bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential Clinical Relevance of Differences in Allele Frequencies Found within Very Important Pharmacogenes between Hmong and East Asian Populations
Authors: Wen Ya‐Feng , Culhane‐Pera Kathleen A. , Thyagarajan Bharat , Bishop Jeffrey R. , Zierhut Heather , Lo Muaj , Xiong Txia , Peng Kerui , Holzer Katherine , Lee Koobmeej , Straka Robert J.
Published: December 2019

Objectives

Implementing pharmacogenetics for very important pharmacogenes (VIPs) holds the promise of improving clinical outcomes through optimal medication selection and dosing. However, significant differences in the frequency of actionable variants in VIPs may exist within subpopulations of a given ancestral group. Furthermore, these differences can potentially impact drug selection and dosing. The purpose of this study was to ascertain allele frequencies for VIPs and to predict medication requirements using Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines in Hmong and compare with published data for East Asians.

Methods

Using a community‐based participatory action research approach, DNA collected from 194 Hmong adults living in the United States was analyzed for 22 genetic variants within eight VIPs (CYP2C9, CYP2C19, CYP4F2, DPYD, G6PD, SLCO1B1, TPMT, VKORC1). Allele frequencies for VIPs and predicted medication requirements using CPIC guidelines were compared between Hmong participants and East Asians.

Results

Significant differences in allele frequencies between the Hmong and East Asians were found for 23% (5/22) of the CPIC‐actionable variants tested. Allele frequencies for VIPs in Hmong versus East Asians were 16.6% versus 3.4% in CYP2C9*3A, 42.2% versus 29.0% for CYP2C19*2, 0.3% versus 8.3% in CYP2C19*3, 6.5% versus 22.1% in CYP4F2*3, and 3.6% versus 0.1% in SLCO1B1*5, respectively. These differences significantly influenced predicted medication usage recommendations in warfarin, simvastatin, and phenytoin between Hmong and East Asians.

Conclusions

Important differences in allele frequencies for key genetic variants influencing selection of medications and dosages were found between the Hmong and East Asians. The magnitude and nature of these differences can be expected to result in different medication recommendations for the Hmong relative to East Asians.
Support, interventions and outcomes for families/carers of people with borderline personality disorder: A systematic review
Authors: Sutherland Ruth , Baker John , Prince Sharon
Published: December 2019

It is clear from existent literature that families and carers of relatives and friends with borderline personality disorder (BPD) experience high levels of burden. Whilst family interventions are considered vital to improving the outcomes of those with a range of mental health difficulties, there has been limited development of direct interventions for carers of people with BPD, despite a high level of need. This systematic review aimed to appraise and synthesize the existing research evidence for interventions for carers of people with BPD. Ten studies were included that were directly related to six interventions for families and carers of people with personality disorder. The findings of these studies, whilst limited, do provide some initial evidence that interventions for carers may lead to significant outcomes for the participants, particularly in improving carer well‐being and reducing carer burden. © 2019 John Wiley & Sons, Ltd.
Characterization of the various functional pathways elicited by synthetic agonists or antagonists at the melatonin MT1 and MT2 receptors
Authors: Legros Céline , Dupré Clémence , Brasseur Chantal , Bonnaud Anne , Bruno Olivier , Valour Damien , Shabajee Preety , Giganti Adeline , Nosjean Olivier , Kenakin Terrence P. , Boutin Jean A.
Published: December 2019

Melatonin is a neurohormone that translates the circadian rhythm to the peripheral organs through a series of binding sites identified as G protein‐coupled receptors MT1 and MT2. Due to minute amounts of receptor proteins in target organs, the main tool of studies of the melatoninergic system is recombinant expression of the receptors in cellular hosts. Although a number of studies exist on these receptors, studies of several signaling pathways using a large number of melatoninergic compounds are rather limited. We chose to fill this gap to better describe a panel of compounds that have been only partially characterized in terms of functionality. First, we characterized HEK cells expressing MT1 or MT2, and several signaling routes with melatonin itself to validate the approach: GTPγS, cAMP production, internalization, β‐arrestin recruitment, and cell morphology changes (CellKey®). Second, we chose 21 compounds from our large melatoninergic chemical library and characterized them using this panel of signaling pathways. Notably, antagonists were infrequent, and their functionality depended largely on the pathway studied. This will permit redefining the availability of molecular tools that can be used to better understand the in situ activity and roles of these receptors.
Migration of bisphenol a into food simulants and meat rations during initial time of storage
Authors: Stojanović Branislav , Radović Ljubica , Natić Dejan , Dodevska Margarita , Vraštanović‐Pavičević Gordana , Balaban Milica , Stojanović Zdenka , Antić Vesna
Published: December 2019

