bluuebunny/crossref_metadata_2025 huggingface dataset:
Obstetric outcomes of ex‐utero intrapartum treatment (EXIT)
Authors: Shamshirsaz Alireza A. , Aalipour Soroush , Erfani Hadi , Nassr Ahmed A. , Stewart Kelsey A. , Kravitz Elizabeth S. , Rezaei Atefeh , Sanz Cortes Magdalena , Espinoza Jimmy , Belfort Michael A.
Published: May 2019

Background/Purpose

The ex‐utero intrapartum treatment (EXIT) procedure is used to secure effective gas exchange prior to postnatal life. We describe the obstetrical course and maternal outcomes of a series of patients who underwent EXIT.

Methods

This is a review of all pregnancies in which fetuses were delivered by EXIT from January 2001 to April 2018. Outcome variables included estimated gestational age (EGA) at delivery, need for emergency EXIT, maternal estimated blood loss (EBL), need for maternal blood transfusion, and maternal postoperative length of hospital stay. Data were tested for normality and reported as median [range] and n (%).

Results

A total of 45 patients were delivered by EXIT procedure. Sixteen (35.6%) of the EXIT procedures were performed emergently. Median maternal EBL was 800 (500‐2000) mL; 6 (13.3%) patients received blood transfusion. Median maternal postoperative length of hospital stay was four [3‐7] days.

Conclusion

Our data highlight the complexity of the obstetrical management in the EXIT procedure as evidenced by an approximately 36% chance of emergency delivery. Despite having an experienced multidisciplinary team, 13.3% of our subjects underwent maternal blood transfusion. This information can be used in counseling EXIT candidates regarding the risks and benefits of this procedure.
A theoretical exploration of therapeutic monomania as a physician‐based instrumental variable
Authors: Potter Brian J. , Dormuth Colin , Le Lorier Jacques
Published: May 2019

Purpose

To explore the utility of physician prescribing preference as an instrumental variable.

Methods

Expert (non‐systematic) review of relevant literature on the appropriate selection of instrumental variables and theoretical exploration of individual physician and physician group prescriber preference.

Results

An instrumental variable must satisfy three criteria: (1) It must predict the treatment received (strength of the instrument); (2) it cannot influence the outcome other that through the treatment received (exclusion restriction); and (3) it cannot be influenced by any factor that also influences the outcome (independence assumption). Arguments in favor of prescriber preference as an instrumental variable and suggestions for how to approach specific scenarios that may be encountered are offered.

Conclusions

Prescriber preference, be it of individual physicians or groups of physicians, may, under the right conditions, be powerful instrumental variables. Empiric experimental data are required to determine the appropriateness of combining propensity matching and instrumental variable analysis.
Synthesis and Properties [1,2,4]Triazolo[4,3‐b][1,2,4,5]Tetrazine N‐Oxide Explosives
Authors: Wang Guilong , Fu Zhanda , Yin Hongquan , Chen Fu‐Xue
Published: May 2019

To improve the detonation performance, 1,2,4,5‐tetrazine and [1,2,4]triazolo[4,3‐b][1,2,4,5]tetrazine N‐oxide explosives were prepared by oxidation reaction with trifluoroacetic peroxide acid. Thus, four compounds were synthesized and characterized. Among them, 3,6‐bis((3‐nitro‐1,2,4‐oxadiazol‐5‐yl)amino)‐1,2,4,5‐tetrazine 1‐oxide (TDOX) showed good detonation performance (D, 8926 m s−1; P, 34.8 GPa) and favorable thermal stability (Td, 228 °C, onset). All compounds featured mechanic insensitivities (IS>40 J, FS>360 N).
Laboratory selection, cross‐resistance, and estimations of realized heritability of indoxacarb resistance in Phenacoccus solenopsis (Homoptera: Pseudococcidae)
Authors: Afzal Muhammad BS , Shad Sarfraz A , Ejaz Masood , Serrao Jose E
Published: May 2019

BACKGROUND

Cotton mealybug Phenacoccus solenopsis is a pest of cotton, vegetables, ornamentals, and medicinal plants. In many parts of the world P. solenopsis has been managed by integration of cultural, mechanical, biological and chemical methods, but in Pakistan the use of insecticide sprays has resulted in the development of resistance to some insecticides. In this study indoxacarb resistance was investigated by selecting a P. solenopsis population under laboratory conditions for many generations. The cross‐resistance potential of indoxacarb resistance with other chemistries and the realized heritability of indoxacarb resistance were also evaluated.

RESULTS

A field population of P. solenopsis selected with indoxacarb for 27 generations had a 25 623.17‐fold resistance level. The highly indoxacarb resistant population showed very high cross‐resistance to spinosad and very low cross‐resistance to bifenthrin and chlorpyrifos. The mean estimated h2 of resistance to indoxacarb was only 0.04. The number of generations predicted for the development of ten‐fold indoxacarb resistance at a constant h2 = 0.04 against selection intensities of 10% and 95% were 346 and 36 (slope = 3.18), 237 and 25 (slope = 2.18) and 128 and 13 (slope = 1.18). However, at a constant slope = 1.18 and selection intensities of 10% and 95%, the same increase in indoxacarb resistance occurred after 128 and 13 (h2 = 0.04), 103 and 11 (h2 = 0.05), and 86 and 9 (h2 = 0.06) generations.

