bluuebunny/crossref_metadata_2025 huggingface dataset:
Tragedy
Authors: Toscano Alberto
Published: November 2019

From Plato’s Republic and Aristotle’s Poetics onward, tragedy has loomed large in the genealogy of literary theory. But this prominence is in many regards paradoxical. The original object of that theory, the Attic tragedies performed at the Dionysian festivals in 5th- century bce Athens, are, notwithstanding their ubiquitous representation on the modern stage, only a small fraction of the tragedies produced in Athens, and are themselves torn from their context of performance. The Poetics and the plays that served as its objects of analysis would long vanish from the purview of European culture. Yet, when they returned in the Renaissance as cultural monuments to be appropriated and repeated, it was in a context largely incommensurable with their existence in Ancient Greece. While the early moderns created their own poetics (and politics) of tragedy and enlisted their image of the Ancients in the invention of exquisitely modern literary and artistic forms (not least, opera), it was in the crucible of German Idealism and Romanticism, arguably the matrix of modern literary theory, that certain Ancient Greek tragedies were transmuted into models of “the tragic,” an idea that played a formative part in the emergence of philosophical modernity, accompanying a battle of the giants between dialectical (Hegelian) and antidialectical (Nietzschean) currents that continues to shape our theoretical present. The gap between a philosophy of the tragic and the poetics and history of tragedy as a dramatic genre is the site of much rich and provocative debate, in which the definition of literary theory itself is frequently at stake. Tragedy is in this sense usefully defined as a genre in conflict. It is also a genre of conflict, in the sense that ethical conflicts, historical transitions, and political revolutions have all come to define its literary forms, something that is particularly evident in the place of both tragedy and the tragic in the dramas of decolonization.
Social Capital and Founder, Team, and Firm Networks in Entrepreneurship
Authors: Hoang Ha
Published: November 2019

Entrepreneurial activity is facilitated by the ties that connect founders and their venture to a broader network of actors. This insight on the value of social capital has been enriched by a large body of research that builds on core concepts of network content, governance, and structure. Network content refers to the resources, information and social support that is exchanged or flows between actors. Governance encompasses the mechanisms that organize and regulate the exchange. Network structure refers to broader patterns created from the relationships between actors. With these building blocks, key findings that have emerged over 30 years of research can be organized into two domains: how networks influence entrepreneurial outcomes and how networks develop over the entrepreneurial process. Core findings regarding the performance consequences of social capital underscore its benefits while identifying limitations due to decreasing returns to growing and maintaining a large network or to contingencies tied to the stage of the venture’s growth. Our understanding of the sources of network evolution and the resulting patterns have also developed significantly. As a motor of network change, scholars have emphasized the goal-oriented behavior of the entrepreneur, but recognize social relationships also engender mutual concern, obligation, and emotional attachment. From a focus on founder and founding team ties to start-up, small firm networks, the literature now spans multiple levels and accounts for contextual variation between industries and institutional environments. Advances within each of these domains of inquiry have led to rich insights and greater conceptual complexity. Future research opportunities will arise that leverage cross-fertilization of the process and performance research streams.
Japanese Pirates and the East Asian Maritime World, 1200–1600
Authors: Shapinsky Peter D.
Published: November 2019

Historians translate a variety of terms from 13th- through 17th-century Japan, China, Korea, and Europe as “Japanese pirates” (e.g., Jp. kaizoku, Kr. waegu, Ch. wokou). These constructs reflected the needs of regimes and travelers dealing with a maritime world over which they had little direct control, and often denoted bands of seafarers who based themselves in maritime regions beyond and between the reach of land-based political centers. Seafarers rarely used the terms to refer to themselves.

Japanese pirates opportunistically traded, raided, and transmitted culture in periods when and places where the influence of central governments attenuated. However, some innovated forms of maritime lordship that enabled them to establish dominance over sea-lanes and territories at the heart of the Japanese archipelago. Pirates developed expertise in navigation and naval warfare that helped them acquire patrons, who provided access to networks of diplomacy and trade. In the 16th century, some Japanese pirates forged multiethnic crews that seized control of the maritime networks linking East and Southeast Asia.

Labels for Japanese pirates also operated as ethnographical, geographical, and historical symbols. Traumatic assaults by waves of Japanese pirates who massacred and enslaved local populations were indelibly etched into the collective memories of Koryŏ–Chosŏn Korea and Ming–Qing China. By contrast, in early modern Japan the eradication of piracy enabled the state to extend its maritime sovereignty as well as to then commemorate pirates as ethnocentric symbols of Japanese warrior prowess.
Heterogeneous Firms, Trade Liberalization, and Welfare
Authors: Spearot Alan
Published: November 2019

While the modern theory of international trade allows for many different modeling assumptions, the gains from trade can often be calculated using a common set of statistics. In particular, the share of a country’s output that is consumed domestically, the elasticity of bilateral trade with respect to trade costs, and the relationship between markups and firm size, each have a clear role in the gains from integration. All of these statistics may also be structurally linked to the degree of firm heterogeneity, usually the dispersion in firm-level productivity. Accordingly, the presence of firm heterogeneity may have a meaningful impact on the welfare response to trade liberalization. A quantitative application of a common firm heterogeneity model indicates that increased dispersion of firm-level productivity has a disproportionately large and positive impact on the gains from trade for smaller, less-developed countries.
General Equilibrium Theories of Spatial Agglomeration
Authors: Berliant Marcus , Wang Ping
Published: November 2019