The aim of this work was to assume the amount of BPA that can migrate to food packed into the cans coated by epoxy‐phenolic lacquer. The assumption was made by determining the amount of BPA which migrates from the inner can coating to different food simulants: 3% acetic acid, 10% ethanol, their mixture (3% acetic acid +10% ethanol), and 50% ethanol. The examined tinplate cans were made by the special requirements of the Serbian Armed Forces. Further, the effect of the sterilization process and the very initial time of storage (15–105 days), on the level of BPA in the canned meatballs in tomato sauce, which are in the regular use of the Serbian Armed Forces, was examined. The BPA content was determined by the high performance liquid chromatography‐mass spectrometry (HPLC–MS), and compared with BPA content found in the food simulants.
Autologous adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistula: A randomized clinical trial with long-term follow-up
Authors: Garcia-Arranz Mariano , Garcia-Olmo Damián , Herreros María Dolores , Gracia-Solana José , Guadalajara Héctor , Portilla Fernando , Baixauli Jorge , Garcia-Garcia Jacinto , Ramirez José Manuel , Sanchez-Guijo Fermín , Prosper Felipe ,   the FISPAC Collaborative Group
Published: December 2019

The aim of this clinical trial (ID Number NCT01803347) was to determine the safety and efficacy of autologous adipose-derived stem cells (ASCs) for treatment of cryptoglandular fistula. This research was conducted following an analysis of the mistakes of a same previous phase III clinical trial. We designed a multicenter, randomized, single-blind clinical trial, recruiting 57 patients. Forty-four patients were categorized as belonging to the intent-to-treat group. Of these, 23 patients received 100 million ASCs plus intralesional fibrin glue (group A) and 21 received intralesional fibrin glue (group B), both after a deeper curettage of tracks and closure of internal openings. Fistula healing was defined as complete re-epithelialization of external openings. Those patients in whom the fistula had not healed after 16 weeks were eligible for retreatment. Patients were evaluated at 1, 4, 16, 36, and 52 weeks and 2 years after treatment. Results were assessed by an evaluator blinded to the type of treatment. After 16 weeks, the healing rate was 30.4% in group A and 42.8% in group B, rising to 55.0% and 63.1%, respectively, at 52 weeks. At the end of the study (2 years after treatment), the healing rate remained at 50.0% in group A and had reduced to 26.3% in group B. The safety of the cellular treatment was confirmed and no impact on fecal continence was detected. The main conclusion was that autologous ASCs for the treatment of cryptoglandular perianal fistula is safe and can favor long-term and sustained fistula healing.

Significance statement Autologous mesenchymal stem cells treatment for complex perianal fistula is safe, but according to the current results, it seems to provide an advantage over a good surgical protocol at 2 years after treatment and then results are similar to those shown with allogenic mesenchymal stem cells in previous clinical trials.
Constructing Built‐in Electric Field in Ultrathin Graphitic Carbon Nitride Nanosheets by N and O Codoping for Enhanced Photocatalytic Hydrogen Evolution Activity
Authors: Yan Bo , Du Chun , Yang Guowei
Published: December 2019

Codoping of N and O in ultrathin graphitic carbon nitride (g‐C3N4) nanosheets leads to an inner electric field. This field restrains the recombination of photogenerated carriers and, thus, enhances hydrogen evolution. The layered structure of codoped g‐C3N4 nanosheets (N‐O‐CNNS) not only provides abundant sites of contact with the reaction medium, but also decreases the distance over which the photogenerated electron–hole pairs are transported to the reaction interface. Quantum confinement in the ultrathin structure results in an increased bandgap and makes the photocatalytic reaction more favorable than bulk g‐C3N4. Under visible light irradiation, N‐O‐CNNS with 3 wt% Pt achieves a hydrogen evolution rate of 9.2 mmol g−1 h−1 and a value of 46.9 mmol g−1 h−1 under AM1.5 with 5 wt% Pt. Thus, this work paves the way for designing efficient nanostructures with increased separation/transfer efficiency of photogenerated carriers and, hence, increased photocatalytic activities.
The effect of water to cement ratio and age on the mechanical properties of cement mortar and concrete made of micro‐nano bubbles without adding any admixtures
Authors: Sheikh Hassani Mohammad , Torki Ali , Asadollahfardi Gholamreza , Saghravani Seyed F. , Shafaei Jalil
Published: December 2019

