bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Peace through strength’: Europe and NATO deterrence beyond the US Nuclear Posture Review
Authors: McCrisken Trevor , Downman Maxwell
Published: February 2019

With its 2018 Nuclear Posture Review, the Trump administration expanded the scope of US nuclear deterrence, re-emphasizing the importance of non-strategic nuclear weapons, perceptively lowering the threshold for nuclear use and casting doubt on the future of arms control. The authors argue that these changes are consistent with the administration's wider ‘peace through strength’ approach that draws on traditional Republican thinking on security policy. While designed to demonstrate credibility and resolve to both allies and adversaries, however, this assertive approach to security policy and specifically nuclear policy as a necessary precursor to renewed engagement in strategic negotiations may have unintended consequences. This article focuses on European reactions to the strategy and argues that the Trump administration's nuclear posture challenges common European understandings in three principal areas. First, changes to US declaratory policy contest European assumptions on the role of nuclear weapons in defending NATO. Second, US modernization plans and their implications for intra-alliance relations risk accentuating controversial debates about the US commitment to Europe. Third, the apparent US rejection of arms control widens the scope for discord with European leaders. If European leaders assert a clear and credible alternative vision advocating nuclear restraint, risk reduction and arms control they could rebuild trust and confidence between the United States, NATO and Russia, demonstrating real strength and ultimately leading to more genuine opportunities for peace and sustainable European security.
Dead heat: copepod carcass occurrence along the Japanese coasts and implications for a warming ocean
Authors: Tang K W , Ivory J A , Shimode S , Nishibe Y , Takahashi K
Published: February 2019

Understanding global warming effects on marine zooplankton is key to proper management of marine resources and fisheries. This is particularly urgent for Japan where the coastal water temperature has been increasing faster than the global average over the past decade. Conventional sampling and monitoring programmes, by ignoring the in situ vital status of the zooplankton, produce incomplete information about the state of the ecosystem. We showed that marine copepod carcasses were ubiquitous along a latitudinal gradient of 34–39°N of the Japanese coasts. On average, 4.4–18.1% of the individuals of the main copepod genera (Acartia, Paracalanus, Oithona, and Pseudocalanus) were carcasses, equivalent to 19–250 µg C m−3. Higher fractions of dead copepods tended to occur at higher water temperatures, implicating temperature-dependent non-predation mortality. Carcass occurrence may represent a loss of copepod production for the traditional predation-based food chain. On average, 49.5% of the carcass carbon would be remineralized in the water column via bacteria respiration, with the remainder potentially exported to the seafloor. Continuous warming in the Japanese coasts is expected to accelerate non-predation copepod mortality, with unknown consequences for the local marine food web.
Collocation methods for integro-differential algebraic equations with index 1
Authors: Liang Hui , Brunner Hermann
Published: February 2019

The notion of the tractability index based on the $\nu $-smoothing property of a Volterra integral operator is introduced for general systems of linear integro-differential algebraic equations (IDAEs). It is used to decouple the given IDAE system of index $1$ into the inherent system of regular Volterra integro-differential equations (VIDEs) and a system of second-kind Volterra integral equations (VIEs). This decoupling of the given general IDAE forms the basis for the convergence analysis of the two classes of piecewise polynomial collocation methods for solving the given index-$1$ IDAE system. The first one employs the same continuous piecewise polynomial space $S_m^{(0)}$ for both the VIDE part and the second-kind VIE part of the decoupled system. In the second one the VIDE part is discretized in $S_m^{(0)}$, but the second-kind VIE part employs the space of discontinuous piecewise polynomials $S_{m - 1}^{(- 1)}$. The optimal orders of convergence of these collocation methods are derived. For the first method, the collocation solution converges uniformly to the exact solution if and only if the collocation parameters satisfy a certain condition. This condition is no longer necessary for the second method; the collocation solution now converges to the exact solution for any choice of the collocation parameters. Numerical examples illustrate the theoretical results.
Nonuniqueness of Conformal Metrics With Constant Q-curvature
Authors: Bettiol Renato G , Piccione Paolo , Sire Yannick
Published: February 2019

We establish several nonuniqueness results for the problem of finding complete conformal metrics with constant (4th-order) $Q$-curvature on compact and noncompact manifolds of dimension $\geq 5$. Infinitely many branches of metrics with constant $Q$-curvature, but without constant scalar curvature, are found to bifurcate from Berger metrics on spheres and complex projective spaces. These provide examples of nonisometric metrics with the same constant negative $Q$-curvature in a conformal class with negative Yamabe invariant, echoing the absence of a maximum principle. We also discover infinitely many complete metrics with constant $Q$-curvature conformal to $\mathbb S^m\times \mathbb R^d$, $m\geq 4$, $d\geq 1$, and $\mathbb S^m\times \mathbb H^d$, $2\leq d\leq m-3$, which give infinitely many solutions to the singular constant $Q$-curvature problem on round spheres $\mathbb S^n$ blowing up along a round subsphere $\mathbb S^k$, for all $0\leq k<(n-4)/2$.
Positivity of Canonical Bases Under Comultiplication
Authors: Fan Zhaobing , Li Yiqiang
Published: February 2019