General equilibrium theories of spatial agglomeration are closed models of agent location that explain the formation and growth of cities. There are several types of such theories: conventional Arrow-Debreu competitive equilibrium models and monopolistic competition models, as well as game theoretic models including search and matching setups. Three types of spatial agglomeration forces often come into play: trade, production, and knowledge transmission, under which cities are formed in equilibrium as marketplaces, factory towns, and idea laboratories, respectively. Agglomeration dynamics are linked to urban growth in the long run.
Religion and Gender in Ancient Rome
Authors: DiLuzio Meghan
Published: November 2019

Roman society was patriarchal, which is to say that it was marked by sexual asymmetry in which males tended to have power over females. As in most ancient societies, religion contributed to a pervasive belief that such an arrangement was part of the “natural” order of things. Ritual practices allowed Romans to perform and internalize ideas about gender roles and the relation between the sexes. This was true in both civic rituals as well as in the ceremonies performed by individuals and households. The ritual sphere was an ideal space for the formation of gender roles because it was fundamentally inclusive. Numerous ancient sources testify to the communal and collective dimension of worship, and not just at births, marriages, and funerals, where women naturally performed a range of important ritual functions. Men and women worshiped the same gods and participated in many of the same civic cults and festivals. They held important public priesthoods and presided over many of the same rituals, including even blood sacrifice. Religion permeated the daily lives of men and women in ancient Rome, playing an important role in the transmission of cultural and social practices and values related to gender.
Expression and Prognostic Value of IFIT1 and IFITM3 in Head and Neck Squamous Cell Carcinoma
Authors: Li Hao , Yang Lei-Lei , Wu Cong-Cong , Xiao Yao , Mao Liang , Chen Lei , Zhang Wen-Feng , Sun Zhi-Jun
Published: November 2019

Objectives

Interferon-induced protein with tetratricopeptide repeats 1 (IFIT1) and interferon-induced transmembrane protein 3 (IFITM3) are commonly induced by type I interferon. The study aims to investigate the expression and clinical significance of IFIT1 and IFITM3 in head and neck squamous cell carcinoma (HNSCC).

Methods

Immunohistochemistry was applied on tissue microarray to reveal IFIT1 and IFITM3 expression in 275 HNSCC, 69 dysplasia, and 42 normal mucosa samples. The clinicopathologic features associated with IFIT1 and IFITM3 expression in HNSCC patients were analyzed.

Results

IFIT1 and IFITM3 were highly expressed in HNSCC tissues. High expression of IFIT1 and IFITM3 predicts a negative prognosis for patients (P < .01). IFIT1 and IFITM3 expression was associated with programmed cell death ligand 1, B7-H4, V-domain Ig suppressor of T-cell activation, indoleamine 2,3-dioxygenase, and macrophage marker immunoreactivity.

Conclusions

IFIT1 and IFITM3 were overexpressed in HNSCC and indicated poor prognoses for patients with HNSCC. IFIT1 and IFITM3 expression was correlated with several immune checkpoint molecules and tumor-associated macrophage markers.
Allogeneic HSCT for adult-onset leukoencephalopathy with spheroids and pigmented glia
Authors: Gelfand Jeffrey M , Greenfield Ariele L , Barkovich Matthew , Mendelsohn Bryce A , Van Haren Keith , Hess Christopher P , Mannis Gabriel N
Published: November 2019

Adult-onset leukoencephalopathy with spheroids and pigmented glia (ALSP) is an autosomal dominant leukoencephalopathy caused by mutations in colony stimulating factor 1 receptor (CSF1R). Here we report clinical and imaging outcomes following allogeneic haematopoietic stem cell transplantation (HSCT) in two patients with ALSP at the University of California, San Francisco between January 2016 and December 2017. Patient 1 proceeded to transplantation at age 53 with a haplo-identical sibling donor. Patient 2, whose sister and mother had died of the disease, proceeded to transplantation at age 49 with a 12/12 human leukocyte antigen-matched unrelated donor. Both patients received reduced intensity conditioning regimens. At 28 and 26 months post-HSCT, respectively, both patients were alive, without evidence of graft-versus-host disease, with major infection at 1 year in one and new-onset seizures in the other. In both cases, neurological worsening continued post-HSCT; however, the progression in cognitive deficits, overall functional status and gait impairment gradually stabilized. There was continued progression of parkinsonism in both patients. On brain MRI, within 1 year there was stabilization of T2/FLAIR abnormalities, and after 2 years there was complete resolution of abnormal multifocal reduced diffusion. In summary, after >2 years of follow-up, allogeneic HSCT in ALSP led to interval resolution of diffusion MRI abnormalities, stabilization of T2/FLAIR MRI abnormalities, and partial clinical stabilization, supportive of treatment response. Allogeneic HSCT may be beneficial in ALSP by providing a supply of bone marrow-derived brain-engrafting myeloid cells with donor wild-type CSF1R to repopulate the microglial niche.
Cat Scratch Disease Presenting as Fever of Unknown Origin Is a Unique Clinical Syndrome
Authors: Landes Michal , Maor Yasmin , Mercer Diego , Habot-Wilner Zohar , Bilavsky Efraim , Chazan Bibiana , Cohen Regev , Glikman Daniel , Strahilevitz Jacob , Katzir Michal , Litachevsky Vladislav , Melamed Rimma , Guri Alex , Shaked Hila , Perets Odelya , Wiener-Well Yonit , Stren Anat , Paul Michal , Zimhony Oren , Srugo Isaac , Rahav Galia , Bishara Jihad , Kuperman Amir A , Ben-Ami Ronen , Ephros Moshe , Giladi Michael
Published: November 2019