The effect of using water containing micro‐nano bubbles (WMNB) without adding any admixtures and normal water (NW) on the mechanical properties of cement mortar and concrete samples were investigated. Four various water to cement ratios equal to 0.6, 0.5, 0.4, and 0.35 (ranging from conventional concrete to high strength concrete), and three different curing ages of 7, 28, and 90 days were considered. The experimental results showed that the initial and final setting time of cement paste, the flow of hydraulic cement mortar and the slump of concrete samples made with WMNB were lower than that of made with NW. However, the compressive strength of cement mortar in using WMNB indicated an increase up to 16 and 7% in at 7 and 28 days, respectively. We also concluded that the optimum percentage of water to cement ratio was 0.35, which in that ratio the compressive strength enhancement of concrete made of WMNB reached the peak of 6, 18.3, and 16.3% at 7, 28, and 90 days age, respectively. Whereas increasing water to cement ratio, resulted in reducing the compressive strength of concrete. Besides, the high‐resolution scanning electron microscopy images with Energy Dispersive X‐Ray analysis were briefly conducted to explore the morphological change.
A corrosion model for the interpretation of cyclic behavior of reinforced concrete sections
Authors: Lavorato Davide , Fiorentino Gabriele , Pelle Angelo , Rasulo Alessandro , Bergami Alessandro Vittorio , Briseghella Bruno , Nuti Camillo
Published: December 2019

A generalized cyclic steel model characterized by isotropic and kinematic hardening, inelastic buckling in compression and corrosion of rebars in reinforced concrete (RC) structures is presented. The model has been implemented in a fiber code, to perform seismic analyses of RC sections. The model is particularly accurate with respect to experimental cyclic behavior of rebars with buckling in compression when the strain does not exceed 1.5%. Twelve configurations of RC cross sections were selected as case studies for three geometries and different steel arrangements, assumed representative of RC columns or bridge piers (in a suitable scale). Each section was subjected to two groups of cyclic curvature histories representative of severe seismic loads, not far from collapse. Different axial loads and corrosion percentages (no corrosion, moderate, or high) have been selected to perform cyclic parametric analyses. One of the cases was taken from an experimental test on columns, deriving also steel characteristics used in all numerical cases. The results of the comparison among RC sections have been discussed. Numerical results show that the maximum compressive strain for steel rebars is always smaller than 1.5%, therefore the proposed steel model is accurate and represents a valid tool for structural assessment. Corrosion reduces RC section capacity, affecting various rebar mechanical characteristics, in particular buckling behavior.
Effect of fly ash on mechanical properties of magnesium oxychloride cement under water attack
Authors: Guo Yingying , Zhang Yixia , Soe Khin , Hutchison Wayne D. , Timmers Heiko , Poblete Myra R.
Published: December 2019

As an eco‐friendly construction material, magnesium oxychloride cement (MOC) has attracted much research interest in recent decades, however, its mechanical properties degrade severely under water attack, which has prevented its wide application in engineering structures. As a widely used mineral waste, fly ash has been applied in civil engineering for decades. The active SiO2 in fly ash is considered to be conductive to improve the water resistance of MOC. In this paper, the influence of fly ash on the mechanical properties of MOC is investigated, especially when subject to water attack. First, the basic mix design of the MOC with a suitable combination of the molar ratios of MgO/MgCl2 and H2O/MgCl2 is developed, and the developed basic MOC mix is modified by adding fly ash to improve its water resistance. Second, the physical and mechanical properties of both the basic MOC and the fly ash modified MOC, such as compressive strength, Young's modulus, flexural strength cured at room temperature, and immersed in water for 28 days at room temperature (25°C) are determined. It is found that the incorporation of fly ash decreases the workability or fluidity, retards the setting time, but improves the compressive strength and water resistance of the MOC. The techniques of X‐ray diffraction, Fourier transform infrared spectroscopy, thermogravimetric analysis/differential scanning calorimetry, scanning electron microscopy, and mercury intrusion porosimetry are applied to the MOC specimens to discover the mechanism by which fly ash affects on the water resistance of MOC. The microscale analysis shows that the addition of fly ash optimizes the pore distribution in MOC resulting in a denser structure, which contributes to the water repellence.
Design of hybrid‐frequency current source based on multiresonance network
Authors: Zhu Xuegui , Luo Chaopeng , Zhu Wang
Published: December 2019

