bluuebunny/crossref_metadata_2025 huggingface dataset:
Interaction between a Vertical Turbulent Jet and a Thermocline
Authors: Ezhova Ekaterina , Cenedese Claudia , Brandt Luca
Published: September 2016

The behavior of an axisymmetric vertical turbulent jet in an unconfined stratified environment is studied by means of well-resolved, large-eddy simulations. The stratification is two uniform layers separated by a thermocline. This study considers two cases: when the thermocline thickness is small and on the order of the jet diameter at the thermocline entrance. The Froude number of the jet at the thermocline varies from 0.6 to 1.9, corresponding to the class of weak fountains. The mean jet penetration, stratified turbulent entrainment, jet oscillations, and the generation of internal waves are examined. The mean jet penetration is predicted well by a simple model based on the conservation of the source energy in the thermocline. The entrainment coefficient for the thin thermocline is consistent with the theoretical model for a two-layer stratification with a sharp interface, while for the thick thermocline entrainment is larger at low Froude numbers. The data reveal the presence of a secondary horizontal flow in the upper part of the thick thermocline, resulting in the entrainment of fluid from the thermocline rather than from the upper stratification layer. The spectra of the jet oscillations in the thermocline display two peaks, at the same frequencies for both stratifications at fixed Froude number. For the thick thermocline, internal waves are generated only at the lower frequency, since the higher peak exceeds the maximal buoyancy frequency. For the thin thermocline, conversely, the spectra of the internal waves show the two peaks at low Froude numbers, whereas only one peak at the lower frequency is observed at higher Froude numbers.
Monthly and Seasonal Rainfall Forecasting in Southern Brazil Using Multiple Discriminant Analysis
Authors: Viana Denilson Ribeiro , Sansigolo Clóvis Angeli
Published: September 2016

A multiple discriminant analysis was employed to forecast monthly and seasonal rainfall in southern Brazil. The methodology used includes six steps: data acquisition, preprocessing, feature extraction, feature selection, classification, and evaluation. The predictors (atmospheric, surface, and oceanic variables) and predictand (rainfall) were obtained from the Twentieth Century Reanalysis (version 2), as well as from the HadISST1 (Met Office Hadley Centre) and Global Precipitation Climatology Centre (GPCC) databases. The definition of key regions (feature extraction step) was performed using spatial principal component analysis. In the selection step, the rainfall time series were allocated into terciles, which were related to the predictors via multiple discriminating analyses. The results revealed that ⅓ of the predictors are associated with atmospheric pressure and also emphasized the role of atmospheric circulation over the Antarctic region and its surroundings. Surface variables (albedo and soil moisture) were also of great importance in the forecasting. The average skill score (gain over climatology) was 29%. It is concluded that the proposed model is a reliable alternative for use in forecasting monthly and seasonal rainfall over southern Brazil.
Patterns of Intimate Partner Violence victimization among Australia and New Zealand female university students: An initial examination of child maltreatment and self-reported depressive symptoms across profiles
Authors: Cale Jesse , Tzoumakis Stacy , Leclerc Benoit , Breckenridge Jan
Published: September 2016

The aim of this study was to examine the relationship between child abuse, depression, and patterns of Intimate Partner Violence victimization among female university students in Australia and New Zealand. Data were based on the Australia/New Zealand portion of the International Dating Violence Study (2001–2005) (n = 293). Using Latent Class Analysis, Low-, Moderate-, and High-level Intimate Partner Violence profiles were identified that differed according to the variety, degree, and severity of Intimate Partner Violence. Furthermore, the combination of child maltreatment and self-reported depressive symptoms differed across profiles. The results highlighted differential pathways from child maltreatment to specific Intimate Partner Violence victimization patterns. These findings provide further evidence for the importance of early intervention strategies to prevent Intimate Partner Violence, and specifically for children who experience abuse and neglect to help prevent subsequent victimization experiences in intimate relationship contexts.
Cognitive Load Reduces Perceived Linguistic Convergence Between Dyads
Authors: Abel Jennifer , Babel Molly
Published: September 2016

Speech convergence is the tendency of talkers to become more similar to someone they are listening or talking to, whether that person is a conversational partner or merely a voice heard repeating words. To elucidate the nature of the mechanisms underlying convergence, this study uses different levels of task difficulty on speech convergence within dyads collaborating on a task. Dyad members had to build identical LEGO® constructions without being able to see each other’s construction, and with each member having half of the instructions required to complete the construction. Three levels of task difficulty were created, with five dyads at each level (30 participants total). Task difficulty was also measured using completion time and error rate. Listeners who heard pairs of utterances from each dyad judged convergence to be occurring in the Easy condition and to a lesser extent in the Medium condition, but not in the Hard condition. Amplitude envelope acoustic similarity analyses of the same utterance pairs showed that convergence occurred in dyads with shorter completion times and lower error rates. Together, these results suggest that while speech convergence is a highly variable behavior, it may occur more in contexts of low cognitive load. The relevance of these results for the current automatic and socially-driven models of convergence is discussed.
Neighbourhood differences in retail turnover: Evidence from New York City
Authors: Meltzer Rachel , Capperis Sean
Published: September 2016