Background

Fever of unknown origin (FUO) is a rare manifestation of cat scratch disease (CSD). Data regarding CSD-associated FUO (CSD-FUO), particularly in adults, are limited. We aimed to study disease manifestations and long-term clinical outcome.

Methods

A national CSD surveillance study has been conducted in Israel since 1991. Data are obtained using questionnaires, review of medical records, and telephone interviews. FUO was defined as fever of ≥14 days without an identifiable cause. CSD-FUO patients were identified in the 2004–2017 CSD national registry. Follow-up included outpatient clinic visits and telephone/e-mail surveys.

Results

The study included 66 CSD-FUO patients. Median age was 35.5 years (range, 3–88). Median fever duration was 4 weeks (range, 2–9). Relapsing fever pattern was reported in 52% of patients, weight loss in 57%, and night sweats in 48%. Involvement of ≥1 organs occurred in 59% of patients; hepatosplenic space-occupying lesions (35%), abdominal/mediastinal lymphadenopathy (20%), ocular disease (18%), and multifocal osteomyelitis (6%) were the most common. Malignancy, particularly lymphoma, was the initial radiological interpretation in 21% of patients; 32% underwent invasive diagnostic procedures. Of the 59 patients available for follow-up (median duration, 31 weeks; range, 4–445), 95% had complete recovery; 3 patients remained with ocular sequelae.

Conclusion

This is the first attempt to characterize CSD-FUO as a unique syndrome that may be severe and debilitating and often mimics malignancy. Relapsing fever is a common clinical phenotype. Multiorgan involvement is common. Recovery was complete in all patients except in those with ocular disease.
O19 OUTCOMES OF IVOR LEWIS VERSUS MCKEOWN OESOPHAGECTOMY FOR CANCER: A PROPENSITY SCORE MATCHED ANALYSIS OF THE NETHERLANDS CANCER REGISTRY
Authors: Luijten J C H B M , Verstegen M , Nieuwenhuijzen G A P , van Berge Henegouwen M I , Gisbertz S S , Wijnhoven B P L , Verhoeven R H A , Rosman C
Published: November 2019

Aim

The aim this study was to investigate possible differences in outcomes between Ivor-Lewis (IL) versus McKeown esophagectomy (MK) in a population based cohort.

Background

It is unknown whether IL or MK should be preferred in patients with potentially curable locoregionally oesophageal or gastro-oesophageal junction (GEJ) cancer.

Methods

Oesophageal and GEJ cancer patients without distant metastases who underwent a transthoracic oesophagectomy between 2015 and 2017 were selected from the Netherlands Cancer Registry. Patient and tumour characteristics, and treatment outcomes were analysed and compared between IL and MK after propensity score matching (PSM). Patients were matched based on sex, age, tumour morphology and topography, comorbidities, neoadjuvant treatment, cT and cN stage, ASA-score and hospital volume. Postoperative complications and survival were compared between both groups using Chi-Square and multivariable Cox regression analyses. In the multivariable Cox regression analyses we corrected for infectious complications (wound complications and pneumonia) and anastomotic leakage to investigate its effect on survival.

Results

Off all 1764 included patients (1201 IL patients and 563 MK patients), 948 patients remained after matching. Significantly more lymph nodes were yielded after IL compared to MK (P=0.02). Surgical radicality did not differ between both groups (P=0.25). The complication rate was significantly lower in the IL group regarding anastomotic leakage (17% vs. 28%, P<0.0007) and recurrent laryngeal nerve palsy (2% vs. 6%, P<0.001). Cardiac complications were seen more frequently in patients who underwent IL (17% vs. 11%, P<0.02). No differences were observed in 30 day and 90 day mortality. Kaplan-Meier showed a better survival for IL (63%) compared to MK (58%) (log-rank p=0.07). When correcting for anastomotic leakage and infectious complications the difference in survival remained (HR=0.84, 95% CI 0.69 – 1.03). Similar results regarding postoperative complications and survival were observed in the unmatched cohort.