In order to overcome the low efficiency and poor resolution of single‐frequency transmitters for electromagnetic sounding and wireless power transfer (WPT), a well‐organized multifrequency resonant network is proposed to generate a synthetized current with two or more frequencies. The complete design and realization of the hybrid‐frequency current source is presented. The characteristic equation method is applied to extract the resonance frequencies from the given network. On the other hand, the nonlinear equation system about the passive elements is built and solved by the trust–region algorithm based on the expected frequencies. The multifrequency sinusoidal pulse width modulation method is first proposed to create the barcode driving signals for a full‐bridge inverter. The asynchronous modulation is recommended to reduce the harmonic components beyond the resonance frequencies, and the modulation ratios for the driving signals are adjusted at any resonance frequency so that the energy can be distributed evenly at different resonance points. The simulation results prove that almost all energy is concentrated at the resonance frequencies, and the frequency leakage is hardly seen. The resonant network and its control method is very useful to create a hybrid‐frequency current source for high‐efficiency and high‐resolution electromagnetic sounding and WPT. © 2019 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.
Development of inductance reference standard using coaxial transmission lines
Authors: Domae Atsushi , Horibe Masahiro
Published: December 2019

The National Metrology Institute of Japan is developing a reference inductance standard using air dielectric coaxial transmission lines that can be used up to the gigahertz range. In this paper, inductance determination steps for a lossy air line were presented. In addition, a verification procedure by comparing electrically determined length le and measurement‐determined length lm was considered. In practice, the inductances of a 60‐mm‐long air line are determined and verified at the measurement frequency from 0.05 to 10 GHz. No significant difference was observed between le and lm. Therefore, the determined inductances from 0.05 to 10 GHz were considered verified. © 2019 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.
Emotional and Social Intelligence Competencies Awareness and Development for Students’ Employability
Authors: Bonesso Sara , Gerli Fabrizio , Cortellazzo Laura
Published: December 2019

This chapter describes a case study, which was designed by a research center of a public university in Italy to foster students’ emotional and social intelligence competencies.
An a priori DNS analysis of scale similarity based combustion models for LES of non-premixed jet flames
Authors: Shamooni A. , Cuoci A. , Faravelli T. , Sadiki A.
Published: December 2019

In this work, recently developed finite-rate dynamic scale similarity (SS) sub-grid scale (SGS) combustion models have been a priori assessed and compared with the Eddy Dissipation Concept (EDC) and “no model” approaches based on a Direct Numerical Simulation (DNS) database of a temporally evolving non-premixed jet flame. Two different filter widths, one placed in the inertial range and the other in the near dissipation range, have been used. The analyses were carried out in two time instants corresponding to instants of maximum local extinction and re-ignition. Conditional averaged filtered chemical source terms, conditioned on different parameters in the composition space, have been presented. Improvements are observed using the dynamic SS models compared to the two other approaches in the prediction of filtered chemical source terms of individual species while using larger filter widths. However, discrepancies still exists using the dynamic SS model on the turbulent/non-turbulent interfaces of the jet, mainly in the prediction of the oxidizer consumption rate.
The impact of catheter ablation of atrial fibrillation on the left atrial volume and function: study using three-dimensional echocardiography
Authors: Hwang Jongmin , Park Hyoung-Seob , Han Seongwook , Jun Seung-Woon , Kang Na-Young , Jeon Jin-Hwa , Choi Sang-Woong , Lee Cheol Hyun , Kim In-Cheol , Cho Yun-Kyeong , Yoon Hyuck-Jun , Kim Hyungseop , Nam Chang-Wook , Hur Seung-Ho
Published: December 2019

Purpose

The exact correlation between the baseline left atrial (LA) volume (LAV) and atrial fibrillation (AF) radiofrequency catheter ablation (RFCA) outcomes and changes to the LA after AF RFCA has not yet been fully understood. We sought to evaluate the serial changes in the LAV and LA function after RFCA using 3D echocardiography.

Methods

Consecutive patients who received RFCA of paroxysmal (PAF) or persistent AF (PeAF) at our center between January 2013 and March 2016 were included. Real-time 3D apical full-volume images were acquired, and a 3D volumetric assessment was performed using an automated three-beat averaging method. The LAV index (LAVI) was calculated and the LA ejection fraction (LAEF) was calculated as [LAVmax − LAVmin]/LAVmax.

