bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbon Emission Reduction of Power Enterprises in Subtropical and Temperate Regions of China
Authors: Li Lei
Published: January 2019

China’s power enterprises consume a large amount of energy and emit a high quantity of carbon dioxide. To reduce carbon emissions and save energy, China has implemented various energy-saving and emission reduction (ESER) policies in the power industry. The purpose of this study is to analyze the carbon emission reduction (CER) performance and the ESER performance of China’s power enterprises. The data envelopment analysis was applied to obtain the CER efficiency and the ESER efficiency of power enterprises in subtropical and temperate regions of China. The research findings are as follows. First, the average ESER efficiency of Chinese power enterprises is lower than their CER efficiency. Second, only 30% of Chinese power enterprises have both high CER and ESER efficiency. Most power enterprises in China need to take measures to further reduce carbon emissions and improve the efficiency of resource utilization. Third, due to their high economic development and advanced use of technology, the CER efficiency of power enterprises in subtropical regions is higher than that in temperate regions. Based on empirical results, specific policy recommendations are provided for Chinese power enterprises.
Serial high-sensitivity cardiac troponin T measurements to rule out acute myocardial infarction and a single high baseline measurement for swift rule-in: A systematic review and meta-analysis
Authors: Arslan M , Dedic A , Boersma E , Dubois EA
Published: January 2019

Aims:

The purpose of this study was to determine (a) the ability of serial high-sensitivity cardiac troponin T measurements to rule out acute myocardial infarction and (b) the ability of a single high baseline high-sensitivity cardiac troponin T measurement to rule in acute myocardial infarction in patients presenting to the emergency department with acute chest pain.

Methods and results:

Embase, Medline, Cochrane, Web of Science and Google scholar were searched for prospective cohort studies that evaluated parameters of diagnostic accuracy of serial high-sensitivity cardiac troponin T to rule out acute myocardial infarction and a single baseline high-sensitivity cardiac troponin T value>50 ng/l to rule in acute myocardial infarction. The search yielded 21 studies for the systematic review, of which 14 were included in the meta-analysis, with a total of 11,929 patients and an overall prevalence of acute myocardial infarction of 13.0%. For rule-out, six studies presented the sensitivity of serial measurements <14 ng/l. This cut-off classified 60.1% of patients as rule-out and the summary sensitivity was 96.7% (95% confidence interval: 92.3–99.3). Three studies presented the sensitivity of a one-hour algorithm with a baseline high-sensitivity cardiac troponin T value<12 ng/l and delta 1 hour <3 ng/l. This algorithm classified 60.2% of patients as rule-out and the summary sensitivity was 98.9% (96.4–100). For rule-in, six studies reported the specificity of baseline high-sensitivity cardiac troponin T value>50 ng/l. The summary specificity was 94.6% (91.5–97.1).

Conclusion:

Serial high-sensitivity cardiac troponin T measurement strategies to rule out acute myocardial infarction perform well, and a single baseline high-sensitivity cardiac troponin T value>50 ng/l to rule in acute myocardial infarction has a high specificity.
A case of a schwannoma in the nasal columella
Authors: Kim Tae Hoon , Shin Joo Hyun , Kwak Eun-Kyoung
Published: January 2019

Schwannoma is a slow-growing, benign tumor of the nerve sheath. It rarely presents in the nasal cavity or the paranasal sinuses. Although schwannomas in the nasal septum have been reported previously, cases of this tumor in the nasal columella are rare in the literature. Here, we report on a 67-year-old woman with a schwannoma in the nasal columella that was successfully removed using a sublabial approach, along with a review of relevant literature.
Rethinking preventing homelessness amongst prison leavers
Authors: Madoc-Jones Iolo , Hughes Caroline , Gorden Caro , Dubberley Sarah , Washington-Dyer Karen , Ahmed Anya , Lockwood Kelly , Wilding Mark
Published: January 2019

The Wales (Housing) Act 2015 introduced a preventative approach to addressing homelessness that impacted on prison leavers in Wales. Since the same changes will take effect in England from October 2018, this paper provides early insight into how new preventative duties have been implemented in Wales. Drawing on interviews with 114 stakeholders and 75 prison leavers, we report that the promise associated with a preventative agenda is presently not fully realised. We contend that resettlement activity might be improved if it was better incentivised and facilitated inside the prison wall. However, we also suggest the time has come for more radical options to be pursued to address homelessness amongst prison leavers. We argue against short prison sentences, which are so often causative of homelessness, and for providers of probation services to be better incentivised and resourced to take a more active role in meeting accommodation needs.
The Story of Dr Stella (1927-2006)
Authors: Van Praagh Richard
Published: January 2019