Conclusion

Patients who underwent an IL have better outcomes in terms of anastomotic leakage and recurrent laryngeal nerve palsy rate and overall survival compared to MK. The difference in survival appears not to be related to the differences in infectious complications. Based on these results, IL appears to be the treatment of choice in patients in whom both oncological resections are appropriate.
O34 A SLIGHTLY CRAZY BUT INFORMATIVE EXPERIMENT OF THE EFFECT OF THE HEAD DOWN (HD) POSTURE ON THE CHARACTERISTICS OF OESOPHAGEAL MOTILITY AND OESOPHAGOGASTRIC JUNCTION (OGJ) USING HIGH RESOLUTION OESOPHAGEAL MANOMETRY
Authors: Al-Saadi Hatem , Evans Stephanie , Sharples Alistair , Bradbury SCarl , Rao Vittal , Nagammapudur Balaji
Published: November 2019

Background

It is known that posture (Supine Vs Sitting) variations can affect the dynamics and manometric characteristics of the OG junction and Oesophageal motility.

Aims

To study the effect of the Head Down (HD) upside down posture on the esophageal motility characteristics and dynamics of the OG junction using High resolution manometry. This would partially replicate the effect of Obesity (High Intraabdominal pressure) on the OGJ.

Methods

A single crazy (but sane) volunteer who had no symptoms of GORD served as the model for this unique experiment. A high-resolution manometry was performed using a solid-state transducer catheter with 36 channels.

The study was performed in the sitting, supine and head down posture. Basal characteristics recording followed by wet swallows of 5ml of water and completed by rapid water swallows was done in each posture.

Analysis was performed in the standard fashion using Chicago classification metrics. Further correlation of findings with a multipostural barium video oesophagogram is awaited.

Results

The procedure was completed satisfactorily in all the three postures. Satisfactory progression of swallows in a peristaltic sequence was obtained in all the 3 postures. However it was noted that there was a sequential change in the following parameters from the sitting to the supine to head down postures. Increased residual and contraction pressures in the Cricopharyngeal high pressure zone more pronounced in the HD position.

Decreased amplitude of contraction of peristaltic sequences Decrease in slope of the peristaltic wave in the HD posture Diminished resting pressure in the HD position Exaggerated separation of the crural diaphragm (CD) and LES on the HD position Increased intragastric pressures in the HD position.

Conclusion

The above experiment is the first reported of Oesophageal function and OGJ dynamics in a completely unaided head down position using high resolution manometry and video fluoroscopy. The findings may serve to imitate the effect of Obesity on the OJ junction
O97 ADJUVANT CHEMORADIOTHERAPY IS BENEFICIAL IN MARGIN POSITIVE PATIENTS FOLLOWING NEO-ADJUVANT CHEMOTHERAPY AND SURGERY FOR LOWER OESOPHAGEAL AND GOJ ADENOCARCINOMA
Authors: Bott R , Zylstra J , Wilkinson M , Knight W , Baker C , Kelly M , Maisey N , Beckmann K , Van Hemelrijck M , Gossage J , Allum W , Smyth E , Cunningham D , Davies A
Published: November 2019

Aim

The aim of this study was to assess the survival benefit of adjuvant therapy in margin positive patients following neo-adjuvant chemotherapy and surgery for lower oesophageal and GOJ adenocarcinoma.

Background & Methods

The role of adjuvant therapy in oesophago-gastric adenocarcinoma patients treated by neo-adjuvant chemotherapy is contentious. In UK practice, surgical resection margin status is often used to stratify patients into receiving adjuvant treatment. Two prospectively collected UK institutional databases were combined. Patients were classified by the adjuvant therapy received. Crude and adjusted Cox regression analyses compared overall and recurrence free survival according to the adjuvant treatment, stratified by resection margin status. Recurrence patterns were assessed as a secondary outcome.

Results

From a total of 616 patients, 242 had positive margins. In this R1 resection group, 112 patients (46%) received adjuvant chemoradiotherapy compared to 46 patients (19%) who received adjuvant chemotherapy and 84 patients (35%) who received no adjuvant treatment. On adjusted analysis, pathological N3 status (p<0.001) and poor differentiation (p=0.024) were independently associated with overall survival. When stratified by tumour response to neo-adjuvant chemotherapy, a significant survival benefit in non-responders (Mandard Grade 4&5, adjuvant chemoradiotherapy HR 0.61 95%CI 0.38-0.97; p=0.037) was observed. Additionally, adjuvant chemoradiotherapy significantly improved recurrence free survival (HR 0.59 95%CI 0.38-0.94; p=0.026) with a specific benefit for systemic recurrence (HR 0.56 95%CI 0.33-0.94; p=0.027) in both responder (Mandard Grade 1-3) and non-responder (Mandard Grade 4&5) patient groups.

Conclusion

Adjuvant chemoradiotherapy improves overall survival, recurrence-free survival and systemic recurrence rates in R1 resection patients. This pattern is most pronounced in non-responders (Mandard 4&5) to neo-adjuvant chemotherapy suggesting a change in strategy to be effective for this specific patient group.
Firm Reputation, Innovation and Employee Startups
Authors: Zábojník Ján
Published: November 2019