We show the positivity of the canonical basis for a modified quantum affine $\mathfrak{sl}_n$ under the comultiplication. Moreover, we establish the positivity of the i-canonical basis in [21] with respect to the coideal subalgebra structure.
Magnitude and Functionality of the NS1-Specific Antibody Response Elicited by a Live-Attenuated Tetravalent Dengue Vaccine Candidate
Authors: Sharma Mayuri , Glasner Dustin R , Watkins Heather , Puerta-Guardo Henry , Kassa Yoseph , Egan Michael A , Dean Hansi , Harris Eva
Published: February 2019

Background

Dengue virus (DENV) can cause life-threatening disease characterized by endothelial dysfunction and vascular leakage. DENV nonstructural protein 1 (NS1) induces human endothelial hyperpermeability and vascular leak in mice, and NS1 vaccination confers antibody-mediated protective immunity. We evaluated the magnitude, cross-reactivity, and functionality of NS1-specific IgG antibody responses in sera from a phase 2 clinical trial of Takeda’s live-attenuated tetravalent dengue vaccine candidate (TAK-003).

Methods

We developed an enzyme-linked immunosorbent assay to measure anti-DENV NS1 IgG in sera from DENV-naive or preimmune subjects pre- and postvaccination with TAK-003 and evaluated the functionality of this response using in vitro models of endothelial permeability.

Results

TAK-003 significantly increased DENV-2 NS1-specific IgG in naive individuals, which cross-reacted with DENV-1, -3, and -4 NS1 to varying extents. NS1-induced endothelial hyperpermeability was unaffected by prevaccination serum from naive subjects but was variably inhibited by serum from preimmune subjects. After TAK-003 vaccination, all samples from naive and preimmune vaccinees completely abrogated DENV-2 NS1-induced hyperpermeability and cross-inhibited hyperpermeability induced by DENV-1, -3, and -4 NS1. Inhibition of NS1-induced hyperpermeability correlated with NS1-specific IgG concentrations. Postvaccination sera also prevented NS1-induced degradation of endothelial glycocalyx components.

Conclusion

We provide evidence for functional NS1-specific IgG responses elicited by a candidate dengue vaccine.

Clinical Trials Registration

NCT01511250.
Generation of a common innate lymphoid cell progenitor requires interferon regulatory factor 2
Authors: Okubo Yohei , Tokumaru Shigeo , Yamamoto Yuta , Miyagawa Shin-ichi , Sanjo Hideki , Taki Shinsuke
Published: February 2019

Innate lymphoid cells (ILCs), composed of heterogeneous populations of lymphoid cells, contribute critically to immune surveillance at mucosal surfaces. ILC subsets develop from common lymphoid progenitors through stepwise lineage specification. However, the composition and temporal regulation of the transcription factor network governing such a process remain incompletely understood. Here, we report that deletion of the transcription factor interferon regulatory factor 2 (IRF-2), known also for its importance in the maturation of conventional NK cells, resulted in an impaired generation of ILC1, ILC2 and ILC3 subsets with lymphoid tissue inducer (LTi)-like cells hardly affected. In IRF-2-deficient mice, PD-1hi ILC precursors (ILCPs) that generate these three ILCs but not LTi-like cells were present at normal frequency, while their sub-population expressing high amounts of PLZF, another marker for ILCPs, was severely reduced. Notably, these IRF-2-deficient ILCPs contained normal quantities of PLZF-encoding Zbtb16 messages, and PLZF expression in developing invariant NKT cells within the thymus was unaffected in these mutant mice. These results point to a unique, cell-type selective role for IRF-2 in ILC development, acting at a discrete step critical for the generation of functionally competent ILCPs.
Interventions to increase patient portal use in vulnerable populations: a systematic review
Authors: Grossman Lisa V , Masterson Creber Ruth M , Benda Natalie C , Wright Drew , Vawdrey David K , Ancker Jessica S
Published: February 2019

Background

More than 100 studies document disparities in patient portal use among vulnerable populations. Developing and testing strategies to reduce disparities in use is essential to ensure portals benefit all populations.

Objective

To systematically review the impact of interventions designed to: (1) increase portal use or predictors of use in vulnerable patient populations, or (2) reduce disparities in use.

Materials and Methods

A librarian searched Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Reviews for studies published before September 1, 2018. Two reviewers independently selected English-language research articles that evaluated any interventions designed to impact an eligible outcome. One reviewer extracted data and categorized interventions, then another assessed accuracy. Two reviewers independently assessed risk of bias.

Results

Out of 18 included studies, 15 (83%) assessed an intervention's impact on portal use, 7 (39%) on predictors of use, and 1 (6%) on disparities in use. Most interventions studied focused on the individual (13 out of 26, 50%), as opposed to facilitating conditions, such as the tool, task, environment, or organization (SEIPS model). Twelve studies (67%) reported a statistically significant increase in portal use or predictors of use, or reduced disparities. Five studies (28%) had high or unclear risk of bias.