A life of professional caring, research, teaching, and inspiration—this is the legacy of Dr Stella Zacharioudaki Van Praagh, MD. Among her many outstanding contributions, only a few are recorded here: (1) a new surgical operation for closing apical muscular ventricular septal defects, (2) a newly discovered form of anomalous pulmonary venous drainage and its surgical repair, (3) a new understanding of sinus venosus defects and their surgical repair, (4) the realization that the concept of atrial-level isomerism (mirror-imagery) in the heterotaxy syndromes of asplenia, polysplenia, and single right-sided spleen is erroneous, (5) the understanding that it is possible to diagnose the atrial situs in the majority of cases of the heterotaxy syndromes, and (6) the fact that the concepts of evolution, natural selection, and survival of the fittest were described by Empedocles, an ancient Greek philosopher, in the fifth century bc, and that these concepts were not discovered and published for the first time by Charles Darwin and Alfred Russell Wallace in the 19th century (1858 ad). Dr Stella was conversant with ancient Greek and read it frequently in an ancient Greek study group that she headed. Dr Stella translated from ancient Greek into English a portion of Aristotle’s The Physics in which Empedocles’ understanding is cited at length. There is no doubt about what Empedocles thought.
Double Arterial Cannulation in the Critical Management of Neonatal Aortic Arch Obstruction With Closed Ductus Arteriosus
Authors: Kulyabin Yuriy Y. , Gorbatykh Yuriy N. , Soynov Ilya A. , Nichay Nataliya R. , Zubritskiy Alexey V. , Bogachev-Prokophiev Alexander V.
Published: January 2019

The neonatal management of critical aortic arch obstruction in association with an arterial duct that remains closed or significantly constricted requires urgent surgical repair, with a postoperative focus on resolving the impaired function of compromised organs. Here, we present two neonatal cases illustrating the use of the dual arterial cannulation perfusion method in the complete repair of interrupted aortic arch and critical coarctation of the aorta with nonfunctional ductus arteriosus. We suggest that dual arterial cannulation, which provides total body perfusion (with the exception of cardiac perfusion during cardioplegic arrest of the heart), may be a good alternative to other perfusion strategies in cases of absent ductal blood flow, as this method allowed us to avoid the further development of severe multiple organ failure.
Delaying Decannulation After Extracorporeal Membrane Oxygenation Is Safe and Advantageous
Authors: Thompson Jess L. , Griffeth Elaine , Rappa Nicholas , Calame Colette , Letton Robert W. , Burkhart Harold M.
Published: January 2019

Removal of extracorporeal membrane oxygenation (ECMO) cannulae and discontinuing systemic anticoagulation typically occurs soon after separation from ECMO. We have found, however, that delaying decannulation after terminating ECMO therapy does not predispose to adverse outcomes and may be advantageous. Between January 2014 and June 2016, 36 postcardiotomy patients at the Children’s Hospital of Oklahoma required ECMO. In this cohort of 36 patients, there was a need for 42 ECMO runs. Of the 42 ECMO runs, 29 (69%) survived to decannulation. Of those ECMO runs that survived to decannulation, 18 (62%) were cannulated centrally and 11 (38%) were cannulated via the neck. For the runs where the patient survived to decannulation, the mean number of days on ECMO support was 4 ± 2 days. There was an average time interval of 21 ± 14 hours from ECMO termination to decannulation. A single patient failed being separated from ECMO support and required reinstitution of ECMO 18 hours after separation (but did not require recannulation).
Outcomes of Single Ventricle Patients Undergoing the Kawashima Procedure: Can We Do Better?
Authors: Alsoufi Bahaaldin , Rosenblum Joshua , Travers Curtis , Kanter Kirk , Trusty Philip M. , Yoganathan Ajit P. , Slesnick Timothy P.
Published: January 2019

Objectives:

Current technology advances in virtual surgery modeling and computational flow dynamics allow preoperative individualized computer-based design of Fontan operation. To determine potential role of those innovations in patients undergoing hepatic vein incorporation (HVI) following Kawashima operation, we retrospectively examined historic cohort of patients who underwent HVI following Kawashima with focus on regression of pulmonary arteriovenous malformations (PAVMs).

Methods:

Twenty-two children with single ventricle and interrupted inferior vena cava underwent Kawashima operation (2002-12). Twenty-one (96%) patients had left atrial isomerism and 21 (96%) had undergone prior first-stage palliation. Clinical outcomes were examined.

Results:

Mean O2 saturation (SaO2) increased from 77% ± 8% to 85% ± 6% ( P = .002) after Kawashima. Fifteen (68%) patients developed PAVMs. Eighteen patients underwent HVI (median age and interval from Kawashima: 4.4 and 3.7 years, respectively). Mean SaO2 prior to HVI was 77% ± 8% and increased to 81% ± 10% at the time of hospital discharge ( P = .250), with five patients requiring home oxygen. On follow-up, mean SaO2 increased to 95% ± 4% ( P < .001). Overall ten-year survival following Kawashima was 94%.

Conclusions:

A large number of patients develop PAVMs and subsequent cyanosis after Kawashima operation. Early following HVI, SaO2 is commonly low and insignificantly different from that prior to HVI. Although SaO2 will improve on follow-up in most patients, a number of patients continue to have low saturations, indicating incomplete resolution of PAVMs. Given the heterogeneity of those patients and lack of preoperative predictors for complete PAVM regression, our findings suggest a role for virtual surgery to determine optimal individual procedure design that would provide even distribution of hepatic blood flow to both pulmonary arteries.
Power of a Learning Network in Congenital Heart Disease
Authors: Anderson Jeffrey B. , Brown David W. , Lihn Stacy , Mangeot Colleen , Bates Katherine E. , Van Bergen Andrew H. , Rudd Nancy A. , Hanke Samuel , Tweddell Jim , Lannon Carole
Published: January 2019

Background:

The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) formed to improve outcomes in infants with hypoplastic left heart syndrome. The collaborative sought to (1) decrease mortality, (2) reduce growth failure, and (3) reduce hospital readmissions due to major medical problems during the interstage period between discharge following stage 1 palliation (S1P) and admission for stage 2 palliation (S2P).