This article studies how a firm’s reputation for rewarding innovative employees affects innovation and startup creation. In any Pareto-efficient equilibrium of the repeated game, low-value innovations are developed in-house, while high-value innovations are developed in startups. When distributions of ideas are ordered by simple cases of first- or second-order stochastic dominance, the firm has a preference for an extreme distribution. The article also characterises the optimal relational contract and workers’ incentives to invest in innovation. The model’s predictions are consistent with a broad set of observed regularities regarding the creation of employee startups.
Defining the eco-enzymological role of the fungal strain Coniochaeta sp. 2T2.1 in a tripartite lignocellulolytic microbial consortium
Authors: Jiménez Diego Javier , Wang Yanfang , Chaib de Mares Maryam , Cortes-Tolalpa Larisa , Mertens Jeffrey A , Hector Ronald E , Lin Junyan , Johnson Jenifer , Lipzen Anna , Barry Kerrie , Mondo Stephen J , Grigoriev Igor V , Nichols Nancy N , van Elsas Jan Dirk
Published: November 2019

Coniochaeta species are versatile ascomycetes that have great capacity to deconstruct lignocellulose. Here, we explore the transcriptome of Coniochaeta sp. strain 2T2.1 from wheat straw-driven cultures with the fungus growing alone or as a member of a synthetic microbial consortium with Sphingobacterium multivorum w15 and Citrobacter freundii so4. The differential expression profiles of carbohydrate-active enzymes indicated an onset of (hemi)cellulose degradation by 2T2.1 during the initial 24 hours of incubation. Within the tripartite consortium, 63 transcripts of strain 2T2.1 were differentially expressed at this time point. The presence of the two bacteria significantly upregulated the expression of one galactose oxidase, one GH79-like enzyme, one multidrug transporter, one laccase-like protein (AA1 family) and two bilirubin oxidases, suggesting that inter-kingdom interactions (e.g. amensalism) take place within this microbial consortium. Overexpression of multicopper oxidases indicated that strain 2T2.1 may be involved in lignin depolymerization (a trait of enzymatic synergism), while S. multivorum and C. freundii have the metabolic potential to deconstruct arabinoxylan. Under the conditions applied, 2T2.1 appears to be a better degrader of wheat straw when the two bacteria are absent. This conclusion is supported by the observed suppression of its (hemi)cellulolytic arsenal and lower degradation percentages within the microbial consortium.
Secrets and Lies: Francesca Melandri’s Sangue Giusto (2017) and the Uncovered Memory of Italian East Africa
Authors: Burdett Charles
Published: November 2019

It is true that expansionism under Fascism did not, for a long time, receive the attention that it deserved. This period of historiographic and literary amnesia has now, however, come to a close. As regards literary production, recent years have seen the publication of a number of highly regarded works – by such well-known writers as Gabriella Ghermandi or Igiaba Scego – that have used the novel as a means of exploring the legacies of empire. The article explores one of the most recent additions to this body of work, Francesca Melandri’s Sangue giusto (2017). More specifically, it addresses the theme of secrets and their revelation that lies at the heart of the novel. It investigates the social and psychological ramifications of the discovery of the nature of imperial conquest under Fascism. It also explores how the novel interacts with the writing of those transnational African/Italian authors who have confronted the legacy of Italy’s colonial past. The article considers the overall vision that Sangue giusto offers of Italy’s relationship with Ethiopia, of the conceptual universe of colonialism, and of the enduring topicality of the memory of Italy’s imperial past.
Association Between Medications Acting on the Central Nervous System and Fall-Related Injuries in Community-Dwelling Older Adults: A New User Cohort Study
Authors: Gray Shelly L , Marcum Zachary A , Dublin Sascha , Walker Rod , Golchin Negar , Rosenberg Dori E , Bowles Erin J , Crane Paul , Larson Eric B
Published: November 2019

Background

It is well established that individual medications that affect the central nervous system (CNS) increase falls risk in older adults. However, less is known about risks associated with taking multiple CNS-active medications.

Methods

Employing a new user design, we used data from the Adult Changes in Thought study, a prospective cohort of community-dwelling people aged 65 and older without dementia. We created a time-varying composite measure of CNS-active medication exposure from electronic pharmacy fill data and categorized into mutually exclusive categories: current (within prior 30 days), recent (31–90 days), past (91–365 days), or nonuse (no exposure in prior year). We calculated standardized daily dose and identified new initiation. Cox proportional hazards models examined the associations between exposures and the outcome of fall-related injury identified from health plan electronic databases.

Results

Two thousand five hundred ninety-five people had 624 fall-related injuries over 15,531 person-years of follow-up. Relative to nonuse, fall-related injury risk was significantly greater for current use of CNS-active medication (hazard ratio [HR] = 1.95; 95% CI = 1.57–2.42), but not for recent or past use. Among current users, increased risk was noted with all doses. Risk was increased for new initiation compared with no current use (HR = 2.81; 95% CI = 2.09–3.78). Post hoc analyses revealed that risk was especially elevated with new initiation of opioids.

Conclusions

We found that current use, especially new initiation, of CNS-active medications was associated with fall-related injury in community-dwelling older adults. Increased risk was noted with all dose categories. Risk was particularly increased with new initiation of opioids.
Comparison Between Multicomponent Exercise and Walking Interventions in Long-Term Nursing Homes: A Randomized Controlled Trial
Authors: Rezola-Pardo Chloe , Rodriguez-Larrad Ana , Gomez-Diaz Julen , Lozano-Real Garbiñe , Mugica-Errazquin Itxaso , Patiño Maria Jesus , Bidaurrazaga-Letona Iraia , Irazusta Jon , Gil Susana María
Published: November 2019

Background and Objectives

There is evidence that exercise interventions counteract the functional and cognitive decline experienced by long-term nursing home (LTNH) residents. To determine the most effective exercise intervention, we compared the effects of a multicomponent exercise intervention and a walking intervention on physical and cognitive performance, habitual physical activity, affective function, and quality of life among older adults living in LTNHs.