CONCLUSION

This study revealed that P. solenopsis has a very high resistance to indoxacarb as a result of laboratory selection. Thus, resistance to this insecticide in the field may also occur. Indoxacarb resistance can be minimized by rotating it with bifenthrin and/or chlorpyrifos due to its very low cross‐resistance to these insecticides and by avoiding its rotation with Spinosad, which has very high cross‐resistance. © 2019 Society of Chemical Industry
Optical, Photocatalytic and Wetting Behavior of GLAD N2‐TiO2 Films
Authors: De Rajnarayan , Haque S. Maidul , Misal Jitendra S. , Shinde Deepak D. , Prathap Chilakala , Polaki Shyam R. , Singh Ranveer , Som Tapobrata , Rao K. Divakar
Published: May 2019

E‐beam evaporated N2‐doped TiO2 vertical nanowires are fabricated using glancing angle deposition technique. Doping is carried out during the deposition process by external supply of N2 gas at different flow rates viz. 0, 5, 10, 20 sccm. The effect of doping concentration on various properties of the coatings is studied in detail. Refractive index value is found to be increased from 1.374 to 1.604 with increase in N2­ flow rate into the deposition chamber. Simultaneous reduction in average film transmittance (≈95–≈92%) is also observed in the visible wavelength range. Substantial reduction in optical band gap (3.85–3.43 eV) value of the coating is also noted. Surface structure of the coatings is also found to be strongly dependent on doping concentration. Samples prepared with highest doping percentage is found to have lowest RMS roughness (≈2.3 nm), void percentage (≈22%), and agglomerated grain structures. Water wetting study reveals increase in water contact angle of the samples with N2 doping. All the samples are found to be photocatalytic in nature with improved efficiency of doped samples.
Effects of Disordered Circular Nodes Dispersion and Missing Ligaments on the Mechanical Properties of Chiral Structures
Authors: Niu Yinghao , Ge Jingran , Liang Jun , Liao Haitao , Wu Wenwang
Published: May 2019

Auxetics with negative Poisson's ratio (NPR) can expand dimensions along the direction perpendicular to the tensile direction, such as rigid rotation, reentrant and chiral structures, etc. The mechanical performances of chiral metastructures are closely related to internal defects and interactions between defects. In this paper, two types of irregular chiral structures with Gaussian dispersion of circular node positions and missing ligaments are designed, namely: anti‐tetrachiral metastructure and tetrachiral hybrid metastructure. These two types of chiral metastructures are characterized by node radius, ligament thickness, ligament length, the circular node center dispersion range, and missing ligament percentages. Effects of random node distribution range and cell wall missing percentage on the elastic modulus and Poisson's ratio of chiral metastructures are investigated through experimental tests and finite element (FE) simulation systematically. Through dimensionless analysis, it is found that ligament thickness has remarkable influence on the negative Poisson's ratio. Effect of missing ligament on the mechanical properties of the structure is greater than effect of random node center dispersion. With the increase of ligament missing percentage, the resultant modulus of chiral metastructures decreases, and the corresponding NPR increases.
Meglumine Promoted Strategy: Environmentally Benign Protocol towards the Synthesis of Polysubstituted 2‐Aminopyrroles in Aqueous Condition
Authors: Yadav Vijay B. , Yadav Neetu , Rai Pragati , Ansari Mohd Danish , Kumar Akhilesh , Verma Ankit , Siddiqui I. R.
Published: May 2019

A facile and highly efficient protocol for the one‐pot, four‐component synthesis of polysubstituted 2‐aminopyrroles by using glyoxal monohydrate derivatives, anilines, coumarin derivatives, and malononitrile has been developed. Meglumine used as an inexpensive, biodegradable and reusable catalyst. Simplicity, green solvent, easy work‐up process, cost effective and reusability of the promoter are the main advantages of reported methodology.
The Problem with Person-Rearing Accounts of Moral Status
Authors: Timmerman Travis , Fischer Bob ,   Philosophy Documentation Center
Published: May 2019

Agnieszka Jaworska and Julie Tannenbaum recently developed the ingenious and novel person-rearing account of moral status, which preserves the commonsense judgment that humans have a higher moral status than nonhuman animals. It aims to vindicate speciesist judgments while avoiding the problems typically associated with speciesist views. We argue, however, that there is good reason to reject person-rearing views. Person-rearing views have to be coupled with an account of flourishing, which will (according to Jaworska and Tannenbaum) be either a species norm or an intrinsic potential account of flourishing. As we show, however, person-rearing accounts generate extremely implausible consequences when combined with the accounts of flourishing Jaworska and Tannenbaum need for the purposes of their view.
Small heat shock protein genes of the green algae Closterium ehrenbergii: Cloning and differential expression under heat and heavy metal stresses
Authors: Abassi Sofia , Wang Hui , Ponmani Thangaraj , Ki Jang‐Seu
Published: May 2019