Methods:

The NPC-QIC is a learning network, coproduced by parents and clinicians, of 65 pediatric cardiology centers that contribute clinical data on care processes and outcomes to a shared registry. The adapted Breakthrough Series Model structure brings teams together regularly to review data, share lessons, and plan improvements. Outcomes are monitored using statistical process control methods.

Results:

Between 2008 and 2016, interstage mortality decreased by >40%, from 9.5% to 5.3%. Identification and use of a nutrition bundle led to improved infant growth, with a 28% reduction in interstage growth failure. The rate of serious hospital readmissions was low and did not significantly change. Importantly, a formed partnership with the parent group Sisters by Heart fostered the coproduction of tools and strategies and an emphasis on data transparency and outcomes.

Conclusions:

The NPC-QIC’s initial efforts led to improvements in interstage growth and mortality. The NPC-QIC has modeled the use of data for improvement and research, the value of coproduction with parents, and the concept “all teach, all learn,” demonstrating the power of the learning network model.
Descending Aortic Translocation and Right Pulmonary Artery Reimplantation for Midline Descending Aorta and Crossed Pulmonary Arteries in an Infant
Authors: Mongé Michael C. , Hauck Amanda L. , Popescu Andrada R. , Forbess Joseph M. , Backer Carl L.
Published: January 2019

Left mainstem bronchial compression by a midline descending thoracic aorta is a rare anatomic variant. Translocation of the descending thoracic aorta to the ascending aorta has recently been described to treat this condition. We performed an aortic translocation and right pulmonary artery reimplantation in a 4-month-old infant with severe pulmonary hypertension secondary to right pulmonary artery stenosis and left bronchial compression by a midline descending thoracic aorta. The procedure was successful in ameliorating the patient’s left mainstem bronchial compression and pulmonary hypertension. Descending aortic translocation should be considered when the left bronchus is compressed causing respiratory symptoms.
Evaluation of Self-Learning Curriculum for Kindergarten Using Stufflebeam’s CIPP Model
Authors: Al-Shanawani Hania M.
Published: January 2019

This study sought to evaluate the self-learning curricula of a kindergarten in Saudi Arabia by applying the context, input, process, product (CIPP) model. To this end, the study utilized a mixed-method design, where teachers ( N = 420) had been randomly selected and surveyed, and school inspectors ( N = 15) had been interviewed. Furthermore, a content analysis had been carried out to analyze the curricula content based on CIPP model construction. Findings revealed that the objectives of the curricula were moderately correlated to the context. The input, process, and product also moderately contributed to the educational needs and to the Saudi community. However, the curricula failed to meet the kindergarten students’ needs and community in providing multiple sources of knowledge, teaching competencies, and training opportunities. The study recommended the need to develop a kindergarten curriculum on the basis of children’s educational needs and the community developmental needs. It suggests that future studies be conducted in various aspects of child education for preschool, continuous and comprehensive evaluation, and development of the kindergarten curriculum.
Regional Risk: Mapping Single and Multiple Chronic Conditions in the United States
Authors: Nowakowski Alexandra C. H. , Shin Jihyung , Carretta Henry J.
Published: January 2019

Prevalence of single and multiple chronic conditions continues to increase in the United States. Chronic conditions predict significant morbidity and health care costs, especially when complicated by additional conditions. Likewise, many conditions are linked to health risk behaviors, and thus amenable to prevention. We examine regional differences in prevalence of single and multiple chronic conditions. In the process, we examine the ability of health risk behaviors to predict condition prevalence in each region. We recommend national prevention strategies with targeted content for specific geographic regions. We used 2009 Behavioral Risk Factor Surveillance System (BRFSS) data ( N = 432,607) for all analyses. After grouping states into nine U.S. Census divisions, we fitted generalized linear mixed regression models and compared regional odds ratios with national averages. Analyses controlled for helpful and harmful behaviors, health insurance coverage, and demographic characteristics. Odds ratios for single and multiple chronic conditions deviated significantly from national averages in all nine regions. Health behaviors significantly predicted prevalence for both single and multiple conditions within regions, but differences in behaviors between regions did not fully account for observed disparities in prevalence. Significant regional differences in disease prevalence suggest priority areas for prevention efforts. Promoting healthy behaviors and mitigating harmful behaviors in high-risk regions may help to reduce overall chronic condition prevalence, but is unlikely to obviate disparities between regions. Targeted needs assessment should be conducted within each region with higher-than-average risk to determine intervention strategies with the greatest likelihood of near-term impact.
The Academic Motivation of Papuan Students in Sebelas Maret University, Indonesia
Authors: Triyanto
Published: January 2019

The primary objective of learning engaged in higher education is to build graduate students who have great competence. This study aims to analyze the academic motivation of Papuan students at Sebelas Maret University. Data were collected through questionnaires and interviews. The participants were undergraduate students of Papua and West Papua. The results showed that the extrinsic motivation of the Papuan student is more dominant than is intrinsic motivation. The factors that influenced the low motivation of Papuan students are peers, family, teacher, the background of education, social conditions, economics, and politics. This research is expected to provide information and a basis for lecturers, universities, and policymakers to pay more attention to Papuan student motivation and further increase their learning motivation.
A Scientific Approach to the Shakespeare Authorship Question
Authors: Leigh R. John , Casson John , Ewald David
Published: January 2019