Research Design and Methods

This 3-month single-blind randomized controlled trial (NCT03996083) involved 81 participants at 9 LTNHs randomly assigned to a multicomponent (MG) or a walking (WG) group. The MG participated in a twice-a-week individualized and progressive program composed of strength and balance exercises for 3 months. The WG was also individualized and participants walked up to 20 min per day. The primary outcome was the score on the short physical performance battery (SPPB). Secondary outcomes included other physical performance tests, habitual physical activity, cognitive performance, affective function, and quality of life.

Results

Compared with the WG, the MG group showed greater improvements in physical performance, including the SPPB (p < .05). No significant differences were observed in cognitive performance or habitual physical activity. Both groups showed improvements in anxiety and quality of life (p < .05).

Discussion and Implications

Although both interventions were effective in maintaining or improving affective function, the MG conferred greater improvements in physical function. Therefore, multicomponent interventions would be preferable over walking-only interventions. Otherwise, individualized and progressive walking interventions should be implemented to face the rapid decline in functionality encountered in LTNHs.
‘Do you trust those data?’—a mixed-methods study assessing the quality of data reported by community health workers in Kenya and Malawi
Authors: Regeru Regeru Njoroge , Chikaphupha Kingsley , Bruce Kumar Meghan , Otiso Lilian , Taegtmeyer Miriam
Published: November 2019

High-quality data are essential to monitor and evaluate community health worker (CHW) programmes in low- and middle-income countries striving towards universal health coverage. This mixed-methods study was conducted in two purposively selected districts in Kenya (where volunteers collect data) and two in Malawi (where health surveillance assistants are a paid cadre). We calculated data verification ratios to quantify reporting consistency for selected health indicators over 3 months across 339 registers and 72 summary reports. These indicators are related to antenatal care, skilled delivery, immunization, growth monitoring and nutrition in Kenya; new cases, danger signs, drug stock-outs and under-five mortality in Malawi. We used qualitative methods to explore perceptions of data quality with 52 CHWs in Kenya, 83 CHWs in Malawi and 36 key informants. We analysed these data using a framework approach assisted by NVivo11. We found that only 15% of data were reported consistently between CHWs and their supervisors in both contexts. We found remarkable similarities in our qualitative data in Kenya and Malawi. Barriers to data quality mirrored those previously reported elsewhere including unavailability of data collection and reporting tools; inadequate training and supervision; lack of quality control mechanisms; and inadequate register completion. In addition, we found that CHWs experienced tensions at the interface between the formal health system and the communities they served, mediated by the social and cultural expectations of their role. These issues affected data quality in both contexts with reports of difficulties in negotiating gender norms leading to skipping sensitive questions when completing registers; fabrication of data; lack of trust in the data; and limited use of data for decision-making. While routine systems need strengthening, these more nuanced issues also need addressing. This is backed up by our finding of the high value placed on supportive supervision as an enabler of data quality.
Providing Health Care to Maltreated Children Receiving Child Welfare Services
Authors: Cheng Tyrone C , Lo Celia C
Published: November 2019

This study sought associations between maltreated children’s receipt of needed health care and five other variables or sets of variables: medical need, social structural factors, access to care, demographic factors, and child welfare intervention. Data for this study came from longitudinal records derived for a sample of 1,465 children (extracted from all records in a national data set) for whom maltreatment had been substantiated. Children in the sample had, following substantiation, either remained in the home or been placed in kinship care or other out-of-home setting. Generalized estimating equations were applied to the data. The results supported a negative association between the sample’s receipt of needed health care and three factors: general physical health, age, and remaining in the home after substantiation. Data analysis also supported a positive association between receiving needed care and Medicaid receipt, family income of between 100 percent and 200 percent of federal poverty level, family income above 200 percent of federal poverty level, needed health care services included in child welfare case plan, and wave 2 interview. The study’s implications for social work practice include the necessity of accurately identifying children’s health problems, of addressing health needs in the case plan, and of coordinating meaningfully with health professionals.
Tilting Bundles on Hypertoric Varieties
Authors: Špenko Špela , Van den Bergh Michel
Published: November 2019

Recently McBreen and Webster constructed a tilting bundle on a smooth hypertoric variety (using reduction to finite characteristic) and showed that its endomorphism ring is Koszul. In this short note we present alternative proofs for these results. We simply observe that the tilting bundle constructed by Halpern-Leistner and Sam on a generic open Geometric Invariant Theory substack of the ambient linear space restricts to a tilting bundle on the hypertoric variety. The fact that the hypertoric variety is defined by a quadratic regular sequence then also yields an easy proof of Koszulity.
Spectral Properties of the Neumann–Poincaré Operator in 3D Elasticity
Authors: Miyanishi Yoshihisa , Rozenblum Grigori
Published: November 2019