The freshwater green algae Closterium ehrenbergii has been considered as a model for eco‐toxicological assessment in aquatic systems. Heat shock proteins (HSPs) are a class of highly conserved proteins produced in all living organisms, which participate in environmental stress responses. In the present study, we determined the cDNA sequences of small heat shock protein 10 (sHSP10) and sHSP17.1 from C. ehrenbergii, and examined the physiological changes and transcriptional responses of the genes after exposure to thermal shock and toxicants treatments. The open reading frame (ORF) of CeHSP10 was 300 bp long, encoding 99 amino acid (aa) residues (10.53 kDa) with a GroES chaperonin conserved site of 22 aa. The CeHSP17.1 had a 468 bp ORF, encoding 155 aa with a conserved C‐terminal α‐crystallin domain. For heat stress, cells presented pigment loss and possible chloroplast damage, with an up‐regulation in the expression of both sHSP10 and sHSP17.1 genes. As for the heavy metal stressors, an increase in the production of reactive oxygen species was registered in a dose dependent manner, with a significant up‐regulation of both sHSP10 and sHSP17.1 genes. These results suggest that sHSP genes in C. ehrenbergii may play a role in responses to stress environments, and they could be used as an early detection parameter as biomarker genes in molecular toxicity assessments.
Learning environment, stress and coping in psychiatry residents within a national training program: a longitudinal study
Authors: Chew Qian Hui , Holmboe Eric , Sim Kang
Published: May 2019

Introduction Perception of one’s learning environment is associated with academic performance and well-being of medical students. Yet, few studies have explored learners’ perceptions and their correlates within a postgraduate environment. This study examined longitudinal changes in learning environment perception, perceived stress and coping for psychiatry residents in junior and senior years of training. Based on extant social learning theories, we hypothesized that learning environment perceptions will improve with seniority, and be accompanied by lower stress levels and better coping.
Methods Eighty-two out of 101 psychiatry residents (81.2%) from our National Psychiatry Residency Program rated their perception of learning environment, perceived stress, and coping strategies from June 2016 to June 2018. Correlations between these variables, and changes across five timepoints were examined.
Results Senior-year residents reported better perception of learning environment over time, together with increased use of problem-focused coping and lowered perceived stress levels. Junior-year residents reported no changes in learning environment perception and coping strategies, despite rating greater perceived stress levels over time. Perception of learning environment negatively correlated with perceived stress levels and specific coping strategies.
Discussion Based on these findings, we suggest specific strategies with the emphasis on context, participation, and social interaction within a community of practice to better support residents in training, which are applicable to other similar training programs.
Schleiermacher's Dialektik: The Discovery of the Self that Kant Lost
Authors: Thandeka
Published: May 2019

In this article I shall argue that Friedrich Schleiermacher found the self that Immanuel Kant lost. Two steps are necessary to support this argument. First, I shall demonstrate that Kant knew that he had lost the self. Second, I shall demonstrate that Schleiermacher knew that he had found the self that Kant had lost. I am aware that these two demonstrations will not actually prove that Schleiermacher did find the self that Kant lost. I believe, however, that if we understand why Kant thought that he had lost the self and if we understand the way in which Schleiermacher believed that he retrieved this self, we shall be better off. We shall have discovered a way to reach beyond the limits of our own mental constructs and affirm the unity and integrity of life itself.
Theology in Mark and Q:Abbaand “Father” in Context
Authors: D'Angelo Mary Rose
Published: May 2019

In the last twenty years, Joachim Jeremias's interpretation of the wordabbahas become a focus of theologies that attempt to base themselves on the Jesus of history. In the face of feminist critiques of the use of “father” for God, Robert Hamerton-Kelly reiterated Jeremias's case for Jesus' supposedly unique usage of bothabbaand “father,” asserting its revelatory status and its freedom from and even opposition to patriarchy. Some feminist scholars have attempted to incorporate Hamerton-Kelly's description of Jesus' use ofabbainto feminist understandings of God, based on reconstructions of Jesus' teaching.
Biological role of excretory–secretory proteins in endemic parasites of Latin America and the Caribbean
Authors: Gomez-Fuentes S. , Morales-Ruiz V. , López-Recinos D. , Guevara-Salinas A. , Arce-Sillas A. , Rodríguez J.F. , Parada-Colin C. , Adalid-Peralta L.
Published: May 2019

Neglected tropical diseases (NTDs) share certain traits: they are parasitic infections, prevailing in tropical environments and affecting marginalized sectors of the population. Six NTDs – ascariasis, cysticercosis, echinococcosis, hookworm infection, onchocerciasis and trichuriasis – all of them endemic in Latin America and the Caribbean (LAC), are analysed in this work. This review aims to discuss key information on the function of excretory/secretory (E/S) proteins from these parasites in their infectivity, pathogeny and diagnosis. The modulation of the host immune system to favour the permanence and survival of the parasite is also discussed. An updated knowledge on the function of E/S molecules in endemic parasitoses in LAC may lead to new approaches for the clinical management and diagnosis of these diseases. In turn, this could allow us to optimize their treatment and make it more affordable – a relevant goal given the economic constraints that the region is facing.
Factors Affecting Germination of Dogfennel (Eupatorium capillifolium) and Yankeeweed (Eupatorium compositifolium)
Authors: Macdonald Gregory E. , Brecke Barry J. , Shilling Donn G.
Published: May 2019