Conclusion

Individually focused interventions have the most evidence for increasing portal use in vulnerable populations. Interventions affecting other system elements (tool, task, environment, organization) have not been sufficiently studied to draw conclusions. Given the well-established evidence for disparities in use and the limited research on effective interventions, research should move beyond identifying disparities to systematically addressing them at multiple levels.
Role of provider encouragement on patient engagement via online portals
Authors: Shimoga Sandhya V , Lu Yang Z
Published: February 2019

Objective

The study sought to examine whether provider encouragement is associated with improvements in engaging patients with their healthcare processes using online portals.

Materials and Methods

Using the Health Information National Trends Survey 2017 (N = 2, 670), we conducted an exploratory factor analysis with varimax orthogonal rotation and derived 3 outcome variables on patient engagement: (1) information access score, (2) care convenience score, and (3) patient engagement score. Multivariable linear regression on each outcome variable was conducted with provider encouragement as the main predictor, controlling for patient demographics.

Results

Women (60%), white participants (69%), and those with a college degree (49%) were more likely to report receiving provider encouragement. Those who were encouraged to use patient portals scored higher on all 3 outcome measures compared with those who were not encouraged (B = 0 .80 vs B = 0.11 for information access, B = 1.13 vs B = 0.13 for care convenience, and B = 0.44 vs B = 0.05 for patient engagement; all P < .001). For every additional 100 patients receiving encouragement, 65 more information access tasks, 94 more care convenience tasks, and 40 more patient engagement tasks would be performed.

Discussion

Provider encouragement was most influential concerning care convenience tasks and least influential on complex decision-making tasks. This may be due to portal design and the content available to patients, which merit consideration in future studies.

Conclusions

Provider encouragement is associated with more patient engagement, as indicated by significantly higher utilization of patient portals for accessing information, participating in routine care processes, and making complex healthcare decisions.
Inaction in Macro-prudential Supervision: Assessing the EU’s Response
Authors: Schammo Pierre
Published: February 2019

In the macro-prudential literature, ‘inaction bias’ describes the supposed tendency of macro-prudential actors to favour inaction over action when considering the use of macro-prudential tools. While inaction bias is a topic of much interest in macro-prudential policy circles, it has received scant attention from legal scholarship. The aim of this article is to contribute to filling this gap by studying inaction in an EU macro-prudential context and by evaluating the institutional arrangements that were put in place in order to address so-called inaction bias. Several actors at the EU level have a role to play in macro-prudential supervision, especially the European Systemic Risk Board and the European Central Bank (ECB). This paper will assess their capabilities and their capacity to turn these into actions. The role of the ECB will be of particular interest since it was vested with real powers to address possible inaction bias among states participating in the Banking Union. Among other things, I will examine whether the ECB’s macro-prudential powers are the cure to the problems that are said to underpin inaction bias at the national level.
Genomic Perspective on Multivariate Variation, Pleiotropy, and Evolution
Authors: Melo Diogo , Marroig Gabriel , Wolf Jason B
Published: February 2019

Multivariate quantitative genetics provides a powerful framework for understanding patterns and processes of phenotypic evolution. Quantitative genetics parameters, like trait heritability or the G-matrix for sets of traits, can be used to predict evolutionary response or to understand the evolutionary history of a population. These population-level approaches have proven to be extremely successful, but the underlying genetics of multivariate variation and evolutionary change typically remain a black box. Establishing a deeper empirical understanding of how individual genetic effects lead to genetic (co)variation is then crucial to our understanding of the evolutionary process. To delve into this black box, we exploit an experimental population of mice composed from lineages derived by artificial selection. We develop an approach to estimate the multivariate effect of loci and characterize these vectors of effects in terms of their magnitude and alignment with the direction of evolutionary divergence. Using these estimates, we reconstruct the traits in the ancestral populations and quantify how much of the divergence is due to genetic effects. Finally, we also use these vectors to decompose patterns of genetic covariation and examine the relationship between these components and the corresponding distribution of pleiotropic effects. We find that additive effects are much larger than dominance effects and are more closely aligned with the direction of selection and divergence, with larger effects being more aligned than smaller effects. Pleiotropic effects are highly variable but are, on average, modular. These results are consistent with pleiotropy being partly shaped by selection while reflecting underlying developmental constraints.
Flight and Walking Performance of Dark Black Chafer Beetle Holotrichia parallela (Coleoptera: Scarabaeidae) in the Presence of Known Hosts and Attractive Nonhost Plants
Authors: Zhang Hongfei , Teng Xiaohui , Luo Qianwen , Sheng Ziyao , Guo Xianru , Wang Gaoping , Li Weizheng , Yuan Guohui
Published: February 2019