Urban neighbourhoods are defined as much by their commercial character as their residential; retail services not only provide material needs for those living nearby, but less-tangible social and cultural capital as well. It is reasonable to expect, then, that excessive churn in these businesses can threaten the stability of a neighbourhood. Using a longitudinal data set on mixed-use neighbourhoods in New York City, we test whether or not neighbourhoods of varying circumstances and characteristics experience different degrees and types of retail turnover. Results suggest that there are meaningful differences in retail turnover across neighbourhoods. Retail turnover is directly associated with the type of business activity, commercial infrastructure and the neighbourhood’s consumer profile. However, when all three sets of factors are considered simultaneously in a regression analysis, consumer-related characteristics explain turnover more than those related to the local commercial environment. Specifically, businesses that provide necessity and more frequently consumed goods/services are more stable and chain establishments are more likely to venture into markets with some housing price discounts, growth potential and possibly less organised opposition. Neighbourhoods with less (and more heterogeneous) general retail (as opposed to food service) concentration, as well as bigger businesses, are more stable. More importantly, bigger households and higher shares of white residents are most strongly associated with less retail churn, and population growth is the strongest predictor of more turnover.
Sensitivity to reward and punishment: Associations with fat and sugar intake among South African students
Authors: Hunt Xanthe , Nespola Angelic , Tapper Katy , Kagee Ashraf
Published: September 2016

This study examined whether higher sensitivity to reward predicted higher fat and sugar intake among a sample of South African students at a university in the Western Cape and explored whether this relationship was mediated by food cue responsivity. It also examined whether sensitivity to punishment predicted higher fat and sugar intake among those who eat in response to anxiety. University students ( n = 320) completed a series of questionnaires that measured sensitivity to reward and punishment, diet, their tendency towards hedonic eating, and their tendency towards eating in response to anxiety. Results showed that higher sensitivity to reward predicted higher fat intake. This relationship was partially mediated by eating in response to food-rich environments (hedonic eating). Sensitivity to punishment failed to predict diet. The results of this study add to the growing body of evidence showing a relationship between sensitivity to reward and eating behaviours, and how this relationship might play out in a university environment.
Validation of the Distress Thermometer and Problem List in Patients with Recurrent Respiratory Papillomatosis
Authors: San Giorgi Michel R. M. , Aaltonen Leena‐Maija , Rihkanen Heikki , Tjon Pian Gi Robin E. A. , van der Laan Bernard F. A. M. , Hoekstra‐Weebers Josette E. H. M. , Dikkers Frederik G.
Published: September 2016

Objective

There is no specific clinical tool for physicians to detect psychosocial and physical distress or health care need in patients with recurrent respiratory papillomatosis (RRP). The main aim of this study is to validate the RRP‐adapted Distress Thermometer and Problem List (DT&PL).

Study Design

Prospective cross‐sectional questionnaire research.

Setting

Academic tertiary care medical centers in Groningen, Netherlands, and Helsinki, Finland.

Subjects and Methods

Ninety‐one juvenile‐ and adult‐onset RRP patients participated from the departments of otorhinolaryngology–head and neck surgery of the University Medical Center Groningen, Netherlands, and Helsinki University Hospital, Finland. The Hospital Anxiety and Depression Scale was used as the gold standard.

Results

A DT cutoff score ≥4 gave the best sensitivity and specificity. Thirty‐one percent of patients had significant distress according to the DT cutoff. Significantly more patients with a score above than under the cutoff had a referral wish. The PL appeared to be reliable. Patients’ opinions on the DT&PL were largely favorable.

Conclusion

The Dutch and Finnish versions of the DT&PL are valid, reliable screening tools for distress in RRP patients.
Novel Dissection Station for Endolaryngeal Microsurgery and Laser Surgery: Development and Dissection Course Experience
Authors: Mattioli Francesco , Presutti Livio , Caversaccio Marco , Bonali Marco , Anschuetz Lukas
Published: September 2016

Objective

We aimed to develop and validate an ex vivo dissection station for endolaryngeal surgery suitable for different kinds of laryngeal specimen and any type of operating technique (CO2 laser, cold instruments by endoscopic or microscopic techniques).

Study Design

Experimental construction and validation of a highly specialized dissection station.

Setting

Laboratory and international dissection course.

Methods

We designed a lightweight dissection station made of polycarbonate resin approved for use with a CO2 laser. The cylindrical box hosts an articulated laryngeal support. The laryngoscope is positioned on an articulated arm, which is fixed on the construction’s footplate. Validation of the larynx box was performed during an international dissection course on laryngeal surgery held in January 2016.

Results

We assessed the suitability of our novel dissection station among specialized laryngologists with a mean experience of 14 years. Feedback from the participants was very positive, with a mean general impression of 9.5 (out of 10 points) and a recommendation score of 9.6 for further use. Its utility in transforming the taught surgical steps into daily practice has been highly recognized, with a score of 9.5.