Laboratory studies were conducted to determine the effect of various factors on germination of dogfennel and yankeeweed. Dogfennel seed were found to be strongly photoblastic with no germination in the dark. Yankeeweed seed were moderately photoblastic, with 12% germination occurring in the absence of light Germination for both species increased in response to red light (650 nm), indicating phytochrome regulation. At the soil surface, dogfennel and yankeeweed emergence was 40 and 48%, respectively, but declined rapidly with increasing soil depths where dogfennel germination was lower than that of yankeeweed. Yankeeweed germination was 60 to 75% from 10 to 30 C while dogfennel germination was 45 to 70% between 15 to 30 C. Both species germinated over a broad range of pH (6 to 10) with the highest germination occurring at pH 8. Yankeeweed and dogfennel were moderately tolerant to water stress, but yankeeweed tolerated higher water stress than dogfennel. Both species germinated over a wide range of conditions, possibly enhancing adaptation to many diverse environments.
Response ofFusarium solanif. sp.pisiandPythium ultimumto Glyphosate
Authors: Kawate Michael K. , Kawate Susan C. , Ogg Alex G. , Kraft John M.
Published: May 2019

The effect of glyphosate on growth and reproduction of two pathogenic fungi of green peas was evaluated in laboratory studies. Liquid and agar media containing 0 to 50 mM glyphosate were inoculated with two isolates each ofFusarium solanif. sp.pisiandPythium ultimum.Mycelial growth and spore production of the fungi were inhibited or stimulated by glyphosate, depending on concentration. Glyphosate did not affect pathogenicity ofF. solanif. sp.pisi.The effect of glyphosate on pathogenicity ofP. ultimumwas not determined. Under field conditions, glyphosate probably would not affect pathogenicity or survival of either fungus.
Shattercane (Sorghum bicolor) Interference in Soybean (Glycine max)
Authors: Fellows Gary M. , Roeth Fred W.
Published: May 2019

Shattercane interference in irrigated soybean was evaluated during 1987, 1988, and 1989 at Clay Center, NE, using ‘Rox’ forage sorghum to simulate shattercane. Soybean yield reduction did not occur if shattercane was removed by 2 wk after emergence in 1987 and 6 wk after emergence in 1988 and 1989. Shattercane interference with soybean began when shattercane height exceeded soybean height. Soybean yield was reduced up to 25% before the height differential reached 30 cm, the minimum difference required for selectively applying glyphosate with a wiper applicator. Soybean nodes per stem, pods per stem, and beans per pod decreased as duration of interference increased. A direct relationship between soybean yield loss and shattercane density fit a rectangular hyperbolic function. Yield loss per shattercane plant was highest at low shattercane densities. Soybean plant height, biomass, nodes per stem, pods per stem, pods per node, and beans per pod decreased as shattercane density increased. An interference model for estimation of soybean yield and economic loss based on shattercane density was developed.
Fluroxypyr Absorption and Translocation in Leafy Spurge (Euphorbia esula)
Authors: Lym Rodney G.
Published: May 2019

Absorption and translocation of14C-fluroxypyr were determined for leafy spurge at various growth stages, under differing relative humidity and temperature conditions, and when applied with picloram or 2,4-D. Absorption of14C-fluroxypyr was greater in vegetative plants (39%) than in flowering or postflowering plants (25%), while total translocated to roots averaged 2% of applied herbicide regardless of growth stage. Greater14C-fluroxypyr absorption and translocation occurred in plants exposed to high relative humidity (>90%) compared to low humidity (<30%) for 6 h or longer following treatment. Absorption and translocation to roots was independent of temperature (18 or 24 C). Absorption and translocation declined by 50% when applied with picloram or 2,4-D. However, absorption and translocation of14C-picloram or14C-2,4-D were not affected by fluroxypyr. Fluroxypyr would likely be used in a leafy spurge control program only during environmental conditions adverse to control with picloram such as unseasonably warm or cold temperatures or in areas with a high water table.
Effect of Droplet Size and Herbicide Concentration on Absorption and Translocation of14C-2,4-D in Oriental Mustard (Sisymbrium orientate)
Authors: Wolf Thomas M. , Caldwell Brian C. , Mcintyre Gordon I. , Hsiao Andrew I.
Published: May 2019

Individual droplets of14C-2,4-D dimethylamine (DMA) were applied to oriental mustard seedlings to determine the effect of droplet size and herbicide concentration on absorption and translocation 1 or 3 d after application. Absorption of14C-2,4-D was generally not affected by droplet size which ranged from 198 to 2760 μm. However, the percentage of absorbed14C-2,4-D that was translocated away from the treated leaf increased as droplet size decreased. Absorption of14C-2,4-D either increased slightly or was not affected by increased herbicide concentration, but translocation of absorbed14C-2,4-D was reduced as herbicide concentration increased. Absorption and translocation of14C-2,4-D DMA were reduced when applied after a drop of 21.3 mM commercially formulated 2,4-D had been applied at the same location on the leaf. These results indicate that large amounts of 2,4-D, either in the form of large droplets or a more concentrated herbicide solution, inhibit translocation of 2,4-D from oriental mustard leaves.
VECCHIO E NUOVO AUTORITARISMO NELL'EUROPA MEDITERRANEA
Authors: Morlino e Leonardo , Mattei Franco
Published: May 2019