Holotrichia parallela damages seriously on peanut (Arachis hypogaea) pods. Elucidation of its flight and walking performance in the presence of different plants may provide an insight in its host selection process and an explanation to its strong olfactory preference to an attractive nonhost, castor bean (Ricinus communis). We determined the relationships among flight performance, mate choice, and body weight of H. parallela beetles, and then investigated their flight and walking patterns in the presence of known hosts and attractive nonhost plants using a flight mill and a locomotion compensator, respectively. Body weights were not related to mating success, regardless of sex. The flight proportion of selected females drastically decreased compared with nonselected females, nonselected males, and selected males. Within mated males, heavier individuals exhibited poorer flight performance than lighter ones. In flight bioassay, peanut showed an arrestment effect on virgin females. For walking activity factors (distance, time, and speed), the host plants velvetleaf (Abutilon theophrasti) and Siberian elm (Ulmus pumila) elicited the strongest responses in females and males, respectively. Interestingly, the most preferred adult host, Siberian elm, and the nonhost, castor bean, elicited the highest values of two orientation factors (orientation and upwind length) in females. The chemical similarity hypothesis, which states that feeding or oviposition of insects mistakenly on nonhost can be traced to their chemical similarity to actual hosts, could explain the attraction of H. parallela to castor bean.
Comment on: Price Discovery in High Resolution
Authors: Buccheri Giuseppe , Bormetti Giacomo , Corsi Fulvio , Lillo Fabrizio
Published: February 2019

This note is commenting on Hasbrouck (2018). The paper investigates the problem of price discovery on markets with trades recorded at sub-millisecond frequencies. The application of the popular information share measure of Hasbrouck (1995) to such data faces several difficulties, as the underlying vector error correction models would need a huge number of lags to capture dynamics at different time-scales. The problem is handled by imposing a set of restrictions on parameters inspired by the Heterogeneous Autoregressive model for realized volatility. We illustrate some potential drawbacks of the information share measure adopted in the paper and propose a modeling strategy aimed at dealing with such limitations. In particular, we introduce a structural multi-market model with a lagged adjustment mechanism describing lagged absorption of information across markets. The advantages of the method are shown in simulations.
Determination of the Critical Concentration of Rifabutin for Susceptibility Testing Using the Proportion Method with Löwenstein-Jensen Medium against Mycobacterium Tuberculosis Isolates
Authors: Dai Guangming , Chen Suting , Dong Lingling , Li Yun Xu , Huo Fengmin , Shang Yuanyuan , Huang Hairong
Published: February 2019

Objective

To determine the critical concentration of rifabutin (RFB) for susceptibility testing against Mycobacterium tuberculosis (Mtb) on Löwenstein-Jensen (L-J) medium using the proportion method.

Methods

We used 47 strains were used to determine the critical concentration of RFB. The microplate antimicrobial assay (MABA) was used as a reference method. We used 160 strains to evaluate its correlation with the classification results derived from the MABA method. We performed antimicrobial susceptibility testing (AST) against RFB and rifampin (RIF) for 2748 other strains using the proportion method on L-J medium.

Results

The determined critical concentration for RFB was 20 μg per mL. Identical classification as susceptible or resistant was observed in 93.8% and 92.5% strains for RFB and RIF, respectively, using the 2 different methods. The cross-resistance ratio between RFB and RIF was 72.7% in the 2748 Mtb strains.

Conclusions

We determined that a critical concentration of 20 μg per mL RFB was reliable for AST of Mtb.
Patterns in language: Text analysis of government reports on the Irish industrial school system with word embedding
Authors: Leavy Susan , Keane Mark T , Pine Emilie
Published: February 2019

Industrial Memories is a digital humanities initiative to supplement close readings of a government report with new distant readings, using text analytics techniques. The Ryan Report (2009), the official report of the Commission to Inquire into Child Abuse (CICA), details the systematic abuse of thousands of children from 1936 to 1999 in residential institutions run by religious orders and funded and overseen by the Irish State. Arguably, the sheer size of the Ryan Report—over 1 million words—warrants a new approach that blends close readings to witness its findings, with distant readings that help surface system-wide findings embedded in the Report. Although CICA has been lauded internationally for its work, many have critiqued the narrative form of the Ryan Report, for obfuscating key findings and providing poor systemic, statistical summaries that are crucial to evaluating the political and cultural context in which the abuse took place (Keenan, 2013, Child Sexual Abuse and the Catholic Church: Gender, Power, and Organizational Culture. Oxford University Press). In this article, we concentrate on describing the distant reading methodology we adopted, using machine learning and text-analytic methods and report on what they surfaced from the Report. The contribution of this work is threefold: (i) it shows how text analytics can be used to surface new patterns, summaries and results that were not apparent via close reading, (ii) it demonstrates how machine learning can be used to annotate text by using word embedding to compile domain-specific semantic lexicons for feature extraction and (iii) it demonstrates how digital humanities methods can be applied to an official state inquiry with social justice impact.
Cavities, shocks and a cold front around 3C 320
Authors: Vagshette Nilkanth D , Naik Sachindra , Patil Madhav K
Published: February 2019