Conclusion

The lightweight and transparent larynx box is suitable for any kind of laryngeal specimen, and any surgical intervention can be taught at reasonable cost. It is safe and suitable for use with CO2 lasers. Validation among experienced surgeons revealed its suitability in the teaching of endolaryngeal microsurgery and laser surgery.
Can the multiphasic computed tomography be useful in the clinical management of small renal masses?
Authors: Gaudiano Caterina , Schiavina Riccardo , Vagnoni Valerio , Busato Fiorenza , Borghesi Marco , Bandini Marco , Di Carlo Maddalena , Brunocilla Eugenio , Martorana Giuseppe , Golfieri Rita
Published: September 2016

Background

Small renal masses (SRMs; ≤4 cm) represent a challenging issue. Computed tomography (CT) is widely used for investigating renal tumors even if its ability to differentiate among the different subtypes has not yet been definitively established.

Purpose

To assess the potential role of the morphological features and angiodynamic behavior on multiphasic CT in the preoperative evaluation of SRMs.

Material and Methods

The CT images of 80 patients with SRMs who underwent surgical resection at our institution were retrospectively reviewed. The morphological features, the pattern, and the quantitative analysis of enhancement were assessed for each lesion and were correlated with the histological subtypes.

Results

Overall, 81 SRMs were evaluated. Final pathological examination showed 30 (37%) oncocytomas, 22 (27.2%) clear cell renal cell carcinomas (ccRCCs), 16 (19.8%) papillary RCCs (pRCCs), and 13 (16%) chromophobe RCCs (chRCCs). Of the morphological features, only necrosis was significantly associated with ccRCC ( P = 0.047). The analysis of enhancement allowed the identification of two groups of lesions, based on arterial behavior: hypervascular (oncocytomas/ccRCC) and hypovascular (chRCC/pRCC) lesions. A significant difference between the two groups in terms of degree of enhancement on CT phases was found ( P < 0.05); this was also confirmed by the receiver operating characteristic (ROC) analysis.

Conclusion

Except for necrosis, the morphological features are not useful in making a correct diagnosis in the case of SRMs. The angiodynamic behavior on multiphasic CT showed high accuracy in differentiating between hypovascular and hypervascular tumors; this differentiation could be useful for deciding on the most appropriate clinical management of SRMs.
PROPER: Development of an Early Pediatric Intensive Care Unit Readmission Risk Prediction Tool
Authors: Kaur Harsheen , Naessens James M. , Hanson Andrew C. , Fryer Karen , Nemergut Michael E. , Tripathi Sandeep
Published: September 2016

Objective:

No risk prediction model is currently available to measure patient’s probability for readmission to the pediatric intensive care unit (PICU). This retrospective case–control study was designed to assess the applicability of an adult risk prediction score (Stability and Workload Index for Transfer [SWIFT]) and to create a pediatric version (PRediction Of PICU Early Readmissions [PROPER]).

Design:

Eighty-six unplanned early (<48 hours) PICU readmissions from January 07, 2007, to June 30, 2014, were compared with 170 random controls. Patient- and disease-specific data and PICU workload factors were compared across the 2 groups. Factors statistically significant on multivariate analysis were included in the creation of the risk prediction model. The SWIFT scores were calculated for cases and controls and compared for validation.

Results:

Readmitted patients were younger, weighed less, and were more likely to be admitted from the emergency department. There were no differences in gender, race, or admission Pediatric Index of Mortality scores. A higher proportion of patients in the readmission group had a Pediatric Cerebral Performance Category in the moderate to severe disability category. Cases and controls did not differ with respect to staff workload at discharge or discharge day of the week; there was a much higher proportion of patients on supplemental oxygen in the readmission group. Only 2 of 5 categories in the SWIFT model were significantly different, and although the median SWIFT score was significantly higher in the readmissions group, the model discriminated poorly between cases and controls (area under the curve: 0.613). A 7-category PROPER score was created based on a multiple logistic regression model. Sensitivity of this model (score ≥12) for the detection of readmission was 81% with a positive predictive value of 0.50.

Conclusion:

We have created a preliminary model for predicting patients at risk of early readmissions to the PICU from the hospital floor. The SWIFT score is not applicable for predicting the risk for pediatric population.
Budget Time
Authors: Barkacs Linda L. , Barkacs Craig B.
Published: September 2016

This article presents a gender-based negotiation simulation designed to make participants aware of gender-based stereotypes and their effect on negotiation outcomes. In this simulation, the current research on gender issues is animated via three role sheets: (a) Vice president (VP), (b) advantaged department head, and (c) disadvantaged department head. While the VP role is the same for everyone, the participants who play the role of department head are unaware that there are two versions of that role. Participants playing either of the department head roles negotiate one-on-one with their VP for an increase in next year’s budget. The participants are purposefully not made aware that the exercise is based on gender issues; thus, both males and females may play any role. Significantly different negotiation results are recorded at the end of the exercise, learning objectives are revealed, and an excellent platform for exploring numerous gender-based issues is in place. The benefits for participants include (a) an enhanced and sophisticated awareness of gender issues in negotiation and (b) prescriptions for mitigating disparate outcomes that are often a function of gender.
The influence of coping styles on long-term employment in multiple sclerosis: A prospective study
Authors: Grytten Nina , Skår Anne BR , Aarseth Jan Harald , Assmus Jorg , Farbu Elisabeth , Lode Kirsten , Nyland Harald I , Smedal Tori , Myhr Kjell Morten
Published: September 2016

Background:

The aim was to investigate predictive values of coping styles, clinical and demographic factors on time to unemployment in patients diagnosed with multiple sclerosis (MS) during 1998–2002 in Norway.