Results

Ninety-nine total patients were enrolled, and the mean age was 58.0 ± 8.2 years and 75 (74.7%) were male. There were 59 (59.6%) PAF patients and the remaining 40 (40.4%) had PeAF. AF recurred in 5 of 59 (8.5%) PAF and in 10 of 40 (25%) PeAF patients. The LAVImax increased on 1 day, decreased at 3 months, and then increased again at 1 year but was lower than that at baseline. The LAEF changes were similar to the volume changes but were more prominent in PeAF than PAF patients. The baseline 3D LAVImax was an independent predictor of AF recurrence after RFCA and the cut-off value was 44.13 ml/m2.

Conclusion

In our study, even after 3 months of scar formation due to ablation, structural remodeling of the LA continued. The changes were more prominent in the non-recurrent, PeAF patients.
Diphenylalanine Peptide Nanowires as a Substrate for Neural Cultures
Authors: Walls Anne B. , Dimaki Maria , Korsgaard Tanya , Swiniarska Małgorzata M. , Castillo-León Jaime , Waagepetersen Helle S. , Svendsen Winnie E.
Published: December 2019

Primary brain cells cultured on flat surfaces, i.e., in a two-dimensional fashion, have a long history of use as an experimental model system in neuroscience research. However, it is questionable to which extent these cultured brain cells resemble their in vivo counterparts. Mainly, it has been claimed that the non-oxidative glucose metabolism reflected by lactate production is unphysiologically high. Furthermore, it is known that culturing in 2D alters the phenotype of cells. Here we present diphenylalanine peptide nanowires (PNWs) as a culturing substrate for primary neocortical neurons from mice. The topology of the PNWs leads to neuronal cultures developing in 2.5D environment and hence improved culturing conditions. We investigate the effect of different concentrations of PNWs and different cell densities of neurons on the culturing conditions. The neocortical neurons were examined through scanning electron microscopy in order to study the effect of PNW concentrations and neuron densities on the structural appearance of the cells. Then employing the optimal combination of neuron density and PNW concentration, the neurons were evaluated functionally and metabolically by comparison with neocortical neurons standard culturing methods in 2D. Specifically, we tested neuronal viability, capacity for vesicular release of neurotransmitter GABA, as well as oxidative and non-oxidative glucose metabolism. It was evident that neurons cultured on PNWs exhibited increased viability combined with an increased capacity for neurotransmitter release and a lower fraction of non-oxidative metabolism than neurons cultured in 2D. Hence, neocortical neurons cultured in 2.5D on PNWs appear to be healthier and less glycolytic than neurons cultured in 2D.
Cerebral Organoids Repair Ischemic Stroke Brain Injury
Authors: Wang Shu-Na , Wang Zhi , Xu Tian-Ying , Cheng Ming-He , Li Wen-Lin , Miao Chao-Yu
Published: December 2019

Stroke is the second leading cause of death and main cause of disability worldwide, but with few effective therapies. Although stem cell-based therapy has been proposed as an exciting regenerative medicine strategy for brain injury, there are limitations. The developed cerebral organoids (COs) represent a promising transplantation source for stroke that remains to be answered. Here, we transplanted COs at 55 days and explored the feasibility in the rat middle cerebral artery occlusion (MCAO) model of stroke. COs transplantation at 6 h or even 24 h after MCAO significantly reduces brain infarct volume and improves neurological motor function. Transplanted COs show the potential of multilineage differentiation to mimic in vivo cortical development, support motor cortex region-specific reconstruction, form neurotransmitter-related neurons, and achieve synaptic connection with host brain via in situ differentiation and cell replacement in stroke. Cells from transplanted COs show extensive migration into different brain regions along corpus callosum. The mechanisms underlying COs transplantation therapy are also associated with enhanced neurogenesis, synaptic reconstruction, axonal regeneration and angiogenesis, and decreased neural apoptosis with more survival neurons after stroke. Moreover, COs transplantation promotes predominantly exogenous neurogenesis in the transplantation periphery of ipsilateral cortex and predominantly endogenous neurogenesis in the hippocampus and subventricular zone. Together, we demonstrate the efficacy and underlying mechanisms of COs transplantation in stroke. This preliminary but promising study provides first-hand preclinical evidence for COs transplantation as a potential and effective intervention for stroke treatment.
A Review on Binderless Tungsten Carbide: Development and Application
Authors: Sun Jialin , Zhao Jun , Huang Zhifu , Yan Ke , Shen Xuehui , Xing Jiandong , Gao Yimin , Jian Yongxin , Yang Hejie , Li Bo
Published: December 2019