We consider the adjoint double layer potential (Neumann–Poincaré (NP)) operator appearing in 3-dimensional elasticity. We show that the recent result about the polynomial compactness of this operator for the case of a homogeneous media follows without additional calculations from previous considerations by Agranovich et al., based upon pseudodifferential operators. Further on, we define the NP operator for the case of a nonhomogeneous isotropic media and show that its properties depend crucially on the character of nonhomogeneity. If the Lamé parameters are constant along the boundary, the NP operator is still polynomially compact. On the other hand, if these parameters are not constant, two or more intervals of continuous spectrum may appear, so the NP operator ceases to be polynomially compact. However, after a certain modification, it becomes polynomially compact again. Finally, we evaluate the rate of convergence of discrete eigenvalues of the NP operator to the tips of the essential spectrum.
A Novel Laminin-Binding Protein Mediates Microbial-Endothelial Cell Interactions and Facilitates Dissemination of Lyme Disease Pathogens
Authors: Bista Sandhya , Singh Preeti , Bernard Quentin , Yang Xiuli , Hart Thomas , Lin Yi-Pin , Kitsou Chrysoula , Singh Rana Vipin , Zhang Fuming , Linhardt Robert J , Zhnag Kai , Akins Darrin R , Hritzo Lucy , Kim Yuri , Grab Dennis J , Dumler J Stephen , Pal Utpal
Published: November 2019

Borrelia burgdorferi conserved gene products BB0406 and BB0405, members of a common B. burgdorferi paralogous gene family, share 59% similarity. Although both gene products can function as potential porins, only BB0405 is essential for infection. Here we show that, despite sequence homology and coexpression from the same operon, both proteins differ in their membrane localization attributes, antibody accessibility, and immunogenicity in mice. BB0406 is required for spirochete survival in mammalian hosts, particularly for the disseminated infection in distant organs. We identified that BB0406 interacts with laminin, one of the major constituents of the vascular basement membrane, and facilitates spirochete transmigration across host endothelial cell barriers. A better understanding of how B. burgdorferi transmigrates through dermal and tissue vascular barriers and establishes disseminated infections will contribute to the development of novel therapeutics to combat early infection.
Transmission potential of paromomycin-resistant Leishmania infantum and Leishmania donovani
Authors: Hendrickx S , Van Bockstal L , Aslan H , Sadlova J , Maes L , Volf P , Caljon G
Published: November 2019

Objectives

Former studies demonstrated quick selection of paromomycin resistance for Leishmania infantum and Leishmania donovani accompanied by increased fitness. The present study aimed to interpret these findings in an epidemiological context by comparing infection of WT and experimentally derived paromomycin-resistant strains in the sand fly vector.

Methods

Depending on the Leishmania species, Lutzomyia longipalpis and Phlebotomus perniciosus or Phlebotomus argentipes sand flies were artificially infected with procyclic promastigotes of WT and paromomycin-resistant L. infantum (MHOM/FR/96/LEM3323-cl4) or L. donovani (MHOM/NP/03/BPK275/0-cl18). The infection rate and gut/stomodeal valve colonization were determined to monitor parasite phenotypic behaviour within the vector. The impact of the previously described gain of fitness in the vertebrate host on infectivity for the vector was assessed by feeding L. longipalpis on Syrian golden hamsters heavily infected with either WT or paromomycin-resistant parasites.

Results

WT and paromomycin-resistant Leishmania of both species behaved similarly in terms of infection and parasite location within the studied sand fly species. Blood feeding on infected hamsters did not reveal differences in acquisition of WT and paromomycin-resistant parasites, despite the higher organ burdens observed for the paromomycin-resistant strain. Strains remained resistant after passage in the vector.

Conclusions

Although paromomycin-resistant parasites show an increased parasite fitness in vitro and in laboratory rodents, the intrinsic infection potential of paromomycin-resistant parasites remains unaltered in the sand fly. Of importance is the fact that paromomycin-resistant Leishmania are able to complete development in the natural vectors and produce stomodeal infection with metacyclic forms, which clearly suggests their potential to spread and circulate in nature.
Image domain least-squares migration with a Hessian matrix estimated by non-stationary matching filters
Authors: Guo Song , Wang Huazhong
Published: November 2019

Assuming that an accurate background velocity is obtained, least-squares migration (LSM) can be used to estimate underground reflectivity. LSM can be implemented in either the data domain or image domain. The data domain LSM (DDLSM) is not very practical because of its huge computational cost and slow convergence rate. The image domain LSM (IDLSM) might be a flexible alternative if estimating the Hessian matrix using a cheap and accurate approach. It has practical potential to analyse convenient Hessian approximation methods because the Hessian matrix is too huge to compute and save. In this paper, the Hessian matrix is approximated with non-stationary matching filters. The filters are calculated to match the conventional migration image to the demigration/remigration image. The two images are linked by the Hessian matrix. An image deblurring problem is solved with the estimated filters for the IDLSM result. The combined sparse and total variation regularisations are used to produce accurate and reasonable inversion results. The numerical experiments based on part of Sigsbee model, Marmousi model and a 2D field data set illustrate that the non-stationary matching filters can give a good approximation for the Hessian matrix, and the results of the image deblurring problem with combined regularisations can provide high-resolution and true-amplitude reflectivity estimations.
Ambivalences of Citizenship: Syrians with Refugee Status Responding to Ambivalences of Citizenship in Denmark
Authors: Shaheen Buthaina
Published: November 2019