Method:

All patients ( N = 108) diagnosed with MS 1998–2002 in Hordaland and Rogaland counties, Western Norway, were invited to participate in the long-term follow-up study in 2002. Baseline recordings included disability scoring (Expanded Disability Status Scale (EDSS)), fatigue (Fatigue Severity Scale (FSS)), depression (Beck Depression Inventory (BDI)), and questionnaire assessing coping (the Dispositional Coping Styles Scale (COPE)). Logistic regression analysis was used to identify factors associated with unemployed at baseline, and Cox regression analysis to identify factors at baseline associated with time to unemployment during follow-up.

Results:

In all, 41 (44%) were employed at baseline. After 13 years follow-up in 2015, mean disease duration of 22 years, 16 (17%) were still employed. Median time from baseline to unemployment was 6 years (±5). Older age at diagnosis, female gender, and depression were associated with patients being unemployed at baseline. Female gender, long disease duration, and denial as avoidant coping strategy at baseline predicted shorter time to unemployment.

Conclusion:

Avoidant coping style, female gender, and longer disease duration were associated with shorter time to unemployment. These factors should be considered when advising patients on MS and future employment.
Examining the effect of reduced input on language development: The case of gender acquisition in Russian as a non-dominant and dispreferred language by a bilingual Turkish–Russian child
Authors: Antonova Ünlü Elena , Wei Li
Published: September 2016

Aims and objectives/purpose/research questions:

The main research question we seek to answer in the present study is: “What effect does reduced input in the non-dominant and dispreferred language have on the acquisition of Russian gender morphology by a bilingual Turkish–Russian child: Is it still sufficient for its monolingual-like development or can it cause incomplete acquisition of Russian gender morphology, at least, in some domains?”

Design/methodology/approach:

This study is a longitudinal case study.

Data and analysis:

The main source of data collection is video and audio recordings. Twenty-five recordings are available. They cover the period of between two years and 11 months (2;11) and 4;0. The data are examined in terms of the availability of masculine, feminine and neuter form-related genders, as well as availability of feminine and masculine semantic-related genders of nouns and pronouns in the first-, second- and third-person contexts. We look into whether the data of the bilingual child is marked with deviations from monolingual Russian data and/or incomplete acquisition of gender in any domain.

Findings/conclusions:

The findings of the present study, on the one hand, support the view that, by and large, reduced to a certain degree, input is still sufficient for monolingual-like language development; on the other hand, it demonstrates that reduced input may lead to non-monolingual-like and/or incomplete acquisition and, therefore, appears to be a main factor determining the development of a language and accounting for its strengths and weaknesses.
FBT With Adjunctive Parent Emotion Coaching in an Adolescent Male With Anorexia Nervosa
Authors: Peterson Claire M. , Fischer Sarah , Loiselle Kristin , Shaffer Anne
Published: September 2016

Family-based therapy (FBT) is the gold standard of treatment for adolescents with anorexia nervosa (AN) and has shown to be more effective than other forms of treatment in several randomized controlled trials. However, FBT is a behaviorally based intervention that does not explicitly address emotional distress often exhibited by patients and their parents. This case study describes the treatment of a 14-year-old adolescent male with AN using FBT as the primary treatment modality. We also implemented an adjunctive treatment designed to address parents’ emotion communication skills (ECSs) to reduce emotion dysregulation and family conflict in the implementation of FBT and in the process of AN recovery. Over the course of 29 sessions, the adolescent has evidenced an increase in weight from 84 pounds to 110.25 pounds and significant decreases in weight and shape concerns. This case provides preliminary support for the feasibility and effectiveness of an adjunct parent emotion coaching intervention combined with FBT for an adolescent male with AN.
Family-Based Cognitive–behavioral Therapy for an Intelligent, Elementary School-Aged Child With Generalized Anxiety Disorder
Authors: Kolomeyer Ellen , Renk Kimberly
Published: September 2016

This case study follows an 8-year-old Caucasian female who presented with symptoms of Generalized Anxiety Disorder (GAD). Given this child’s age but advanced cognitive skills, careful selection of an appropriate treatment was made. In the current case study, a family-based cognitive–behavioral therapy intervention (Wood & McLeod, 2008) was implemented to treat this child’s symptoms of GAD. Following completion of the intervention, the child demonstrated significant decreases in her symptoms. In addition, she demonstrated a thorough understanding of coping skills, successfully applied and generalized her skills to a variety of situations, and took pride in teaching her skills to others. This child showed quantitative improvements on objective self-report measures as well as qualitative improvements in her overall emotional and behavioral functioning. This case study suggested that cognitive–behavioral therapy interventions, particularly when used in a family-based approach, are effective for children with symptoms of GAD.
Chip inward curl and its influence on dimensional accuracy in groove cutting with a novel restricted contact tool
Authors: Wang Bin , Zhang Jiayang , Zhou Wei , Xia Wei , Deng Wen Jun
Published: September 2016