We present results obtained from the analysis of a total of 110 ks of Chandra observations of the Fanaroff–Riley class II (FR II) radio galaxy 3C 320, located at the centre of a cluster of galaxies at redshift z = 0.342. A pair of X-ray cavities has been detected at an average distance of ∼38 kpc along the east and west directions, with cavity energy, age and total power equal to ∼7.7 × 1059 erg, ∼7 × 107 yr and ∼3.5 × 1044 erg s−1, respectively. The cooling luminosity within the cooling radius of ∼100 kpc was found to be Lcool ∼ 8.5 × 1043 erg s−1. Comparison of these two estimates (total cavity power and cooling luminosity) implies that the cavity power is sufficiently high to balance radiative loss. A pair of weak shocks has also been detected at distances of ∼47 and ∼76 kpc surrounding the radio bubbles. Using the observed density jumps of ∼1.8 and ∼2.1 at the shock locations along the east and west directions, we estimate the Mach numbers ($\mathcal {M}$) to be ∼1.6 and ∼1.8, respectively. A sharp surface-brightness edge was also detected at a relatively larger radius (∼80 kpc) along the south direction. The density jump at this surface-brightness edge was estimated to be ∼1.6 and it is probably due to the presence of a cold front in this cluster. The far-infrared luminosity yielded a star formation rate of 51 M⊙ yr−1, which is a quarter of the cooling rate ($\dot{M}$ ∼ 192 M⊙ yr−1).
The nuclear structural protein NuMA is a negative regulator of 53BP1 in DNA double-strand break repair
Authors: Salvador Moreno Naike , Liu Jing , Haas Karen M , Parker Laurie L , Chakraborty Chaitali , Kron Stephen J , Hodges Kurt , Miller Lance D , Langefeld Carl , Robinson Paul J , Lelièvre Sophie A , Vidi Pierre-Alexandre
Published: February 2019

P53-binding protein 1 (53BP1) mediates DNA repair pathway choice and promotes checkpoint activation. Chromatin marks induced by DNA double-strand breaks and recognized by 53BP1 enable focal accumulation of this multifunctional repair factor at damaged chromatin. Here, we unveil an additional level of regulation of 53BP1 outside repair foci. 53BP1 movements are constrained throughout the nucleoplasm and increase in response to DNA damage. 53BP1 interacts with the structural protein NuMA, which controls 53BP1 diffusion. This interaction, and colocalization between the two proteins in vitro and in breast tissues, is reduced after DNA damage. In cell lines and breast carcinoma NuMA prevents 53BP1 accumulation at DNA breaks, and high NuMA expression predicts better patient outcomes. Manipulating NuMA expression alters PARP inhibitor sensitivity of BRCA1-null cells, end-joining activity, and immunoglobulin class switching that rely on 53BP1. We propose a mechanism involving the sequestration of 53BP1 by NuMA in the absence of DNA damage. Such a mechanism may have evolved to disable repair functions and may be a decisive factor for tumor responses to genotoxic treatments.
Is Admission Lipoprotein-Associated Phospholipase A2 a Novel Predictor of Vasospasm and Outcome in Patients With Aneurysmal Subarachnoid Hemorrhage?
Authors: Ding Chen-Yu , Cai Han-Pei , Ge Hong-Liang , Yu Liang-Hong , Lin Yuang-Xiang , Kang De-Zhi
Published: February 2019

BACKGROUND

The relationships between lipoprotein-associated phospholipase A2 (Lp-PLA2) level, vasospasm, and clinical outcome of patients with aneurysmal subarachnoid hemorrhage (aSAH) are still unclear.

OBJECTIVE

To identify the associations between admission Lp-PLA2 and vasospasm following subarachnoid hemorrhage and the clinical outcome of aSAH.

METHODS

A total of 103 aSAH patients who had Lp-PLA2 level obtained within 24 h postbleeding were included. The relationships between Lp-PLA2 level, vasospasm, and clinical outcome were analyzed.

RESULTS

Vasospasm was observed in 52 patients (50.49%). Patients with vasospasm had significantly higher Lp-PLA2 level than those without (P < .001). Both modified Fisher grade (P = .014) and Lp-PLA2 level (P < .001) were significant predictors associated with vasospasm. The Z test revealed that power of Lp-PLA2 was significantly higher than that of modified Fisher grade in predicting vasospasm (Z = 2.499, P = .012). At 6-mo follow-up, 44 patients (42.72%) had unfavorable outcome and 36 patients (34.95%) died. The World Federation of Neurosurgical Societies (WFNS) grade and Lp-PLA2 level were both significant predictors associated with 6-mo unfavorable outcome and mortality (all P < .001). The predictive values of Lp-PLA2 for unfavorable outcome and mortality at 6-mo tended to be lower than those of the WFNS grade, but the differences were not statistically significant (P = .366 and 0.115, respectively). Poor-grade patients having Lp-PLA2 > 200 μg/L had significantly worse 6-mo survival rate than poor-grade patients having Lp-PLA2 ≤ 200 μg/L (P = .001).

CONCLUSION

The Lp-PLA2 might be useful as a novel predictor in aSAH patients. A total of 30 poor-grade patients; those with elevated Lp-PLA2 level have higher risk of 6-mo mortality compared to those without.
Predicting 90-Day and 1-Year Mortality in Spinal Metastatic Disease: Development and Internal Validation
Authors: Karhade Aditya V , Thio Quirina C B S , Ogink Paul T , Bono Christopher M , Ferrone Marco L , Oh Kevin S , Saylor Philip J , Schoenfeld Andrew J , Shin John H , Harris Mitchel B , Schwab Joseph H
Published: February 2019

BACKGROUND

Increasing prevalence of metastatic disease has been accompanied by increasing rates of surgical intervention. Current tools have poor to fair predictive performance for intermediate (90-d) and long-term (1-yr) mortality.