In the field of science, it is widely accepted that all hypotheses and theories can, and should, be tested. Here, we treat the authorship of the works attributed to William Shakespeare from Stratford-upon-Avon as a hypothesis (rather than received truth) and review the current methods available for testing this hypothesis. Justification for this investigation arises from the recent identification of several of Shakespeare’s coauthors. To illustrate potential approaches, we compare the widely accepted Stratfordian hypothesis with other competing hypotheses (authorship candidates), mainly referring to the case for Henry Neville (1562-1615). First, we identify important components of the scientific method as applied to the Shakespeare authorship issue: evaluation of evidence, formulation of a hypothesis, testing the hypothesis, and rejecting or revising the hypothesis. Referring to historical examples, we show how the scientific method has produced precise, dependable advances, even though the way in which it proceeds is often messy. Crucial for science’s progress is confirmation of experimental results, and discussion (with peer review) by the community of scientists before any hypothesis gains general acceptance. Second, using the example of Neville as a candidate, we provide specific examples of application of these principles to factors such as a candidate’s social networks, access to privileged knowledge, and textual analysis; we comment on the strengths and weakness of each approach, and how they might be applied in future studies. Throughout, we stress how doubt is an essential ingredient of progress not only in science but also in knowledge generally, including the Shakespeare authorship debate.
Being Mindful: A Long-term Investigation of an Interdisciplinary Course in Mindfulness
Authors: Braun Sarah Ellen , Kinser Patricia , Carrico Caroline K , Dow Alan
Published: January 2019

Background

Burnout and work-related stress in health-care professionals (HCPs) is a growing concern to the optimal functioning of the health-care system. Mindfulness-based interventions may be well-suited to address burnout in HCPs.

Objective

The purpose of this study was (1) to quantitatively evaluate the effect of a mindfulness-based intervention for interdisciplinary HCPs over time and at a long-term follow-up and (2) to explore perceived benefits, facilitators, and barriers to the practice of mindfulness at the long-term follow-up.

Design

A mixed-method, repeated measures, within-subjects design was used to investigate Mindfulness for Interdisciplinary HCPs (MIHP) at baseline, post-MIHP, and a follow-up (6 months to 1.5 years after MIHP). MIHP is an 8-week, group-based course for interdisciplinary HCPs and students, with weekly meditation training, gentle yoga, and discussions on the application of mindfulness to common stressors faced by HCPs. Main outcome measures were the Maslach Burnout Inventory—Health Services Survey and the Five Facet Mindfulness Questionnaire. A semistructured interview was used to explore participants’ perceptions of sustained effects and practice in the context of HCP work at the long-term follow-up. The study protocol was registered with ClinicalTrials.gov (NCT02736292).

Results

Eighteen HCPs (88% female) participated in the study. Significant reductions were found after the intervention for 2 subscales of burnout: depersonalization, F(2, 17) = 5.98, P = .01, and emotional exhaustion, F(2, 17) = 2.64, P = .10. Three facets of dispositional mindfulness showed significant increases at long-term follow-up, act aware: F(2, 15) = 4.47, P = .03, nonjudge: F(2, 15) = 4.7, P = .03, and nonreactivity: F(2, 15) = 3.58, P = .05. Continued practice of skills long term was facilitated by the use of informal practice and perceived improvement in work and personal life.

Conclusion

In sum, MIHP improved subscales of burnout and mindfulness. These findings should be further explored with a larger, controlled study. Interventions should focus on developing mindfulness practice that can be integrated into the work of HCPs.
Clinical and radiological outcomes of arthroscopic en bloc repair for delaminated rotator cuff tear versus non-delaminated tear
Authors: Shim Jae Woo , Hong Sung Woo , Park Yong Bok , Lee Sang Min , Yoo Jae Chul
Published: January 2019

Purpose:

The objective of the study is to determine clinical and radiological outcomes of arthroscopic repair for delaminated tears versus non-delaminated tears.

Methods:

Consecutive 138 patients with full-thickness rotator cuff tear were retrospectively enrolled. They were divided into two groups based on the presence of delamination. All delaminated tears were repaired by en bloc technique (suturing both layers by single stitch). Delaminated tears were categorized into two types: (1) posterior type, delamination involving mainly infraspinatus and (2) complete type, delamination involving both supraspinatus and infraspinatus. Clinical assessments were done using pain visual analog scale (PVAS), functional VAS, American Shoulder Elbow Surgeons score, the Constant score, and range of motion. Postoperative MRI was performed at 6 months after surgery to determine repair integrity.

Results:

Of the 138 patients, 78 (56.5%) had delaminated tears, including 30 cases of posterior type and 48 cases of complete type. The retear rate was 6.7% (4/60) in the non-delamination group and 5.1% (4/78) in the delamination group, showing no significant difference between the two groups. There was no significant difference in Sugaya classification between the two groups. Clinical scores were improved significantly in both delamination and non-delamination groups postoperatively, showing no significant difference between the two groups. Delamination subgroup (posterior or complete type) showed no significant correlation with retear rate, Sugaya classification, or clinical outcome.