Tool geometry has a significant influence on cutting force, cutting temperature, and surface quality. Restricted contact tools show good advantages in reducing cutting force, decreasing temperature, and improving surface quality. In this article, a new pattern of chip curl, “chip inward curl,” and its influence on dimensional accuracy were investigated using a novel restricted contact tool when cutting grooves. This novel restricted contact tool has symmetrical tool/chip contact length which varies along the main cutting edge and has a smaller tool land length in the middle of the rake face. In order to analyze the chip inward curl and its influence on dimensional accuracy with this novel restricted contact tool, a theoretical method to predict the chip back-flow angle using a slip-line model taking into consideration of cutting tool edge was proposed. Dimensional accuracy of the grooves achieved by this novel restricted contact tool in groove cutting tests was investigated and compared with those cut by a conventional flat-faced tool. Also, three-dimensional finite element models were developed to analyze the chip back-flow angle and chip inward curl. Results indicate that this new type of restricted contact tool has significant advantages in the control of chip curl and obtains better dimensional accuracy in groove cutting.
Social Media in Gay London: Tinder as an Alternative to Hook-Up Apps
Authors: MacKee Freddy
Published: September 2016

The article explores how the mobile app Tinder complements dating practices and the wider app ecosystem gay men use in London. Within the local gay community discourse, Tinder is said to be a site where the gay “nice guys” go, rendering the platform as a socially constructed environment where gay men behave in a diametrically opposed way to the normative hyper-sexualized behavior of widespread gay hook-up apps. The research question, therefore, is whether Tinder is in fact a place where these “nice guys” go and where one would find them. Through an ethnographic methodology conducted both online and offline, a case is built on how initial conceptions about the app cannot be fully studied or interpreted without understanding the place it holds among other social networks. Evidence is presented to support the case that gay users of Tinder do, in fact, curate the portrayal of their digital identity to present a considerably less sexualized persona with the hopes of finding dates or a relationship. This, however, does not mean that users refrain from using other platforms in parallel as a way of exploring different subject positions and motivations. Behavior and normativity on Tinder are largely explained both by context and also by the design of the platform, which imports and displays personal data from other social networks. Findings should be limited to the population and location proposed as the fieldsite.
Outcomes of CLL patients treated with sequential kinase inhibitor therapy: a real world experience
Authors: Mato Anthony R. , Nabhan Chadi , Barr Paul M. , Ujjani Chaitra S. , Hill Brian T. , Lamanna Nicole , Skarbnik Alan P. , Howlett Christina , Pu Jeffrey J. , Sehgal Alison R. , Strelec Lauren E. , Vandegrift Alexandra , Fitzpatrick Danielle M. , Zent Clive S. , Feldman Tatyana , Goy Andre , Claxton David F. , Bachow Spencer Henick , Kaur Gurbakhash , Svoboda Jakub , Nasta Sunita Dwivedy , Porter David , Landsburg Daniel J. , Schuster Stephen J. , Cheson Bruce D. , Kiselev Pavel , Evens Andrew M.
Published: September 2016

Key Points

Toxicity was the most common reason for discontinuation of ibrutinib or idelalisib in treated patients with CLL. KI-intolerant patients, but less so those with CLL progression, can be successfully treated with an alternate KI.
Jackson Pollock’s Number 1A, 1948: a non-invasive study using macro-x-ray fluorescence mapping (MA-XRF) and multivariate curve resolution-alternating least squares (MCR-ALS) analysis
Authors: Martins A. , Coddington J. , Van der Snickt G. , van Driel B. , McGlinchey C. , Dahlberg D. , Janssens K. , Dik J.
Published: September 2016

Jackson Pollock’s Number 1A, 1948 painting was investigated using in situ scanning macro-x-ray fluorescence mapping (MA-XRF) to help characterize the artist’s materials and his creative process. A multivariate curve resolution-alternating least squares (MCR-ALS) approach was used to examine the hyperspectral data and obtain distribution maps and signature spectra for the paints he used. The composition of the paints was elucidated based on the chemical elements identified in the signature spectra and a tentative list of pigments, fillers and other additives is proposed for eleven different paints and for the canvas. The paint distribution maps were used to virtually reconstruct the artist process and document the sequence and manner in which Pollock applied the different paints, using deliberate and specific gestures.
Low-density granulocytes: functionally distinct, immature neutrophils in rheumatoid arthritis with altered properties and defective TNF signalling
Authors: Wright Helen L , Makki Fatima A , Moots Robert J , Edwards Steven W
Published: September 2016