OBJECTIVE

To develop predictive algorithms for spinal metastatic disease at these time points and to provide patient-specific explanations of the predictions generated by these algorithms.

METHODS

Retrospective review was conducted at 2 large academic medical centers to identify patients undergoing initial operative management for spinal metastatic disease between January 2000 and December 2016. Five models (penalized logistic regression, random forest, stochastic gradient boosting, neural network, and support vector machine) were developed to predict 90-d and 1-yr mortality.

RESULTS

Overall, 732 patients were identified with 90-d and 1-yr mortality rates of 181 (25.1%) and 385 (54.3%), respectively. The stochastic gradient boosting algorithm had the best performance for 90-d mortality and 1-yr mortality. On global variable importance assessment, albumin, primary tumor histology, and performance status were the 3 most important predictors of 90-d mortality. The final models were incorporated into an open access web application able to provide predictions as well as patient-specific explanations of the results generated by the algorithms. The application can be found at https://sorg-apps.shinyapps.io/spinemetssurvival/

CONCLUSION

Preoperative estimation of 90-d and 1-yr mortality was achieved with assessment of more flexible modeling techniques such as machine learning. Integration of these models into applications and patient-centered explanations of predictions represent opportunities for incorporation into healthcare systems as decision tools in the future.
Overview of Mechanical Thrombectomy Techniques
Authors: Munich Stephan A , Vakharia Kunal , Levy Elad I
Published: February 2019

The recently reported superiority of mechanical thrombectomy to intravenous thrombolytics has jettisoned endovascular intervention into the forefront of acute ischemic stroke (AIS) management. These successes have allowed a chance for recanalization for patients not meeting the strict eligibility criteria for intravenous thrombolytics. Stent retrieval and aspiration have emerged as two of the most popular and effective approaches for AIS thrombectomy. Since the beginning of mechanical thrombectomy with the Merci device (Stryker) and first-generation Penumbra aspiration system (Penumbra Inc), contemporary techniques have demonstrated reliable recanalization and improved clinical outcomes. Here, we review the use of stent retrieval and aspiration, as well as their synergy, in the management of AIS.
Pain Outcomes Following Microvascular Decompression for Drug-Resistant Trigeminal Neuralgia: A Systematic Review and Meta-Analysis
Authors: Holste Katherine , Chan Alvin Y , Rolston John D , Englot Dario J
Published: February 2019

BACKGROUND

Microvascular decompression (MVD) is a potentially curative surgery for drug-resistant trigeminal neuralgia (TN). Predictors of pain freedom after MVD are not fully understood.

OBJECTIVE

To describe rates and predictors for pain freedom following MVD.

METHODS

Using preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, PubMed, Cochrane Library, and Scopus were queried for primary studies examining pain outcomes after MVD for TN published between 1988 and March 2018. Potential biases were assessed for included studies. Pain freedom (ie, Barrow Neurological Institute score of 1) at last follow-up was the primary outcome measure. Variables associated with pain freedom on preliminary analysis underwent formal meta-analysis. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for possible predictors.

RESULTS

Outcome data were analyzed for 3897 patients from 46 studies (7 prospective, 39 retrospective). Overall, 76.0% of patients achieved pain freedom after MVD with a mean follow-up of 1.7 ± 1.3 (standard deviation) yr. Predictors of pain freedom on meta-analysis using random effects models included (1) disease duration ≤5 yr (OR = 2.06, 95% CI = 1.08-3.95); (2) arterial compression over venous or other (OR = 3.35, 95% CI = 1.91-5.88); (3) superior cerebellar artery involvement (OR = 2.02, 95% CI = 1.02-4.03), and (4) type 1 Burchiel classification (OR = 2.49, 95% CI = 1.32-4.67).

CONCLUSION

Approximately three-quarters of patients with drug-resistant TN achieve pain freedom after MVD. Shorter disease duration, arterial compression, and type 1 Burchiel classification may predict more favorable outcome. These results may improve patient selection and provider expectations.
Magnetoelectricity in multiferroics: a theoretical perspective
Authors: Dong Shuai , Xiang Hongjun , Dagotto Elbio
Published: February 2019

The key physical property of multiferroic materials is the existence of coupling between magnetism and polarization, i.e. magnetoelectricity. The origin and manifestations of magnetoelectricity can be very different in the available plethora of multiferroic systems, with multiple possible mechanisms hidden behind the phenomena. In this review, we describe the fundamental physics that causes magnetoelectricity from a theoretical viewpoint. The present review will focus on mainstream physical mechanisms in both single-phase multiferroics and magnetoelectric heterostructures. The most recent tendencies addressing possible new magnetoelectric mechanisms will also be briefly outlined.
Parliamentary Representation: A Cross-national Study of Candidates’ Views
Authors: Sudulich Laura , Trumm Siim , Bridgewater Jack
Published: February 2019