Conclusions:

Arthroscopic en bloc repair for delaminated rotator cuff tear showed no significant difference in clinical or radiological outcome from that for non-delaminated rotator cuff tear. The extent of delamination did not affect outcome either. Levels of Evidence: Level III, Retrospective comparative study.
Effect of the positional relationship between the interference screw and the tendon graft in the bone tunnel in ligament reconstruction
Authors: Aoki Akira , Imade Shinji , Uchio Yuji
Published: January 2019

Purpose:

To reveal the effects of the positional and length relationships between the interference screws (ISs) and the tendon graft in the bone tunnel on the fixation strength in ligament reconstruction.

Methods:

We compared three IS positions on the anterior (the Anterior group) or posterior (the Posterior group) or side (the Side group) of the tendon graft in relation to the pullout direction. The tendon graft was pulled at 0°, 30°, 60°, and 90° to the bone tunnel, and the maximum pullout load at each angle was compared among the groups. We also investigated the relationship between the length of the tendon graft and the length of the IS in the bone tunnel. The direction of the pullout force was the same as that of the Anterior group, and the maximum load was compared between groups in which the tendon graft was longer or shorter than the IS.

Results:

The maximum loads of the Anterior group were significantly greater than those of the Posterior and Side groups at the traction angles of 30° and 60°, respectively. An IS shorter than the tendon graft was found to provide significantly superior fixation strength compared to an IS longer than the tendon graft.

Conclusions:

Better fixation strength was achieved when the IS was placed on the side of the anchorage tunnel on which the tendon graft was loaded and the IS was shorter than the tendon graft.
Consumer Products Contributing to Fall Injuries in Children Aged <1 to 19 Years Treated in US Emergency Departments, 2010 to 2013: An Observational Study
Authors: Ali Bina , Lawrence Bruce , Miller Ted , Swedler David , Allison Jennifer
Published: January 2019

Consumer products are often associated with fall injuries, but there is limited research on nonfatal unintentional falls in children that examines both the child’s age group and the involvement of consumer products and activities. We combined 2 data sources to investigate products and activities that contribute to fall injuries in children at different developmental ages (ie, <1, 1-2, 3-4, 5-9, 10-14, and 15-19 years). We analyzed data from the National Electronic Injury Surveillance System–All Injury Program for the years 2010 through 2013 and augmented it with product information from the National Electronic Injury Surveillance System. Between 2010 and 2013, children aged <1 to 19 years accounted for 11.1 million nonfatal unintentional fall-related emergency department visits. Fall injuries associated with home furnishings/fixtures were highest among children in age groups <1 year, 1 to 2 years, and 3 to 4 years. In the home furnishings/fixtures product group, beds were the leading contributor to falls. Fall injuries associated with sports/recreation were highest among children in age groups 5 to 9 years, 10 to 14 years, and 15 to 19 years. In this product group, monkey bars and basketball were the leading contributors to falls. Our findings indicate priority areas for falls injury prevention and intervention.
A large-scale framework for symbolic implementations of seismic inversion algorithms in Julia
Authors: Witte Philipp A. , Louboutin Mathias , Kukreja Navjot , Luporini Fabio , Lange Michael , Gorman Gerard J. , Herrmann Felix J.
Published: January 2019

Writing software packages for seismic inversion is a very challenging task because problems such as full-waveform inversion or least-squares imaging are algorithmically and computationally demanding due to the large number of unknown parameters and the fact that waves are propagated over many wavelengths. Therefore, software frameworks need to combine versatility and performance to provide geophysicists with the means and flexibility to implement complex algorithms that scale to exceedingly large 3D problems. Following these principles, we have developed the Julia Devito Inversion framework, an open-source software package in Julia for large-scale seismic modeling and inversion based on Devito, a domain-specific language compiler for automatic code generation. The framework consists of matrix-free linear operators for implementing seismic inversion algorithms that closely resemble the mathematical notation, a flexible resilient parallelization, and an interface to Devito for generating optimized stencil code to solve the underlying wave equations. In comparison with many manually optimized industry codes written in low-level languages, our software is built on the idea of independent layers of abstractions and user interfaces with symbolic operators. Through a series of numerical examples, we determined that this allows users to implement a series of increasingly complex algorithms for waveform inversion and imaging as simple Julia scripts that scale to large-scale 3D problems. This illustrates that software based on the paradigms of abstract user interfaces and automatic code generation and makes it possible to manage the complexity of the algorithms and performance optimizations, thus providing a high-performance research and production framework.
Ordovician glacial paleogeography: Integration of seismic spectral decomposition, well sedimentological data, and glacial modern analogs in the Murzuq Basin, Libya
Authors: Bataller Francisco J. , McDougall Neil , Moscariello Andrea
Published: January 2019