Our aim was to determine whether rheumatoid arthritis (RA) low-density granulocytes (LDGs) are functionally different from RA neutrophils. LDGs from 32 RA patients were characterized using flow cytometry and quantitative PCR (qPCR). RNA sequencing (RNA-Seq) was carried out on paired RA LDGs and neutrophils (n = 4) and validated using qPCR. Functional assays included chemotaxis, phagocytosis, reactive oxygen species (ROS) production, cell-cycle analysis, apoptosis, neutrophil extracellular trap (NET)osis, and measurement of cytokine production (n ≥ 5 paired RA LDGs/neutrophils). RA LDGs had a substantially altered transcriptome, expressing >5000 genes at significantly different levels compared with RA neutrophils, including elevated levels of transcripts for granule proteins [including elastase and myeloperoxidase (MPO)] and cell-cycle genes [including cyclin-dependent kinase (CDK)2, CDK4, and CDK6]. Approximately 1% of RA LDGs stained positive for the G2/S phase of the cell cycle. RA LDGs had a significantly lower constitutive rate of apoptosis compared with RA neutrophils and did not respond to TNF-α in culture. Expression of transcripts for cytokines and cytokine receptors was lower in RA LDGs. NET formation was lower in LDGs in response to PMA compared with RA neutrophils. Chemotaxis and phagocytosis was lower in RA LDGs compared with neutrophils. RA LDGs produced significantly lower amounts of ROS in response to fMLP following priming with TNF-α. Expression of TNFR1 and -2 mRNA and protein was significantly lower in LDGs. We conclude that RA LDGS are functionally different from RA neutrophils, representing an immature neutrophil population within peripheral blood. Their enhanced survival properties and decreased TNF signaling are likely to have important consequences for disease pathology and response to therapy.
Use and Effectiveness of Neoadjuvant Chemotherapy for Treatment of Ovarian Cancer
Authors: Meyer Larissa A. , Cronin Angel M. , Sun Charlotte C. , Bixel Kristin , Bookman Michael A. , Cristea Mihaela C. , Griggs Jennifer J. , Levenback Charles F. , Burger Robert A. , Mantia-Smaldone Gina , Matulonis Ursula A. , Niland Joyce C. , O’Malley David M. , Wright Alexi A.
Published: September 2016

Purpose

In 2010, a randomized clinical trial demonstrated noninferior survival for patients with advanced ovarian cancer who were treated with neoadjuvant chemotherapy (NACT) compared with primary cytoreductive surgery (PCS). We examined the use and effectiveness of NACT in clinical practice.

Patients and Methods

A multi-institutional observational study of 1,538 women with stages IIIC to IV ovarian cancer who were treated at six National Cancer Institute–designated cancer centers. We examined NACT use in patients who were diagnosed between 2003 and 2012 (N = 1,538) and compared overall survival (OS), morbidity, and postoperative residual disease in a propensity-score matched sample of patients (N = 594).

Results

NACT use increased from 16% during 2003 to 2010 to 34% during 2011 to 2012 in stage IIIC disease ( Ptrend < .001), and from 41% to 62% in stage IV disease ( Ptrend < .001). Adoption of NACT varied by institution, from 8% to 30% for stage IIIC disease (P < .001) and from 27% to 61% ( P = .007) for stage IV disease during this time period. In the matched sample, NACT was associated with shorter OS in stage IIIC disease (median OS: 33 v 43 months; hazard ratio [HR], 1.40; 95% CI, 1.11 to 1.77) compared with PCS, but not stage IV disease (median OS: 31 v 36 months; HR, 1.16; 95% CI, 0.89 to 1.52). Patients with stages IIIC and IV disease who received NACT were less likely to have ≥ 1 cm postoperative residual disease, an intensive care unit admission, or a rehospitalization (all P ≤ .04) compared with those who received PCS treatment. However, among women with stage IIIC disease who achieved microscopic or ≤ 1 cm postoperative residual disease, NACT was associated with decreased OS (HR, 1.49; 95% CI, 1.01 to 2.18; P = .04).

Conclusion

Use of NACT increased significantly between 2003 and 2012. In this observational study, PCS was associated with increased survival in stage IIIC, but not stage IV disease. Future studies should prospectively consider the efficacy of NACT by extent of residual disease in unselected patients.
Prostate-Specific Antigen Failure and Risk of Death Within Comorbidity Subgroups Among Men With Unfavorable-Risk Prostate Cancer Treated in a Randomized Trial
Authors: Giacalone Nicholas J. , Wu Jing , Chen Ming-Hui , Renshaw Andrew , Loffredo Marian , Kantoff Philip W. , D’Amico Anthony V.
Published: September 2016

Purpose

Physicians sometimes make management recommendations on the basis of early results from randomized controlled trials (RCTs) relating to reduced prostate-specific antigen (PSA) failure, yet whether this early end point is associated with all-cause mortality (ACM), particularly in men with competing risks, is unknown. Using a validated metric in men treated within the context of an RCT, we aimed to determine whether PSA failure is associated with the risk of ACM stratified by comorbidity score.

