development of MP, with particular attention to its current indication in HCL.
An updated phytoplankton check-list for the Helgoland Roads time series station with eleven new records of diatoms and dinoflagellates
Authors: Kraberg Alexandra , Kieb Ute , Peters Silvia , Wiltshire Karen Helen
Published: October 2019

The Helgoland Roads time series is one of the longest and most detailed time series in the world. It comprises daily phytoplankton counts accompanied by physico-chemical measurements. As such, it provides valuable long-term record of changes and their underlying causes in the phytoplankton community around Helgoland. This work provides an updated check-list of the phytoplankton species encountered at the Helgoland Roads LTER station with additional taxonomic assessments from live net samples and scanning electron microscope surveys. Since the last check-list was published 11 additional taxa have been recorded for the first time comprising 9 diatom and 2 dinoflagellate species. Of the 9 diatom species 3 were Chaetoceros species: Chaetoceros anastomosans, C. pseudocurvisetus and C. lorenzianus (the latter identified by their resting cysts) which were all first recognised in September 2009. The toxic dinoflagellate Dinophysis tripos, and the bipolar centric diatom Odontella longicruris both were first observed in September 2015. The latest new record is the potentially toxic dinoflagellate Alexandrium ostenfeldii, first recorded in August 2017. All of the first records (with the exception of Dinophysis tripos) were first observed in semi-quantitative surveys based on live samples and SEM demonstrating that adding less frequent but very detailed assessments can complement high frequency counts of fixed samples as long as these data of different origin are linked efficiently to the individual sampling event and all metadata including representative pictorial metadata are recorded in a consistent manner. In this manner the enhanced checklist serves as a baseline against which long-term changes in phytoplankton potentially related to ecosystem state can be addressed.
Heterogeneous BCR-ABL1 signal patterns identified by fluorescence in situ hybridization are associated with leukemic clonal evolution and poorer prognosis in BCR-ABL1 positive leukemia
Authors: Zhang Zhanglin , Chen Zhiwei , Jiang Mei , Liu Shuyuan , Guo Yang , Wan Lagen , Li Fei
Published: October 2019

Background

Although extensive use of tyrosine kinase inhibitors has resulted in high and durable response rate and prolonged survival time in patients with BCR-ABL1 positive chronic myeloid leukemia (CML) and acute leukemia, relapse and drug resistance still remain big challenges for clinicians. Monitoring the expression of BCR-ABL1 fusion gene and identifying ABL kinase mutations are effective means to predict disease relapse and resistance. However, the prognostic impact of BCR-ABL1 signal patterns detected by fluorescence in situ hybridization (FISH) remains largely unaddressed.

Methods

BCR-ABL1 signal patterns were analyzed using FISH in 243 CML-chronic phase (CML-CP), 17 CML-blast phase (CML-BP) and 52 BCR-ABL1 positive acute lymphoblastic leukemia (ALL) patients.

Results

The patterns of BCR-ABL1 signals presented complexity and diversity. A total of 12 BCR-ABL1 signals were observed in this cohort, including 1R1G2F, 1R1G1F, 2R1G1F, 1R2G1F, 2R2G1F, 1R2G2F, 1R1G3F, 1G3F, 2G3F, 1G4F, 1R1G4F and 1R4F. Complex BCR-ABL1 signal patterns (≥ two types of signal patterns) were observed in 52.9% (n = 9) of the CML-BP patients, followed by 30.8% (n = 16) of the ALL patients and only 2.1% (n = 5) of the CML-CP patients. More importantly, five clonal evolution patterns related to disease progression and relapse were observed, and patients with complex BCR-ABL1 signal patterns had a poorer overall survival (OS) time compared with those with single patterns (5.0 vs.15.0 months, p = 0.006).

Conclusions

Our data showed that complex BCR-ABL1 signal patterns were associated with leukemic clonal evolution and poorer prognosis in BCR-ABL1 positive leukemia. Monitoring BCR-ABL1 signal patterns might be an effective means to provide prognostic guidance and treatment choices for these patients.
Correction to: Informal healthcare provision in Lebanon: an adaptive mechanism among displaced Syrian health professionals in a protracted crisis
Authors: Honein-AbouHaidar Gladys , Noubani Aya , El Arnaout Nour , Ismail Sharif , Nimer Hana , Menassa Marilyne , Coutts Adam P. , Rayes Diana , Jomaa Lamis , Saleh Shadi , Fouad Fouad M.
Published: October 2019

The original publication of this article [1] contained an incomplete funding section. The full funding section is listed in this correction article. The missing information is indicated in bold.
Imaging of shoulder arthroplasties and their complications: a pictorial review
Authors: Combes Damien , Lancigu Romain , Desbordes de Cepoy Patrick , Caporilli-Razza Filippo , Hubert Laurent , Rony Louis , Aubé Christophe
Published: October 2019