Introduzione

Nel corso degli anni settanta, crisi autoritaria e transizione alla democrazia hanno caratterizzato Portogallo, Spagna e Grecia (O'Donnell, Schmitter e Whitehead 1986). Nello stesso periodo il quarto paese dell'Europa mediterranea, l'Italia, attraversava la sua crisi democratica piò difficile dai tempi dell'instaurazione repubblicana (1945-48), o addirittura dagli anni venti. In Spagna e Portogallo, il fallimento dei regimi autoritari e i relativi processi di democratizzazione erano scaturiti da una combinazione di trasformazioni interne, economiche e sociali, e internazionali (Morlino 1986). In Grecia quel fallimento veniva dal mancato consolidamento del regime militare, insieme all'attivazione di una notevole opposizione al regime e alla crisi di Cipro, cioè ancora da una combinazione di elementi interni ed internazionali. Trasformazioni socio-economiche e conseguente mobilitazione politica di nuovi gruppi e movimenti (lavoratori, giovani, donne) ovvero emergere di nuove domande erano anche alla base della crisi italiana (Farneti 1978; Morlino 1985).
NUOVI E VECCHI PARTITI DI ESTREMA DESTRA IN EUROPA
Authors: Ignazi Piero
Published: May 2019

Introduzione

I sistemi di partito dell'Europa occidentale stanno attraversando una fase di trasformazioni (Crewe and Denver 1985, Dalton, 1988, Daltonet al.1984, Daalder e Mair 1983, Mair 1984, 1989a, 1989b, Wolinetz 1988). Questa trasformazione è individuabile a due diversi livelli di analisi, elettorale e partitico.
Frequency and Cause of Parkinson’s Disease
Authors: Rajput A.H.
Published: May 2019

Parkinson syndrome (PS) is a common disorder in the North American population. The annual incidence rate is 20.5/100,000 population and the mean survival after onset is approximately 12.3 years. The estimated prevalence rate is about 300/100,000 population. The incidence and prevalence rates rise with advancing age. Both the widespread use of levodopa and the improved health care in general have increased the longevity in PS. The survival in PS from the time of the first clinic visit is still significantly shorter when compared with the regional age and sex matched population. The cause of IPD may be related to some environmental factor(s) – most likely a toxin. Genetic factors are not the cause but in some families, may predispose to IPD.
Sustained Release Antiparkinson Agents: Controlled Release Levodopa
Authors: Gauthier Serge , Amyot Donna
Published: May 2019

The rationale for sustained release oral levodopa preparations is to deliver levodopa in the areas of maximal intestinal absorption in a slow and predictable way, leading to stable plasma levodopa levels and brain dopamine levels, therefore resulting in a lengthened duration of action. Sinemet CR is the prototype of such preparations, with demonstrated efficacy in decreasing periods of akinesia in parkinsonian patients with mild to moderate motor fluctuations. Total doses of levodopa are raised 10 to 30% because of the lowered bioavailability; diphasic dyskinesias may increase at the end of the day. Tolerance is good in de novo patients and studies are in progress to establish if early treatment with Sinemet CR delays the onset or attenuates the severity of motor fluctuations as compared to standard Sinemet.
Mechanism of Cerebral Vasospasm Following Subarachnoid Hemorrhage in Monkeys
Authors: Macdonald R.L. , Weir B.K.A. , Grace M.G.A. , Chen M.H. , Martin T.P. , Young J.D.
Published: May 2019

This paper reviews our recent studies on the mechanism of cerebral vasospasm following subarachnoid hemorrhage (SAH) in monkeys. Middle cerebral artery (MCA) vasospasm was maximal at 7 days, resolving by 14 days, and absent at 28 days after SAH. Arterial fibrosis was not detected during vasospasm, although there was intimal hyperplasia with fibrosis 28 days after SAH. On scanning electron microscopy, smooth muscle cells from vasospastic arteries had corrugated cell membranes and appeared similar to cells contracted pharmacologically, suggesting that vasospastic smooth muscle is contracted. Morphometric analysis of arteries obtained 7 days after SAH showed no significant increases in arterial wall area of vasospastic arteries compared with normal MCAs. The results suggest vasospasm in monkeys is not due to hypertrophy, hyperplasia, or fibrosis in the arterial wall. Vasospasm may be mainly vascular smooth muscle contraction, which damages the arterial wall, leading to secondary structural changes in the arterial wall which occur after angiographic vasospasm.
Symptomatic Dystonia: Clinical Profile of 46 Brazilian Patients
Authors: Ferraz Henrique B. , Andrade Luiz Augusto F.
Published: May 2019

Dystonia is a syndrome characterized by sustained muscle contraction, provoking twisting and repeti-tive movements or abnormal postures. It may be classified according to etiology, as idiopathic or symptomatic. We studied 122 Brazilian patients with a dystonic syndrome. Of these, 46 (37.7%) had symptomatic dystonia. The most frequent cause was tardive dystonia (34.8%) followed by perinatal cerebral injury (30.4%). Other causes were stroke (13.0%), encephalitis (6.5%) and Wilson’s disease (4.3%). Cranial trauma, mitochondrial cytopathy and psychogenic, were the least frequent causes with one patient in each category. The etiology in two patients could not be established. Perinatal cerebral injury and postencephalitic dystonia were seen in the younger age group, while post-stroke and tardive dystonia were seen in the older age group.
Magnetic Resonance Imaging and 31P Magnetic Resonance Spectroscopy Study of the Effect of Temperature on Ischemic Brain Injury
Authors: Sutherland Garnette R. , Lesiuk Howard , Hazendonk Paul , Peeling James , Buist Richard , Kozlowski Piotr , Jazinski Andrzej , Saunders John K.
Published: May 2019