Patients and Methods

Between 1995 and 2001, 206 men with localized (T1b to 2b) intermediate- and high-risk prostate cancer (PC) were randomly assigned to receive radiation therapy or radiation therapy and 6 months of ADT. Cox regression analyses were performed to evaluate whether PSA failure modeled as a time-dependent covariate was associated with an increased risk of ACM among men with Adult Comorbidity Evaluation-27–defined no or minimal versus moderate-to-severe comorbidity adjusting for age, PC prognostic factors, and treatment.

Results

After a median follow-up of 16.62 years, 156 men (76%) died, 29 of whom (19%) died as a result of PC. PSA failure was associated with an increased ACM risk among men with no or minimal (adjusted hazard ratio, 1.59; 95% CI, 1.03 to 2.46; P = .04), but not moderate or severe comorbidity (adjusted hazard ratio, 1.75; 95% CI, 0.76 to 3.99; P = .19).

Conclusion

Recommending treatment on the basis of reduced PSA failure observed from early results of RCTs is unlikely to prolong survival in men with moderate-to-severe comorbidity but may prolong survival in men with no or minimal comorbidity, providing evidence to support discussing the early results with these men.
Optimizing Treatment for Elderly Patients With Newly Diagnosed Multiple Myeloma: A Personalized Approach
Authors: Larocca Alessandra , Palumbo Antonio
Published: September 2016

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

An 84-year-old woman presented with bone pain and lytic bone lesions in April 2010. Diagnosis of multiple myeloma was based on the presence of an immunoglobulin G lambda serum M protein (4,784 mg/dL) and confirmed by the findings of bone marrow plasma cell infiltration, with t(11;14) chromosomal abnormality detected by fluorescence in situ hybridization analysis. The patient’s medical history was significant for hypertension; she had an Eastern Cooperative Oncology Group performance status of 1, International Staging System (ISS) stage of 1, and Durie–Salmon stage of IIIA. In May 2010, the patient was enrolled in a randomized phase III trial comparing different lenalidomide-based treatments and received induction with lenalidomide plus dexamethasone (nine cycles) followed by lenalidomide maintenance. The patient started treatment with lenalidomide 25 mg per day for 21 days and reduced-dose dexamethasone 20 mg per week per protocol because of age. Induction was well tolerated; no relevant complications occurred, except for grade 1 fatigue and grade 1 diarrhea. Best response was partial response. In March 2011, she started maintenance with lenalidomide 10 mg per day. A dose reduction of lenalidomide 5 mg per day was required because of grade 2 diarrhea. In July 2015, the patient experienced relapse, with painful collapse of L3 vertebral body.
Team Leadership and Cancer End-of-Life Decision Making
Authors: Waldfogel Julie M. , Battle Dena J. , Rosen Michael , Knight Louise , Saiki Catherine B. , Nesbit Suzanne A. , Cooper Rhonda S. , Browner Ilene S. , Hoofring Laura H. , Billing Lynn S. , Dy Sydney M.
Published: September 2016

End-of-life decision making in cancer can be a complicated process. Patients and families encounter multiple providers throughout their cancer care. When the efforts of these providers are not well coordinated in teams, opportunities for high-quality, longitudinal goals of care discussions can be missed. This article reviews the case of a 55-year-old man with lung cancer, illustrating the barriers and missed opportunities for end-of-life decision making in his care through the lens of team leadership, a key principle in the science of teams. The challenges demonstrated in this case reflect the importance of the four functions of team leadership: information search and structuring, information use in problem solving, managing personnel resources, and managing material resources. Engaging in shared leadership of these four functions can help care providers improve their interactions with patients and families concerning end-of-life care decision making. This shared leadership can also produce a cohesive care plan that benefits from the expertise of the range of available providers while reflecting patient needs and preferences. Clinicians and researchers should consider the roles of team leadership functions and shared leadership in improving patient care when developing and studying models of cancer care delivery.
Of Mice and Academics: Examining the Effect of Openness on Innovation
Authors: Murray Fiona , Aghion Philippe , Dewatripont Mathias , Kolev Julian , Stern Scott
Published: September 2016

This paper argues that openness, by lowering costs to access existing research, can enhance both early and late stage innovation through greater exploration of novel research directions. We examine a natural experiment in openness: late-1990s NIH agreements that reduced academics’ access costs regarding certain genetically engineered mice. Implementing difference-in-differences estimators, we find that increased openness encourages entry by new researchers and exploration of more diverse research paths, and does not reduce the creation of new genetically engineered mice. Our findings highlight a neglected cost of strong intellectual property restrictions: lower levels of exploration leading to reduced diversity of research output. (JEL I23, O31, O33, O34)
Actomyosin stress fiber mechanosensing in 2D and 3D
Authors: Lee Stacey , Kumar Sanjay
Published: September 2016