This study explores political elites’ self-conceptualisation of parliamentary representation by using data on nearly 7000 candidates encompassing 18 elections in 15 countries. We examine the relevance of institutional features, closeness to the sources of representatives’ mandates, party family, as well as candidates’ personal characteristics, with a modelling strategy that accommodates the understanding of role orientation as a two-stage process. We posit that choosing between being loyal to a party or to voters is not equivalent to prioritising one’s own agency in the first place, and suggest that self-conceptualisation of parliamentary representation happens in two different stages. We find that individual-level characteristics such as gender and ideological proximity to one’s party, but also party family, play a key role in shaping views on authority versus independence. The effects of political environment and institutions are limited to shaping a choice between responding to one’s party or constituents.
The Prevalence, Impact, and Risk Factors for Persistent Pain After Breast Cancer Surgery in a New Zealand Population
Authors: Chiang Daniel L C , Rice David A , Helsby Nuala A , Somogyi Andrew A , Kluger Michal T
Published: February 2019

Objective

Few Australasian studies have assessed persistent pain after breast cancer surgery. This study aims to evaluate the prevalence, impact, and risk factors of moderate to severe persistent pain after breast cancer surgery in a New Zealand population.

Methods

Retrospective cross-sectional study of patients who underwent breast cancer surgery between six and 48 months previously. Validated questionnaires were used to assess pain prevalence and impact, psychological distress, and upper limb function. Patients’ clinical records were assessed for potential risk factors.

Results

Of the 375 patients who were sent questionnaires, 201 were included in the study. More than half of the patients (N = 111, 55%) reported breast surgery related–persistent pain, with 46 (23%) rating the pain as moderate to severe. Neuropathic pain was reported by 21 (46%) patients with moderate to severe pain. Pain interference, upper limb dysfunction, and psychological distress were significantly higher in patients with moderate to severe pain (P < 0.001). Non-European ethnicity (odds ratio [OR] = 5.02, 95% confidence interval [CI] = 2.05–12.25, P < 0.001), reconstruction surgery (OR = 4.10, 95% CI = 1.30–13.00, P = 0.02), and axillary node dissection (OR = 4.33, 95% CI = 1.19–15.73, P < 0.03) were identified as risk factors for moderate to severe pain by multivariate logistic regression analysis.

Conclusions

Moderate to severe persistent pain after breast cancer surgery affects many New Zealand patients, and is associated with impaired daily life activities, physical disability, and psychological distress. Large numbers of patients undergo breast cancer surgery annually. This study emphasizes the importance of identification and management of these patients perioperatively.
Conditional Recommendations for Specific Dietary Ingredients as an Approach to Chronic Musculoskeletal Pain: Evidence-Based Decision Aid for Health Care Providers, Participants, and Policy Makers
Authors: Boyd Courtney , Crawford Cindy , Berry Kevin , Deuster Patricia ,   the HERB Working Group
Published: February 2019

Objective

Approximately 55–76% of Service members use dietary supplements for various reasons; although such use has become popular for a wide range of pain conditions, decisions to use supplements are often driven by information that is not evidence-based. This work evaluates whether the current research on dietary ingredients for chronic musculoskeletal pain provides sufficient evidence to inform decisions for practice and self-care, specifically for Special Operations Forces personnel.

Methods

A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. GRADE was used to determine confidence in the effect estimates. A decision table was constructed to make evidence-informed judgments across factors required for decision-making, and recommendations were made for practice and self-care use.

Results

Nineteen dietary ingredients were included. Conditional evidence-based recommendations were made for the use of avocado soybean unsaponifiables, capsaicin, curcuma, ginger, glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D. In these cases, desirable effects outweighed undesirable effects, but there was uncertainty about the trade-offs, either because the evidence was low quality or because benefits and downsides were closely balanced.

Conclusions

The evidence showed that certain dietary ingredients, when taken as part of a balanced diet and/or as a supplement (e.g., pill, tablet, capsule, cream), may alleviate musculoskeletal pain with no to minimal risk of harm. This finding emphasizes and reinforces the critical importance of shared decision-making between Operators and their health care providers.
Integrating Adjuvant Analgesics into Perioperative Pain Practice: Results from an Academic Medical Center
Authors: Chin Kuo-Kai , Carroll Ian , Desai Karishma , Asch Steven , Seto Tina , McDonald Kathryn M , Curtin Catherine , Hernandez-Boussard Tina
Published: February 2019

Background

Opioid-sparing postoperative pain management therapies are important considering the opioid epidemic. Total knee arthroplasty (TKA) is a common and painful procedure accounting for a large number of opioid prescriptions. Adjuvant analgesics, nonopioid drugs with primary indications other than pain, have shown beneficial pain management and opioid-sparing effects following TKA in clinical trials. We evaluated the adjuvant analgesic gabapentin for its usage patterns and its effects on opioid use, pain, and readmissions.

Methods

This retrospective, observational study included 4,046 patients who received primary TKA between 2009 and 2017 using electronic health records from an academic tertiary care medical institute. Descriptive statistics and multivariate modeling were used to estimate associations between inpatient gabapentin use and adverse pain outcomes as well as inpatient oral morphine equivalents per day (OME).

Results

Overall, there was an 8.72% annual increase in gabapentin use (P < 0.001). Modeled estimates suggest that gabapentin is associated with a significant decrease in opioid consumption (estimate = 0.63, 95% confidence interval = 0.49–0.82, P < 0.001) when controlling for patient characteristics. Patients receiving gabapentin had similar discharge pain scores, follow-up pain scores, and 30-day unplanned readmission rates compared with patients receiving no adjuvant analgesics (P > 0.05).