Transient forebrain ischemia was induced in rats whose brain temperature was 31, 33, 35, 38, or 40°C. The development of regional injury was followed using magnetic resonance (MR) imaging, with the ultimate extent of neuronal injury quantified histopathologically. Animals in the hypothermic groups showed minimal changes in MR images over 4 days; normothermic animals snowed intensity enhancement attributed to progressive edema developing in the striatum and, later, in the hippocampus. Ischemia at 40°C resulted in widespread edema formation by I day post-ischemia; animals in this group did not survive beyond 30 hours. Histopathological analysis at 4 days (1 day for the hyperthermic group) post-ischemia showed that neuronal damage in the normothermic group was confined to the hippocampus and striatum. Minimal damage was found in the hypothermic groups; damage in the hyperthermic group was severe throughout the forebrain. There were no differences in the pre-ischemia 31P MR spectra for the different groups. During ischemia, the increase in intensity of the Pi peak and the fall in tissue pH increased with temperature in the order hypothermic < normothermic < hyperthermic group of animals. Post-ischemia energy recovery was similar in all groups, while pH recovered more rapidly in hypothermic animals.
The Distinctive Clinical Features of Paraneoplastic Sensory Neuronopathy
Authors: Chalk Colin H. , Windebank Anthony J. , Kimmel David W. , McManis Philip G.
Published: May 2019

A 15-year experience with paraneoplastic sensory neuronopathy at the Mayo Clinic is reviewed. Of 26 patients with paraneoplastic sensory neuronopathy, 19 had small cell lung cancer, 4 had breast cancer, and 3 had other neoplasms. There was a striking predominance of females (20:6). Neuropathic symptoms (pain, paresthesia, sensory loss) were asymmetric at onset, with a predilection for the upper limbs; in three patients, symptoms were confined to the arms. Electrophysiologic testing revealed absent sensory responses and normal or minimally altered motor responses. Slightly more than half the patients had associated autonomic, cerebellar, or cerebral abnormalities. In some patients, treatment of the neoplasm seemed to halt progression of the neuronopathy, but none had neurologic improvement and most continued to worsen, even when the oncologic response was good. Distinguishing between paraneoplastic and nonparaneoplastic sensory neuronopathies can be difficult, but prominent neuropathic pain, neurologic dysfunction involving more than the peripheral sensory system, or an increased cerebrospinal fluid protein value should prompt a careful search for a cancer.
Clinically Non-Functioning Human Pituitary Adenomas
Authors: Asa Sylvia L. , Kovacs Kalman
Published: May 2019

Clinically non-functioning pituitary adenomas are morphologically classified into two groups, those which have hormone immunoreactivity and ultrastructural features of known adenohypophysial cell types but are clinically silent, and those composed of cells that do not resemble nontumorous adenohypophysial cell types. Among the fomer are the silent somatotroph adenomas, silent corticotroph adenomas and silent gonadotroph adenomas; the latter include the silent type III adenomas, null cell adenomas and oncocytomas. We review their histological, immunohistochemical and ultrastructural features, the results of in situ hybridization to determine hormone synthesis by these tumors and data obtained from tissue culture characterizing their hormone release in vitro. Non-functioning adenomas represent a heterogeneous group. The discrepancies between morphology, immunoreactivity and lack of endocrine activity of silent adenomas are not clear. Oncocytomas are variants of null cell adenomas. We suggest that null cell adenomas and oncocytomas originate in uncommitted pluripotent precursor cells capable of undergoing multidirectional differentiation. The progenitor cells differentiate most frequently toward FSH / a-subunit producing cells; the mechanism of preferential differentiation is obscure.
Chronic Lymphocytic Leukemia Presenting as a Pituitary Mass Lesion
Authors: Fain Jonathan S. , Naeim Faramarz , Becker Donald P. , Van Herle Andre , Yan-Go Frisca , Petrus Leonard , Vinters Harry V.
Published: May 2019

We describe a unique case of chronic lymphocytic leukemia (CLL) in a patient who presented with bitemporal hemianopsia, adrenal insufficiency, and gonadotrophin deficiency. Studies revealed an enhancing intrasellar mass with suprasellar extension and displacement of the optic chiasm. Peripheral blood and cerebrospinal fluid (CSF) studies disclosed a monoclonal IgM kappa expressing B-cell CLL. Biopsy of the pituitary mass revealed dense infiltration of the pituitary gland by leukemic cells. This is, to our knowledge, the first reported case of CLL presenting as a pituitary mass lesion.
Agricultural Adaptation to Urbanization: Farm Types in Northeast Metropolitan Areas
Authors: Heimlich Ralph E. , Barnard Charles H.
Published: May 2019

Metropolitan agriculture is not homogeneous. This paper delves beneath metropolitan county averages using data on individual farms in the Northeast classified into three statistically distinct types. A small group of adaptive farms profit from intensive production on smaller acreage to accommodate themselves to the urban environment. Traditional farms have increased costs and pressures on their more extensive operations without compensating increases in revenue from better-adapted enterprises. A large group of recreational farms subsidize small-farm activities from nonfarm income. Operating characteristics of each farm type are presented and their importance to metropolitan agriculture is assessed. Implications for preserving farming and farmland in the Northeast are drawn.
Protest Bidders in Contingent Valuation
Authors: Halstead John M. , Luloff A.E. , Stevens Thomas H.
Published: May 2019

Protest bids are often excluded during analysis of contingent valuation method data. It is suggested that this procedure might introduce significant bias. Protest bids are often registered by respondents who may actually place ahigher-orlower-than-average value on the commodity in question but refuse to pay on the basis of ethical or other reasons. Exclusion of protest bids may therefore bias willingness to pay (WTP) results, but the direction of bias is indeterminate a priori.
Prehospital Research
Authors: Yealy Donald M.
Published: May 2019

Prehospital care experienced a “honeymoon” from the early 1970s until recently. Treatments usually were extrapolated directly from the hospital setting, even though the prehospital environment is markedly different. That honeymoon is over and emergency medical services (EMS) providers must prove what is beneficial. Additionally, academic prehospital care physicians interested in professional advancement, must show the same ability as do the more traditional medical academicians to expand the knowledge base of their chosen field.