Mechanotransduction is the process through which cells survey the mechanical properties of their environment, convert these mechanical inputs into biochemical signals, and modulate their phenotype in response. These mechanical inputs, which may be encoded in the form of extracellular matrix stiffness, dimensionality, and adhesion, all strongly influence cell morphology, migration, and fate decisions. One mechanism through which cells on planar or pseudo-planar matrices exert tensile forces and interrogate microenvironmental mechanics is through stress fibers, which are bundles composed of actin filaments and, in most cases, non-muscle myosin II filaments. Stress fibers form a continuous structural network that is mechanically coupled to the extracellular matrix through focal adhesions. Furthermore, myosin-driven contractility plays a central role in the ability of stress fibers to sense matrix mechanics and generate tension. Here, we review the distinct roles that non-muscle myosin II plays in driving mechanosensing and focus specifically on motility. In a closely related discussion, we also describe stress fiber classification schemes and the differing roles of various myosin isoforms in each category. Finally, we briefly highlight recent studies exploring mechanosensing in three-dimensional environments, in which matrix content, structure, and mechanics are often tightly interrelated. Stress fibers and the myosin motors therein represent an intriguing and functionally important biological system in which mechanics, biochemistry, and architecture all converge.
Do Client Characteristics Really Drive the Big N Audit Quality Effect? New Evidence from Propensity Score Matching
Authors: DeFond Mark , Erkens David H. , Zhang Jieying
Published: September 2016

A large auditing literature concludes that Big N auditors provide higher audit quality than non-Big N auditors. Recently, however, a high-profile study suggests that propensity score matching (PSM) on client characteristics eliminates the Big N effect [Lawrence A, Minutti-Meza M, Zhang P (2011) Can Big 4 versus non-Big 4 differences in audit-quality proxies be attributed to client characteristics? Accounting Rev. 86(1):259–286]. We conjecture that this finding may be affected by PSM’s sensitivity to its design choices and/or by the validity of the audit quality measures used in the analysis. To investigate, we examine random combinations of PSM design choices that achieve covariate balance, and four commonly used audit quality measures. We find that the majority of these design choices support a Big N effect for most of the audit quality measures. Overall, our findings show that it is premature to suggest that PSM eliminates the Big N effect.

This paper was accepted by Suraj Srinivasan, accounting.
Specialist versus Generalist Positioning: Demand Heterogeneity, Technology Scalability and Endogenous Market Segmentation
Authors: Adner Ron , Ruiz-Aliseda Francisco , Zemsky Peter
Published: September 2016

At the heart of competitive strategy is the question of where firms choose to position themselves within an industry. We characterize when generalists desegment markets, and when they are “stuck in the middle” because they are outcompeted by specialists. In our formal equilibrium model, firms face a positioning trade-off between cost and quality that is moderated by a choice of technologies that vary in their scalability. On the demand side, we incorporate consumer heterogeneity via two segments that vary in their willingness to pay for quality. Specialists in our model correspond to Porter’s generic strategies, with a “cost leader” targeting the low-end segment and a “differentiator” targeting the high-end segment. Generalists target both segments and hence have greater ability to exploit economies of scale. Central to our analysis is the interplay between the extent of demand heterogeneity and technology scalability. We show that this interplay determines when a Generalist is stuck in the middle; when it dominates from the middle with an intermediate quality level that outcompetes Specialist firms optimally positioned for cost leadership and differentiation; and when it dominates from above with a quality level greater than even that of a Differentiator. We explicitly link positioning on a cost-quality frontier to the value-bar analysis that is widely used in strategy teaching, and show how cost allocation rules impact positioning choices and competitive outcomes.
Research Roundup
Authors: Cowan Helen
Published: September 2016

Helen Cowan presents a selection of recently published articles of interest to nurses working in cardiovascular nursing. The aim of this roundup is to provide a brief overview of the research papers selected. A full reference is provided for those who wish to take a look at the research in further detail
Reflections of Research
Authors: Stoll Victoria
Published: September 2016

The British Heart Foundation (BHF) annual image competition, Reflections of Research, provides a glimpse into the cutting-edge research that the BHF funds
Iranian nurse attitudes towards the presence of family members during CPR
Authors: Esmaeli Abdar Mohammad , Rafiei Hossein , Amiri Masoud , Tajadini Maryam , Tavan Asghar , Rayani Forough , Ebrahimi Farah , Farokhzadian Jamileh
Published: September 2016

Aim:

The presence of family members at the time of cardiopulmonary resuscitation (CPR) is essential in family-centered care. Since nurses have an important role in facilitating the attendance of patients' family members in this regard, the present study was conducted to examine nurse attitudes towards the family's presence during CPR.

Methods:

This study was conducted across three teaching hospitals in Kerman province located in South East of Iran. Using convenience sampling, all registered nurses were invited to participate in the study. Data were collected between January and March 2014 using the attitude questionnaire on family presence during resuscitation.

Results:

Of 303 nurses, 92.5% were women. The mean attitude score of nurses was 50.99 ±7.12. The main perceived barriers to family presence during resuscitation by Iranian nurses were increased stress and anxiety among CPR team members, traumatic experience for the family members, difficulty around stopping CPR in futile situations owing to family requests, and family impressions about the fear of litigation related to resuscitation.

Conclusion:

This study revealed that nurses may have not positive attitudes towards family presence during CPR. It is necessary to improve these attitudes via educational programmes.