Upon the arrival of unprecedented number of Syrian refugees to Denmark in 2015, the government exerted its full power in order to put a stop to this flow. It signed the EU-Turkey agreement, imposed border control and enacted numerous restrictions on the Alien Act sending a blatant message: Do not come to Denmark, we need to cope up with the numbers we have received, while, at the same time, the government has demanded its new residents—refugees and migrants—to live up to its ultimate requirements where they should demonstrate and act as full citizens, while they are denizens. This article investigates Syrian refugees’ responses to this ambivalence: act as a citizen while you are not a citizen! It employs theoretical notions of citizenship such as Per Mouritsen’s approach to citizenship by stressing the integration of its three components: equality, membership and participation supplemented by supporting theoretical concepts such as racialized citizenship and cultural citizenship.
Problematizing Parenting: The Regulation of Parenting Practices within Reception Centres for Syrian Refugees in Ireland
Authors: Ní Raghallaigh Muireann , Smith Karen , Scholtz Jennifer
Published: November 2019

This article examines the problematization and regulation of parenting practices within reception centres accommodating Syrian asylum-seeking and refugee parents who had recently arrived in the Republic of Ireland through relocation and resettlement schemes. Based on qualitative research, the article demonstrates how reception-centre staff often assumed a regulatory role over parenting in a number of different ways: by informing and warning; watching and regulating; taking on parental roles; and referring. The findings suggest that parents are subject to intrusive observations and interventions within reception centres. This happens in a context where refugee families are living in institutional-type ‘collective’ accommodation staffed by personnel who generally lack the requisite qualifications and competencies to undertake the complex roles involved. An undue burden is placed on personnel to respond to situations for which they do not have the necessary skills, resulting in negative consequences for parents and children. Ultimately, this article points to the structural causes of these issues, namely the unsuitability of institutional-type accommodation for family life.
Drug interactions with antimalarial medications in older travelers: a clinical guide
Authors: Lewis Jelena , Gregorian Tania , Portillo Ivan , Goad Jeff
Published: November 2019

Increasingly older adults are traveling to international destinations with malaria as a present risk. Surveillance systems indicate that older adults are more likely to suffer severe complications from malaria. The role of health care providers in selecting an appropriate medication for chemoprophylaxis or treatment of malaria in adults becomes more difficult as older adults undergo physiologic changes that alter the pharmacokinetic and pharmacodynamic nature of medications potentially causing increased drug interactions, adverse events and altered drug action. A comprehensive literature search from 1970 to present, with a focus on the past 10 years, was conducted on drug interactions, pharmacokinetic and pharmacodynamic effects on antimalarials in adults. It was determined that due to pharmacodynamic and pharmacokinetic changes in older adults, especially renal and cardiovascular, special attention should be given to this population of travelers in order to minimize the likelihood of adverse events or altered drug efficacy. Antimalarial drug–disease interactions in older adults can occur more often due to QT prolongation, exacerbation of hypoglycemia, decreased renal elimination and decreased hepatic metabolism. Older antimalarials have well-documented drug–drug interactions. Tafenoquine, a new antimalarial, requires glucose-6-phosphate dehydrogenase screening like primaquine and monitoring of new potential drug interaction with MATE1 and OCT2 substrates. While drug–drug interactions in older travelers may occur more often as a result of polypharmacy, data did not indicate adverse reactions or decreased drug efficacy is greater compared with younger adults. Overall, with the exception of recently approved tafenoquine, much is known about antimalarial drug and disease interactions, but new drugs are always being approved, requiring travel health providers to understand the pharmacokinetics and pharmacodynamics of antimalarial drugs to predict the impact on safety and efficacy in travelers. This guide provides travel health providers with valuable insights on potential outcomes associated with drug interactions in adults and recommended monitoring or drug regimen modification.
Differences in the intrinsic spatial dynamics of the chromatin contribute to cell differentiation
Authors: Zhang She , Chen Fangyuan , Bahar Ivet
Published: November 2019

Advances in chromosome conformation capture techniques as well as computational characterization of genomic loci structural dynamics open new opportunities for exploring the mechanistic aspects of genome-scale differences across different cell types. We examined here the dynamic basis of variabilities between different cell types by investigating their chromatin mobility profiles inferred from Hi-C data using an elastic network model representation of the chromatin. Our comparative analysis of sixteen cell lines reveals close similarities between chromosomal dynamics across different cell lines on a global scale, but notable cell-specific variations emerge in the detailed spatial mobilities of genomic loci. Closer examination reveals that the differences in spatial dynamics mainly originate from the difference in the frequencies of their intrinsically accessible modes of motion. Thus, even though the chromosomes of different types of cells have access to similar modes of collective movements, not all modes are deployed by all cells, such that the effective mobilities and cross-correlations of genomic loci are cell-type-specific. Comparison with RNA-seq expression data reveals a strong overlap between highly expressed genes and those distinguished by high mobilities in the present study, in support of the role of the intrinsic spatial dynamics of chromatin as a determinant of cell differentiation.