This manuscript will highlight the basic features and identify the potential benefits and pitfalls of prehospital research. This chapter is not a cookbook for EMS research, nor will it obviate the need for accessing other sources on research design. Other manuscripts within this series will focus on more specific topics; yet, it will be obvious that many of the points made here will be re-emphasized in the following papers. That simply is a reflection of the importance of these commonly overlooked perils and pitfalls.
Die geschützte Station
Authors: Volmar Benjamin
Published: May 2019

Zusammenfassung. Viele psychiatrische Kliniken und Altenheime proklamieren für sich spezialisierte Bereiche, in denen sie Menschen mit schweren psychischen Problemlagen behandeln. In diesen „geschützten Stationen“ entsteht durch die eine „geschlossene Unterbringung“ eine besondere Atmosphäre für die Patienten. Diese Settings wurden in früheren Diskursen als geschlossene Stationen bezeichnet. Der Begriff der „geschlossene Unterbringung“ kann mit einem Gefängnisaufenthalt oder gefährlichen Klientel assoziiert werden. Eine Hypothese zur Nutzung der veränderten Begrifflichkeit von der „geschlossenen Station“ hin zur „geschützten Station“ ist die veränderte Sinndeutung im Kontext der Herstellung einer offenen Haltung der Nutzer psychiatrischer Dienstleistungen.
Variations in Ocean Deoxygenation Across Earth System Models: Isolating the Role of Parameterized Lateral Mixing
Authors: Bahl A. , Gnanadesikan A. , Pradal M.‐A.
Published: May 2019

Modern Earth system models (ESMs) disagree on the impacts of anthropogenic global warming on the distribution of oxygen and associated low‐oxygen waters. A sensitivity study using the GFDL CM2Mc model points to the representation of lateral mesoscale eddy transport as a potentially important factor in such disagreement. Because mesoscale eddies are smaller than the spatial scale of ESM ocean grids, their impact must be parameterized using a lateral mixing coefficientAREDI. The value ofAREDIvaries across modern ESMs and nonlinearly impacts oxygen distributions. This study shows that an increase in atmospheric CO2results in a decline in productivity and a decrease in ventilation age in the tropics, increasing oxygen concentrations in the upper thermocline. In high latitudes global warming causes shallowing of deep convection, reducing the supply of oxygen to the deep. The net impact of these processes depends onAREDI, with an increase in hypoxic volume yet smaller total deoxygenation in the low‐mixing models, but a decrease in hypoxic volume yet larger total deoxygenation in the high‐mixing models. All models show decreases in suboxic volume, which are largest in the low‐mixing models. A subset of Coupled Model Intercomparison Project Phase 5 models exhibits a similar range of responses to global warming and similar decoupling between total deoxygenation and change in hypoxic volume. Uncertainty in lateral mixing remains an important contributor to uncertainty in projecting ocean deoxygenation.
Intensification of the North American Monsoon Rainfall as Observed From a Long‐Term High‐Density Gauge Network
Authors: Demaria Eleonora M. C. , Hazenberg Pieter , Scott Russell L. , Meles Menberu B. , Nichols Mary , Goodrich David
Published: May 2019

As the atmosphere gets warmer, rainfall intensification is expected across the planet with anticipated impacts on ecological and human systems. In the southwestern United States and northwestern Mexico, the highly variable and localized nature of rainfall during the North American Monsoon makes it difficult to detect temporal changes in rainfall intensities in response to climatic change. This study addresses this challenge by using the dense, subdaily, and daily observations from 59 rain gauges located in southeastern Arizona. We find an intensification of monsoon subdaily rainfall intensities starting in the mid‐1970s that has not been observed in previous studies or simulated with high‐resolution climate models. Our results highlight the need for long‐term, high spatiotemporal observations to detect environmental responses to a changing climate in highly variable environments and show that analyses based on limited observations or gridded data sets fail to capture temporal changes potentially leading to erroneous conclusions.
Enhancing Pain Assessment in Pediatric Sickle Cell Disease by Applying Quality Improvement Science
Authors: Sil Soumitri , Goldstein-Leever Alana , Travers Curtis , Gilleland-Marchak Jordan , Alexander Ashley , Thompson Beth , Griffin Anya , McCracken Courtney , New Tamara
Published: May 2019