Currently, an increasing number of patients benefit from shoulder prosthesis implantation. Radiologists are therefore more often confronted with imaging examinations involving shoulder arthroplasty, whether during a dedicated examination or incidentally. Standard radiography is the first-line imaging modality in the follow-up of these implants, before the possible use of cross-sectional imaging modalities (computed tomography and magnetic resonance imaging), ultrasound, or nuclear medicine examinations. Shoulder arthroplasties are divided into three categories: reverse shoulder arthroplasty, total shoulder arthroplasty, and partial shoulder joint replacement (including humeral hemiarthroplasty and humeral head resurfacing arthroplasty). Each of these prostheses can present complications, either shared by all types of arthroplasty or specific to each. Infection, periprosthetic fractures, humeral component loosening, heterotopic ossification, implant failure, and nerve injury can affect all types of prostheses. Instability, scapular notching, and acromial fractures can be identified after reverse shoulder arthroplasty implantation. Glenoid component loosening and rotator cuff tear are specific complications of total shoulder arthroplasty. Progressive wear of the native glenoid is the only specific complication observed in partial shoulder joint replacement. Knowledge of different types of shoulder prostheses and their complications’ radiological signs is crucial for the radiologist to initiate prompt and adequate management.
Agreement between simulated patients and faculty: Assessment of communication skills during objective structured clinical examination
Authors: Yousuf Farheen , Yousuf Naveed
Published: October 2019

Objective: Ensuring competence in communication skills amongst trainees is essential in health professions education. Involving faculty members for the same is a challenge in Obstetrics and Gynecology (OBGYN) due to their clinical commitments. The present study compares scores of OBGYN faculty, non-OBGYN faculty and simulated patients (SPs) on communication skills of postgraduate trainees during formative Objective Structured Clinical Examination (OSCE).

Methods: This is a psychometric study conducted in Feburary 2017 at the Aga Khan University Medical College (AKU-MC). All thirty-two postgraduate trainees of OBGYN gave consent. Each trainee was assessed by OBGYN faculty, non-OBGYN faculty and SP on communication skills at six stations using nine-point itemized rating-scale during formative OBGYN OSCE. The scores were reviewed using descriptive statistics, reliability was calculated using Cronbach’s alpha and inter-rater reliability was analyzed using Pearson correlation and intra-class correlation coefficient.

Results: The score reliability of each of the examiners was >0.7. The mean scores showed that OBGYN faculty were most stringent while SPs were lenient examiners, however, non-OBGYN faculty scored in between. The inter-rater reliability among any two of the OBGYN, non-OBGYN and SP examiner was >0.84 using Pearson correlation and >0.9 using intra-class correlation.Conclusion: The SPs and non-OBGYN clinical faculty can also be used to assess communication and counseling skills on OBGYN OSCEs after required training as examiners.

doi: https://doi.org/10.12669/pjms.35.6.1000

How to cite this:Yousuf F, Yousuf N. Agreement between simulated patients and faculty: Assessment of communication skills during objective structured clinical examination. Pak J Med Sci. 2019;35(6):1570-1574. doi: https://doi.org/10.12669/pjms.35.6.1000

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Presentation, diagnosis and management of locally advanced breast cancer: Is it different in low/middle income countries?
Authors: Manzoor Shahneela , Anwer Mariyah , Soomro Salim , Kumar Dileep
Published: October 2019

Background and Objective: Breast cancer incidence is increasing and it is highest in low income countries. The main challenge is regarding awareness, screening, late presentation and its management in a third-world country. Our objective was to share the experience faced in various presentations, diagnosis and management of locally advanced breast cancer (LABC) in a third world country and discuss if they are different with respect to developed countries.

Methods: It is a retrospective case series study performed at Jinnah Postgraduate Medical Centre Karachi, from January 2015 to December 2017, over period of three years. Data was collected from the record maintained by authors about patients presenting in breast clinic. Patients of breast cancer were managed in breast clinic over 3 years. Our study included patients who presented with LABC based on their clinical presentation confirmed by histopathological diagnosis and followed by surgical management. Statistical analysis for students t-test was performed using SPSS (version 20.0). A p-value less than 0.05 was considered statistically significant.

Results: One hundred twelve patients presented with LABC over period of 3 years. All but two were female. Mean age was 52 years (range 26-78 years), SD 18.96. On presentation size of tumor was 5cm & more in 103 (91.9%) patients. Involvement of axilla was in 86 (76.7%). Chest wall was involved in 22 (19.6%). Total T3 and T4 were 71 (63.3%) and 41 (36.6%) respectively Diagnosis of all patients was confirmed by histopathology. Neoadjuvant was given to all patients to downstage the tumor. ER/PR was positive in 46(41.1%), HER-2/neu positive in 31 (27.6%). On staging breast carcinoma was metastatic in 13(11.6%) with liver, lung and bone in 4 (3.5%), 3 (2.7%) and 6 (5.3%) respectively. Breast conservation was done in 6 (6.1%) patients, Modified Radical Mastectomy was done in 86 (86.9%), Radical Mastectomy in 3 (3.03%), Toilet Mastectomy in 4 (4.045) and 13 (11.6%) patients were not operated.

Conclusion: In our series 65% of all breast cancers are LABC at presentation. In low/middle income countries high percentage of LABC at presentation result in high metastatic disease, poor prognosis and limits conservation of breast. Awareness and education can improve outcomes.

doi: https://doi.org/10.12669/pjms.35.6.165

How to cite this:Manzoor S, Anwer M, Soomro S, Kumar D. Presentation, diagnosis and management of locally advanced breast cancer: Is it different in low/middle income countries (LMICs)?. Pak J Med Sci. 2019;35(6):1554-1557. doi: https://doi.org/10.12669/pjms.35.6.165

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.