Ancient glacial sediments form major hydrocarbon plays in several parts of the world; most notably, North Africa, Latin America, and the Middle East. We have described a methodology for reconstructing broad-scale paleogeographies in just such a depositional system, using an extensive subsurface data set from the uppermost Ordovician glacial sediments of the Murzuq Basin of southwest Libya. Our workflow begins with the analysis of a large, high-quality 3D seismic data set, to understand the frequency content. Subsequently, optimum frequency bands are extracted, after applying spectral decomposition, and then recombined into an R (red) G (green) B (blue) blended cube. This volume is then treated as an image within which paleomorphological features can be distinguished and compared with modern glacial analogs. Mapping at different depths (time slices) of these features is then tied, by integration with core and image-log sedimentology, to specific depositional environments defined within the framework of a facies scheme developed using the well data and published outcrop studies. These depositional environments are extrapolated into areas with little or no well data using the spectral decomposition as a framework, always taking into account the significant difference in vertical resolution between the seismic data set and core-scale descriptions. The result of this methodology is a set of calibrated maps, at three different time depths (two-way time travel), indicating paleogeographic reconstructions of the glacial depositional environments in the study area and the evolution through time (at different depths/time slices 2D + 1) of these glacial settings.
PROREPAIR-B: A Prospective Cohort Study of the Impact of Germline DNA Repair Mutations on the Outcomes of Patients With Metastatic Castration-Resistant Prostate Cancer
Authors: Castro Elena , Romero-Laorden Nuria , del Pozo Angela , Lozano Rebeca , Medina Ana , Puente Javier , Piulats Josep Maria , Lorente David , Saez Maria Isabel , Morales-Barrera Rafael , Gonzalez-Billalabeitia Enrique , Cendón Ylenia , García-Carbonero Iciar , Borrega Pablo , Mendez Vidal M. José , Montesa Alvaro , Nombela Paz , Fernández-Parra Eva , Gonzalez del Alba Aránzazu , Villa-Guzmán José Carlos , Ibáñez Kristina , Rodriguez-Vida Alejo , Magraner-Pardo Lorena , Perez-Valderrama Begoña , Vallespín Elena , Gallardo Enrique , Vazquez Sergio , Pritchard Colin C. , Lapunzina Pablo , Olmos David
Published: January 2019

Purpose

Germline mutations in DNA damage repair (DDR) genes are identified in a significant proportion of patients with metastatic prostate cancer, but the clinical implications of these genes remain unclear. This prospective multicenter cohort study evaluated the prevalence and effect of germline DDR (gDDR) mutations on metastatic castration-resistance prostate cancer (mCRPC) outcomes.

Patients and Methods

Unselected patients were enrolled at diagnosis of mCRPC and were screened for gDDR mutations in 107 genes. The primary aim was to assess the impact of ATM/BRCA1/BRCA2/ PALB2 germline mutations on cause-specific survival (CSS) from diagnosis of mCRPC. Secondary aims included the association of gDDR subgroups with response outcomes for mCRPC treatments. Combined progression-free survival from the first systemic therapy (PFS) until progression on the second systemic therapy (PFS2) was also explored.

Results

We identified 68 carriers (16.2%) of 419 eligible patients, including 14 with BRCA2, eight with ATM, four with BRCA1, and none with PALB2 mutations. The study did not reach its primary end point, because the difference in CSS between ATM/BRCA1/BRCA2/PALB2 carriers and noncarriers was not statistically significant (23.3 v 33.2 months; P = .264). CSS was halved in germline BRCA2 (g BRCA2) carriers (17.4 v 33.2 months; P = .027), and g BRCA2 mutations were identified as an independent prognostic factor for CCS (hazard ratio [HR], 2.11; P = .033). Significant interactions between g BRCA2 status and treatment type (androgen signaling inhibitor v taxane therapy) were observed (CSS adjusted P = .014; PFS2 adjusted P = .005). CSS (24.0 v 17.0 months) and PFS2 (18.9 v 8.6 months) were greater in g BRCA2 carriers treated in first line with abiraterone or enzalutamide compared with taxanes. Clinical outcomes did not differ by treatment type in noncarriers.

Conclusion

g BRCA2 mutations have a deleterious impact on mCRPC outcomes that may be affected by the first line of treatment used. Determination of g BRCA2 status may be of assistance for the selection of the initial treatment in mCRPC. Nonetheless, confirmatory studies are required before these results can support a change in clinical practice.
Piloting a Financial Counseling Intervention for Patients With Cancer Receiving Chemotherapy
Authors: Kircher Sheetal M. , Yarber Jessica , Rutsohn Josh , Guevara Yanina , Lyleroehr Madison , Alphs Jackson Hannah , Walradt Jessica , Desai Bijal , Mulcahy Mary , Kalyan Aparna , Benson Al B. , Agulnik Mark , Mohindra Nisha , DeSouza Jonas , Garcia Sofia F.
Published: January 2019

Purpose:

National organizations encourage communication about costs of cancer care; however, few data are available on health system models for identifying and assisting patients with financial distress (FD). We report the feasibility and acceptability of a financial counseling (FC) intervention for patients who receive chemotherapy at a comprehensive cancer center.

Materials and Methods:

Patients were randomly assigned 1:1 to FC or standard care. The FC arm received education, financial assistance screening, and an estimation tool with total billed charges and out-of-pocket (OOP) cost of one cycle of chemotherapy from a financial counselor through phone call and in-person visit. Participants completed measures of FD, health-related quality of life, and acceptability.

Results:

Ninety-five participants enrolled (mean age, 61 years; 72% white; 50% commercially insured), with a 32% attrition rate between assessments. Rates of completion for the phone call, in-person, and entire intervention were 98%, 47%, and 30%, respectively. The OOP estimation tool was considered understandable and acceptable to the majority of participants. No significant changes in FD were found between arms. Emotional functioning was negatively associated with having high FD (95% CI, −0.13379 to −0.013; P = .0189). Being married was associated with a decrease in log-odds of having high FD (β = −1.916; 95% CI, −3.358 to −0.475; P = .0092).