Objective: Standardized pain assessment and interventions are recommended for youth hospitalized for pain. This quality improvement project integrated into a pediatric psychology service aimed to increase the standardized assessment of pain-related functional ability for youth with sickle cell disease (SCD) hospitalized for pain. Method: Children and adolescents ( n = 102) with SCD referred for psychology consultation for poor coping in response to pain during hospitalization completed a validated self-report of functional ability in addition to pain intensity during inpatient psychology visits. At the time of the quality initiative, routine and standardized assessment of pain-related functional ability was not integrated into standard clinical care. Plan–do–study–act cycles determined the feasibility and addressed common barriers of routine assessment and documentation of pain-related functional ability among youth with SCD during inpatient psychology visits with the primary goal to increase assessment of functional ability to at least 85% among patients with SCD referred for pediatric psychology consultation to address pain management within 1 year. Results: Through iterative plan–do–study–act cycles, routine assessment of pain-related functional ability during psychology visits increased to an average of 93% over the course of 12 months. Routine, standardized assessment of functional ability was considered feasible within a pediatric psychology service. Conclusions/Lessons Learned: This project supported the feasibility of integrating standardized assessment of functional ability to enhance pain assessment for youth hospitalized for SCD pain as part of routine clinical care in a multidisciplinary setting regardless of psychology referral.

Implications for Impact Statement

This project illustrates that small systematic changes using an iterative quality improvement process can improve the assessment rates of pain-related functional ability for youth with sickle cell disease hospitalized for pain. Improved multidimensional pain assessment was feasible for clinicians to implement and for patients to complete.
Behavioral Assessment and Treatment of Pica in a Typically Developing 3-Year-Old
Authors: Ness Emily , Strohmeier Craig W. , Ramazon Nicholas , O’Connor Julia T.
Published: May 2019

Pica involves the persistent ingestion of nonfood and nonnutritive substances and may result in harmful consequences such as choking, poisoning, and even death. Most commonly, pica is observed in individuals diagnosed with intellectual and developmental disabilities (IDDs) where the cause is oftentimes reported as related to automatic reinforcement or the sensory consequences of ingesting substances. Objectives: In the IDD population, several well-established behavioral treatments are available for pica. Less often reported in the literature are cases of pica in typically developing individuals, in which case, medical interventions are more prevalent despite mixed reports of their success. The current study describes the behavioral treatment of pica for a typically developing 3-year-old female. Method: After a pretreatment functional assessment indicated that pica was maintained by attention from caregivers, a multiple baseline across settings single-case experimental design was used to demonstrate the effects of differential reinforcement, extinction, and a token economy treatment package to decrease rates of pica. Results: Reductions in pica were observed across all settings. Caregivers implemented the final treatment package, with high integrity, which continued to produce low rates of pica. Conclusions: This case report demonstrated that behavioral treatments may lead to reductions in pica in typically developing children when medical interventions are not effective.

Implications for Impact Statement

Treatments for pica in typically developing children usually involve medical interventions to address nutritional deficiencies (e.g., iron) that may be the cause of pica. This case report describes the successful use of behavioral assessment and treatment technology, commonly used for children with development disabilities, for a typically developing child when a medical intervention failed to resolve pica.
Participant-reported priorities and preferences for developing a home-based physical activity telemonitoring program for persons with tetraplegia: a qualitative analysis
Authors: Pekmezaris Renee , Kozikowski Andrzej , Pascarelli Briana , Handrakis John P. , Chory Ashley , Griffin Doug , Bloom Ona
Published: May 2019

Study design

Focus group.

Objectives

The purpose of this qualitative study was to explore perceptions and priorities of persons with spinal cord injury (SCI) for physical activity and to incorporate their feedback to inform future development of a physical activity program delivered via a telemonitoring platform.

Setting

New York.

Methods

Qualitative data were collected from a purposive sample of adults with tetraplegia (N = 7). Two investigators led an audio-recorded focus group using a moderator’s guide. Data were analyzed using a six-phase thematic analysis approach.

Results

The discussion focused on two major areas, which resulted in multiple derived themes and subthemes. The first theme centered on the daily life of persons with tetraplegia, including changes after SCI, gain of function prioritization, and identification of psychosocial support systems that facilitate community reintegration after injury. The second theme centered on participant perceptions and recommendations for a physical activity program delivered via a telemonitoring platform. Desired design features included variations in schedule, diverse activities, or exercises included in each class, and optional two-way video to enable social interactions with classmates.

Conclusions

Participants favorably viewed the concept of a physical activity program delivered via a telemonitoring platform and contributed program design ideas. Although this was a small sample size, challenges to obtaining physical activity expressed by participants were consistent with those identified previously in larger studies of persons with tetraplegia. Therefore, we expect these concepts and their recommendations to be relevant to the greater SCI community.
miR-23b-3p suppressing PGC1α promotes proliferation through reprogramming metabolism in osteosarcoma
Authors: Zhu Ran , Li Xinpan , Ma Yanhong
Published: May 2019

Metabolic shift from oxidative phosphorylation (OXPHOS) to glycolysis is a hallmark of osteosarcoma (OS). However, the mechanisms of the metabolic switch have not been completely elucidated. Here we reported that the miR-23b-3p was significantly upregulated in OS cells. Functional studies suggested that knockdown of miR-23b-3p could inhibit OS cell proliferation in vitro or in vivo. In addition, suppression of miR-23b-3p could lead to upregulation of OXPHOS and suppression of glycolysis. Mechanistically, miR-23b-3p promoted OS cell proliferation and inhibited OXPHOS in OS, at least in part, by directly targeting peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC1α) and inhibiting its expression. Our data highlights important roles of miR-23b-3p and PGC1α in glucose metabolism reprogram of OS. The suppression of miR-23b-3p may provide effective therapeutic strategies for the treatment of OS.