Conclusions

When assessed in a real-world setting over a large cohort of TKA patients, gabapentin is an effective pain management therapy that is associated with reduced opioid consumption—a national priority in this time of opioid crisis—while maintaining the same quality of pain management.
Interviewer Involvement in Sample Selection Shapes the Relationship Between Response Rates and Data Quality
Authors: Eckman Stephanie , Koch Achim
Published: February 2019

Several studies have shown that high response rates are not associated with low bias in survey data. This paper shows that, for face-to-face surveys, the relationship between response rates and bias is moderated by the type of sampling method used. Using data from Rounds 1 through 7 of the European Social Survey, we develop two measures of selection bias, then build models to explore how sampling method, response rate, and their interaction affect selection bias. When interviewers are involved in selecting the sample of households or respondents for the survey, high reported response rates can in fact be a sign of poor data quality. We speculate that the positive association detected between response rates and selection bias is because of interviewers’ incentives to select households and respondents who are likely to complete the survey.
Do Exercise Interventions Improve Balance for Children and Adolescents With Down Syndrome? A Systematic Review
Authors: Maïano Christophe , Hue Olivier , Lepage Geneviève , Morin Alexandre J S , Tracey Danielle , Moullec Grégory
Published: February 2019

Background

Youths with Down syndrome are characterized by deficits in balance/postural stability. One way to palliate balance deficits among this population is through exercise interventions. However, to the authors’ knowledge, the effects of exercise interventions designed to improve the balance of youths with Down syndrome have never been systematically reviewed.

Purpose

The purpose of this review was to summarize the findings from studies examining the effects of exercise interventions designed to improve balance in youths with Down syndrome.

Data Sources

A systematic literature search was performed in 10 databases (Academic Search Complete, CINAHL Plus With Full-Text, Education Source, ERIC, Medline With Full-Text, PsycARTICLES, Psychology and Behavioral Sciences Collection, Scopus, SocINDEX, and SPORTDiscus With Full-Text) on June 12, 2017.

Study Selection

Randomized controlled trials and controlled trials examining the effects of exercise interventions designed to improve balance in youths with Down syndrome were included.

Data Extraction

Two authors selected the studies and extracted their characteristics and results. Three authors assessed the risk of bias in the studies using the Cochrane Collaboration tool.

Data Synthesis

Eleven studies, published between 2010 and 2017, met the inclusion criteria. The findings showed that exercise interventions were more effective than control conditions for improving the static balance of children with Down syndrome and the static-dynamic balance (ie, global balance score obtained with a scale measuring both static and dynamic balance) of children and adolescents with Down syndrome. Nevertheless, the findings on dynamic balance in children and static balance in adolescents were inconclusive.

Limitations

With a small number of studies and their high risk of bias, the present findings must be interpreted with caution.

Conclusions

The reviewed exercise interventions were successful in improving the static balance of children with Down syndrome and the static-dynamic balance of children and adolescents with Down syndrome.
Gender Expertise in Public Policymaking: The European Women’s Lobby and the EU Maternity Leave Directive
Authors: Seibicke Helena
Published: February 2019

Civil society organizations are involved in EU policymaking processes, but are faced with the potential dilemma of providing efficient expertise while at the same time advocating for their interests. This article asks whether the European Women’s Lobby, an EU-level umbrella organization representing women’s interests, manages this inbuilt tension by empirically investigating the balancing of three different types of expertise-based claims (procedural, technical, and normative) in a concrete instance of policymaking, namely the European Maternity Leave Directive. The analysis shows that although the EWL engaged in technical expertise provision, it infused the policy process with normative expertise-based claims.
Genome-Wide Association Study of Resistance to Xanthomonas gardneri in the USDA Pepper (Capsicum) Collection
Authors: Potnis Neha , Branham Sandra E. , Jones Jeffery B. , Wechter W. Patrick
Published: February 2019

Bacterial spot Xanthomonas species cause significant disease outbreaks on tomato and pepper in tropical and subtropical regions throughout the world. Host resistance has been one of the key components of integrated disease management approaches to mitigate plant pathogens. Although a number of resistance genes have been identified in pepper against bacterial spot xanthomonads, emergence of bacterial spot pathogen variants capable of overcoming these sources and changing pathogen distributions reinforce the importance of identifying novel candidates to incorporate into breeding programs. We conducted a genome-wide association study (GWAS) on a diverse U.S. Department of Agriculture collection of pepper germplasm including different species of Capsicum to identify novel sources of disease resistance against a highly virulent X. gardneri strain isolated from a recent outbreak. GWAS identified highly significant single nucleotide polymorphisms associated with defoliation in response to infection with X. gardneri. Functionally relevant candidate genes encoded products involved in disease resistance/susceptibility, hormone signaling, and basal resistance against multiple pathogens in various host-pathogen systems. The X. gardneri-resistant genotypes and quantitative trait loci identified in this study provide alleles that could be used for a resistance gene pyramiding effort against different species of bacterial spot xanthomonads in pepper.