Conclusion:

Implementation of an FC program that provides transparent cost data is feasible and acceptable. Incorporation of FC into clinical workflow, including phone counseling, is important to improve feasibility. Additional work is needed to develop tailored educational materials that are patient specific.
Bifacial cambium stem cells generate xylem and phloem during radial plant growth
Authors: Shi Dongbo , Lebovka Ivan , López-Salmerón Vadir , Sanchez Pablo , Greb Thomas
Published: January 2019

A reduced rate of stem cell division is considered a widespread feature which ensures the integrity of genetic information during somatic development of plants and animals. Radial growth of plant shoots and roots is a stem cell-driven process that is fundamental for the mechanical and physiological support of enlarging plant bodies. In most dicotyledonous species, the underlying stem cell niche, the cambium, generates xylem inwards and phloem outwards. Despite the importance and intriguing dynamics of the cambium, the functional characterization of its stem cells is hampered by the lack of experimental tools for accessing distinct cambium sub-domains. Here, we use the hypocotyl of Arabidopsis thaliana to map stem cell activity in the proliferating cambium. Through pulse labeling and genetically encoded lineage tracing, we find that a single bifacial stem cell generates both xylem and phloem cell lineages. This cell is characterized by a specific combination of PXY (TDR), SMXL5 and WOX4 gene activity and a high division rate in comparison with tissue-specific progenitors. Our analysis provides a cellular fate map of radial plant growth, and suggests that stem cell quiescence is not a general prerequisite for life-long tissue production.

This article has an associated ‘The people behind the papers’ interview.
Risk Aversion or Model Uncertainty? An Empirical Cross-Sectional Analysis Across Countries
Authors: Almeida Caio , Engel Pedro , Valente Joao Paulo
Published: January 2019

By analyzing a panel of macro data including both Emerging Markets (EM) and Advanced Economies (AE), we identify that an acceptable level of model uncertainty helps to explain the equity premium existing in all these markets. Model uncertainty aversion is in general higher for EMs than for AEs. In addition, the degree of cross-sectional heterogeneity across countries' estimates of model uncertainty aversion is smaller than the corresponding heterogeneity of the risk aversion estimates in a traditional CRRA preference. We also compute separate costs of model risk and uncertainty for these economies in terms of present consumption, and conclude that the most significant effects come from uncertainty.
Is the public-private mix approach increasing tuberculosis case notification in Azad Jammu and Kashmir, Pakistan? A cross-sectional study
Authors: Hussain Mumtaz , Fatima Razia , Qasim Zahida , Yaqoob Aashifa , Wali Ahmed , Abbasi Sabir , Tahseen Sabira
Published: January 2019

Background: Pakistan ranks among high tuberculosis (TB) burden countries, with about 200,000 missing TB cases. Despite significant increase in case detection and treatment outcomes through public-private mix (PPM) globally, the contribution of the private sector may vary in different parts of Pakistan

Methods: This was a cross sectional study conducted in state of Azad Jammu and Kashmir (AJK), Pakistan. The study was a retrospective record review of routine TB notification and treatment outcomes for 2015 to 2016 in districts with and without a PPM approach. The study was conducted in all districts of AJK, including all public and private health facilities. Intra-district comparison in PPM supported districts was also carried out.   

Results: Total notified TB cases during 2015-16 were 11479. Districts with PPM support has notified 5882 (51.24%) of TB cases while districts without PPM support contributed 5597 (48.87%). Pulmonary clinical diagnosis was higher in PPM supported districts (45.43%) as compared to districts without PPM support (31.11%). Notification of extra pulmonary TB cases was lower in PPM supported districts (1256; 21.35%) as compared to districts without PPM support (1877; 33.54%). Unfavourable treatment outcomes (treatment failure, died, lost to follow-up) was higher in PPM facilities (5.84%).

Conclusion: The study shows minimal increase in TB case finding through the PPM approach. While this is an important aspect in END TB strategy, this needs more careful evaluation.
A simple formula for enumerating comparisons in trials and network meta-analysis
Authors: Shokraneh Farhad , Adams Clive E.
Published: January 2019

We present use of a simple formula to calculate the number of pairwise comparisons of interventions within a single trial or network meta-analyses. We used the data from our previous network meta-analysis to build a study-based register and enumerated the direct pairwise comparisons from the trials therein. We then compared this with the number of comparisons predicted by use of the formula and finally with the reported number of comparisons (indirect or direct) within the network meta-analysis. A total of 133 trials included in the network generated 163 comparisons (16 unique direct comparisons for 8 interventions). The formula predicted an expected 28 indirect or direct comparisons and this is the number that were indeed reported. The formula produces an accurate enumeration of the potential comparisons within a single trial or network meta-analysis. Its use could help transparency of reporting should a shortfall occur between comparisons actually used and the potential total.
Pangenome guided pharmacophore modelling of enterohemorrhagic Escherichia coli sdiA
Authors: Bandoy DJ Darwin
Published: January 2019