WC-Co alloys have enjoyed great practical significance owing to their excellent properties during the past decades. Despite the advantages, however, recently there have been concerns about the challenges associated with the use of Co, i.e. price instability, toxicity and properties degeneration, which necessitates the fabrication of binderless tungsten carbide (BTC). On the other hand, BTC or BTC composites, none of them, to date has been commercialized and produced on an industrial scale, but only used to a limited extent for specialized applications, such as mechanical seals undergoing high burthen as well as high temperature electrical contacts. There are two challenges in developing BTC: fully densifying the sintered body together with achieving a high toughness. Thus, this review applies towards comprehensively summarize the current knowledge of sintering behavior, microstructure, and mechanical properties of BTC, highlighting the densification improving strategies as well as toughening methods, so as to provide reference for those who would like to enhance the performance of BTC with better reliability advancing them to further wide applications and prepare the material in a way that is environment friendly, harmless to human health and low in production cost. This paper shows that the fabrication of highly dense and high-performance BTC is economically and technically feasible. The properties of BTC can be tailored by judiciously selecting the chemical composition coupled with taking into careful account the effects of processing techniques and parameters.
Learning versus optimal intervention in random Boolean networks
Authors: Karlsen Matthew R. , Moschoyiannis Sotiris K. , Georgiev Vlad B.
Published: December 2019

Random Boolean Networks (RBNs) are an arguably simple model which can be used to express rather complex behaviour, and have been applied in various domains. RBNs may be controlled using rule-based machine learning, specifically through the use of a learning classifier system (LCS) – an eXtended Classifier System (XCS) can evolve a set ofcondition-actionrules that direct an RBN from any state to a target state (attractor). However, the rules evolved by XCS may not be optimal, in terms of minimising the total cost along the paths used to direct the network from any state to a specified attractor. In this paper, we present an algorithm for uncovering the optimal set of control rules for controlling random Boolean networks. We assign relative costs for interventions and ‘natural’ steps. We then compare the performance of this optimal rule calculator algorithm (ORC) and the XCS variant of learning classifier systems. We find that the rules evolved by XCS are not optimal in terms of total cost. The results provide a benchmark for future improvement.
Well-posedness of semilinear heat equations in L1
Authors: Laister R. , Sierżęga M.
Published: December 2019

The problem of obtaining necessary and sufficient conditions for local existence of non-negative solutions in Lebesgue spaces for semilinear heat equations having monotonically increasing source term
f
has only recently been resolved (Laister et al. (2016)). There, for the more difficult case of initial data in

L^{1}

, a necessary and sufficient integral condition on
f
emerged. Here, subject to this integral condition, we consider other fundamental properties of solutions with

L^{1}

initial data of indefinite sign, namely: uniqueness, regularity, continuous dependence and comparison. We also establish sufficient conditions for the global-in-time continuation of solutions for small initial data in

L^{1}

.
Determining the hospital cost of anterior epistaxis treatment modalities at a Canadian tertiary care centre
Authors: Nithianandan Harrish , Thavorn Kednapa , Banaz Fatmahalzahra , Macdonald Kristian , Lasso Andrea , Kilty Shaun J.
Published: December 2019

Objective

To estimate the hospital costs of managing anterior epistaxis in the Emergency Department at a Tertiary Care centre in Canada.

Material and methods

A cost analysis was conducted based on a retrospective review of Emergency Department visits from January 2012 to May 2014. A consecutive sample of adult patients with a diagnosis of anterior epistaxis was included. Anterior epistaxis was managed via one of: Nasal clip, Merocel®, Silver Nitrate cautery, Vaseline packing, other treatment or no treatment. Both the direct and indirect hospital costs ($CDN) for anterior epistaxis treatment were calculated from the hospital's perspective. Generalized linear models were used to assess the association between treatment modalities and total hospital costs while controlling for potential confounding factors.

Results

Three hundred and fifty‐three patients (49% female) with a mean age of (69.9 ± 18.5) years were included in the analysis. The median (interquartile ranges) costs of treatment ranged from C$227.83 (C$167.96, C$328.69) for observation to C$763.98 (C$632.25,C$830.23) for Merocel®. The overall median total hospital costs incurred across all modalities was C$566.24 (C$459.61, C$753.46) for the management of anterior epistaxis. Silver Nitrate, nasal clip, and observation were statistically associated with a lower cost when compared to Merocel® (P < 0.001) even after potential confounding factors were controlled.

Conclusions

Our results show wide difference in the hospital cost of epistaxis across treatment modalities. These cost estimates can help inform future economic evaluation studies aiming to guide the allocation of health care resources for patients with epistaxis.
An Examination of the Adequacy of Supplemental Nutrition Assistance Program (SNAP) Benefit Levels: Impacts on Food Insecurity
Authors: Gundersen Craig , Waxman Elaine , Crumbaugh Amy S.
Published: December 2019

The Supplemental Nutrition Assistance Program (SNAP) serves as the primary tool to alleviate food insecurity in the United States. Its effectiveness has been demonstrated in numerous studies, but the majority of SNAP recipients are still food insecure. One factor behind this is the difference in food prices across the country—SNAP benefits are not adjusted to reflect these differences. Using information from Feeding America's Map the Meal Gap (MMG) project, we compare the cost of a meal by county based on the Thrifty Food Plan (TFP)—which is used to set the maximum SNAP benefit—with the cost of the average meal for low-income food-secure households. We find that the cost of the latter meal is higher than the TFP meal for over 99 percent of the counties. We next consider the reduction in food insecurity if, by county, the maximum SNAP benefit level was set to the cost of the average meal for low-income food-secure households. We find that if this approach were implemented, there would be a decline of 50.9 percent in food insecurity among SNAP recipients at a cost of $23 billion.
Diverse Perspectives on the Impact of Colonialism in International Law: The Case of the Chagos Archipelago
Authors: Negm Namira
Published: December 2019

FREEDOM … AFRICA FREE OF DECOLONIZATION … that was the dream of our founding fathers from Nyerere, Nasser, Nkrumah, Haile Selassie, to Lumumba, and many others. The call for freedom laid the basis for the African unity, so it came as no surprise that we, at the African Union, had the support of an entire continent, with its fifty-five member states, to defend the Mauritian Cause to free Chagos.
Federalism Strikes Back: Brexit and the Potential Decline of the One-Voice Doctrine?
Authors: Sarooshi Dan
Published: December 2019

I am going to discuss today three issues relating to the One Voice Doctrine arising from “Brexit” which is short for the British Exit from the European Union.
Jurisdiction in Foreign Direct Liability Cases in Europe
Authors: Roorda Lucas
Published: December 2019

The right to remedy for victims of human rights abuses by transnational corporations is far from guaranteed. Often, the state where the abuses occurred is unwilling or incapable of offering effective remedies, especially effective judicial remedies. The victims may then choose to “go global” and bring civil suits in the courts of other states, including the home states of the corporations alleged to have committed the abuse. One way in which they have done so is by bringing so-called “foreign direct liability” (FDL) cases: civil claims in domestic courts of foreign states against corporate actors, in the hopes of getting financial compensation as a remedy.
Introductory Remarks by Katja Samuel
Authors: Samuel Katja
Published: December 2019

The scale and impact of disasters is rising exponentially, with insurance sector cost estimates for “natural” disasters increasing from $188 billion (2016) to $300 billion (2017). In response, the global shift since the 1990s, reflected in the Sendai Framework on Disaster Risk Reduction (DRR) (2015–2030), has been toward concentrating resources on disaster prevention and mitigation, including through improved preparedness and response mechanisms.
Disaster Risk Reduction and International Cultural Heritage Law: Moving Toward Cross-Fertilization
Authors: Bartolini Giulio
Published: December 2019

As the purpose of this panel is to explore the critical need for embedding international legal instruments within paradigms provided by disaster risk reduction (DRR), the area of international cultural heritage law could be a significant test-case in this regard. First, as experienced by several other branches of international law, it is possible to recognize an increasing attention paid by relevant specialized institutions, in this case the UN Educational, Scientific and Cultural Organization (UNESCO), to challenges posed by DRR, and finally permitting to: (1) integrate DRR concerns in the institutional and lawmaking agenda of this international organization, in order to inform and guide activities to be carried out by member states who face threats posed by disasters against their cultural heritage; and (2) provide an evolutionary and contextual interpretation of the existing commitments in this area in light of DRR paradigms. Second, a cross-fertilization phenomenon could also be recognized, as for the emerging recognition of cultural concerns in the same DRR system, through a process which has subsequently permitted UNESCO to additionally foster action in this area.
Condominium Government and the Right to Live in the City
Authors: Harris Douglas C.
Published: December 2019