Enterohemorrhagic Escherichia coli (EHEC) continues to be a significant public health risk. With the onset of next generation sequencing, whole genome sequences are a potential resource for predictive modelling of the different regulatory mechanism of pathogens, particularly quorum sensing. We used a pangenome approach to determine EHEC genome clustering, determine the synonymous and nonsynonymous mutations across the EHEC sdiA and modelled the associated amino acid changes. Across the EHEC population, nonsynonymous variants are notably absent in ligand binding site for quorum sensing, indicating that population wide conservation of sdiA ligand site can be targeted for potential prophylactic purposes. Applying pathotype-wide pangenomics as a guide for determining evolution of pharmacophore sites is a potential approach in drug discovery.
Effects of sub-lethal concentrations of copper ammonium acetate, pyrethrins and atrazine on the response of Escherichia coli to antibiotics
Authors: Jun Hyunwoo , Kurenbach Brigitta , Aitken Jack , Wasa Alibe , Remus-Emsermann Mitja N.P. , Godsoe William , Heinemann Jack A.
Published: January 2019

Background: Antibiotic resistance in human and animal pathogens is mainly the outcome of human use of antibiotics. However, bacteria are also exposed to thousands of other antimicrobial agents. Increasingly those exposures are being investigated as co-selective agents behind the rapid rise and spread of resistance in bacterial pathogens of people and our domesticated animals.

Methods: We measured the sub-lethal effects on antibiotic tolerance of the human pathogen/commensal Escherichia coli caused by exposure to three common biocide formulations based on either copper, pyrethrins, or atrazine as active ingredients. The influence of the efflux pump AcrAB-TolC was investigated using deletion strains, and the persistence of observed effects was determined.

Results: Some effects were seen for all biocides, but the largest effects were observed with copper in combination with the antibiotic tetracycline. The effect was caused by both the induction of the adaptive efflux system and by chelation of the antibiotic by copper. Finally, persistence of the adaptive response was measured and found to persist for about two generations.

Conclusions: Through a combination of microbe-chemical and chemical-chemical interactions, humanity may be creating micro-environments in which resistance evolution is accelerated.
Nurturing tomorrow’s leaders: The ISCB Student Council Symposia in 2018
Authors: Parisi Daniele , Olguín-Orellana Gabriel J. , Draizen Eli J. , Da Rocha Coimbra Nilson , Papadopoulos Nikolaos , Kirchen Susanne , Gladbach Yvonne Saara , Fadra Numrah , Fatima Nazeefa , Alex Namasivayam Aishwarya , Shome Sayane , DeBlasio Dan , Monzon Alexander M. , Rahman Farzana , Parra R. Gonzalo
Published: January 2019

The Student Council of the International Society for Computational Biology (ISCB-SC) is a student-focused organization for researchers from all early career levels of training (undergraduates, masters, PhDs and postdocs) that organizes bioinformatics and computational biology activities across the globe. Among its activities, the ISCB-SC organizes several symposia in different continents, many times, with the help of the Regional Student Groups (RSGs) that are based on each region. In this editorial we highlight various key moments and learned lessons from the 14th Student Council Symposium (SCS, Chicago, USA), the 5th European Student Council Symposium (ESCS, Athens, Greece) and the 3rd Latin American Student Council Symposium (LA-SCS, Viña del Mar, Chile).
It is not diabetic foot: it is my foot
Authors: Meriç Meltem , Ergün Gül , Meriç Coşkun , Demirci İbrahim , Azal Ömer
Published: January 2019

Objective:

To examine the experiences of patients with diabetic foot ulcers (DFUs).

Method:

This qualitative study, using patient interviews, focused on how inpatients receiving treatment for diabetes experience the disease. Patients were selected using a purposive sampling method.

Results:

A total of 15 patients participated in the study. Following analysis of patient interviews, four main themes were determined: ‘developing diabetic foot’, ‘living with diabetic foot’, ‘coping with diabetic foot’ and ‘expectations’.

Conclusion:

Most of the patients were afraid of losing their feet and had difficulties in coping with the situation. Patients expected health professionals to understand the difficulties they were experiencing. To better understand the needs and experiences of patients, healthcare professionals should work with these patient groups as part of in-service training programmes. Such programmes should also include therapeutic communication techniques and models for professional patient-client communication.
Gold-substituted Silver-intensified Peroxidase Immunolabeling for FIB-SEM Imaging
Authors: Boey Adrian , Rybakin Vasily , Kalicharan Dharamdajal , Vints Katlijn , Gounko Natalia V.
Published: January 2019

Modern electron microscopy offers a wide variety of tools to investigate the ultrastructural organization of cells and tissues and to accurately pinpoint intracellular localizations of macromolecules of interest. New volumetric electron microscopy techniques and new instrumentation provide unique opportunities for high-throughput analysis of comparatively large volumes of tissue and their complete reconstitution in three-dimensional (3D) electron microscopy. However, due to a variety of technical issues such as the limited penetration of label into the tissue, low antigen preservation, substantial electron density of secondary detection reagents, and many others, the adaptation of immuno-detection techniques for use with such 3D imaging methods as focused ion beam–scanning electron microscopy (FIB-SEM) has been challenging. Here, we describe a sample preparation method for 3D FIB-SEM, which results in an optimal preservation and staining of ultrastructural details at a resolution necessary for tracing immunolabeled neuronal structures and detailed reconstruction of synapses. This technique is applicable to neuronal and non-neuronal cells, tissues, and a wide variety of antigens.