Condominium is an architecture of land ownership that produces separate, privately owned units within multi-unit developments. Condominium also constructs a form of private, democratic government, described as a fourth order of government, that acts beneath federal and provincial governments, and alongside municipal government, to govern owners and their property. This article considers a conflict between residential-unit owners and a commercial-unit owner within a condominium development in Vancouver’s Downtown Eastside. Drawing from material produced in litigation, the article situates the dispute within its property and urban contexts to argue that condominium government requires attention, and not just for its impact on owners, or even residents within, but also because cities must now account for, work alongside, and, in some circumstances, contend with these rapidly proliferating sites of government that are helping to shape who has the right to live in the city.
Transgressing the Division of Powers: The Case of the James Bay and Northern Quebec Agreement
Authors: Scholtz Christa , Polataiko Maryna
Published: December 2019

In 1975, the Bourassa government received legal advice that the James Bay Northern Quebec Agreement exceeded provincial jurisdiction. Legal counsel advised the constitutionality of the Agreement be secured through formal constitutional amendment. No such amendment was sought. Based on authorized access to Premier Bourassa’s archived dossier on the Agreement’s negotiation, this article sets out the following: 1) why the provincial government sought to encroach on federal jurisdiction; 2) the strategic means employed to insulate the Agreement from s. 91(24) litigation; and 3) provincial negotiators’ views on how judges would approach the Agreement going forward. This article confirms theoretical expectations about when governments might coordinate to transgress federalism’s division of powers: a high probability that courts would find a transgression occurred, and a high political cost should governments not coordinate on a transgression strategy.
“The Poe Test: Global English and The Gold Bug”
Authors: Malouf Michael
Published: December 2019

This essay examines the production of Global English through literary texts by examining three adaptations of Edgar Allan Poe’s short story “The Gold Bug” in the 1930s by competing figures in the vocabulary control movement—Harold Palmer, Michael West, and C. K. Ogden—leaders in the formation of the field of applied linguistics. The first part of the essay explains the colonial origins of the vocabulary word list and its ascendant value in the interwar period for the new discipline of applied linguistics, and as part of the competition for English language textbooks. This leads to an analysis of these three simplifications of Poe’s story that demonstrates how the language politics in Poe’s story provides a structure through which to express a nascent Global English ideology regarding race, vernacular, and auxiliary languages.
Neolithic Farming and Wild Plant Exploitation in Western Britain: Archaeobotanical and Crop Stable Isotope Evidence from Wales (c. 4000–2200 calbc)
Authors: Treasure Edward R. , Gröcke Darren R. , Caseldine Astrid E. , Church Mike J.
Published: December 2019

The introduction of agriculture is a key defining element of the Neolithic, yet considerable debate persists concerning the nature and significance of early farming practices in north-west Europe. This paper reviews archaeobotanical evidence from 95 Neolithic sites (c. 4000–2200 calbc) in Wales, focusing on wild plant exploitation, the range of crops present, and the significance of cereals in subsistence practices. Cereal cultivation practices in Early Neolithic Wales are also examined using cereal grain stable carbon (δ13C) and nitrogen (δ15N) isotope analysis. The Early Neolithic period witnessed the widespread uptake of cereals alongside considerable evidence for continued wild plant exploitation, notably hazelnuts and wild fruits. The possibility that wild plants and woodlands were deliberately managed or altered to promote the growth of certain plants is outlined. Small cereal grain assemblages, with little evidence for chaff and weed seeds, are common in the Early Neolithic, whereas cereal-rich sites are rare. Emmer wheat was the dominant crop in the Early Neolithic, while other cereal types were recorded in small quantities. Cereal nitrogen isotope (δ15N) values from Early Neolithic sites provided little evidence for intensive manuring. We suggest that cultivation conditions may have been less intensive when compared to other areas of Britain and Europe. In the later Neolithic period, there is evidence for a decline in the importance of cereals. Finally, the archaeobotanical and crop isotope data from this study are considered within a wider European context.
An introductory guide to fluid models with anisotropic temperatures. Part 1. CGL description and collisionless fluid hierarchy
Authors: Hunana P. , Tenerani A. , Zank G. P. , Khomenko E. , Goldstein M. L. , Webb G. M. , Cally P. S. , Collados M. , Velli M. , Adhikari L.
Published: December 2019

We present a detailed guide to advanced collisionless fluid models that incorporate kinetic effects into the fluid framework, and that are much closer to the collisionless kinetic description than traditional magnetohydrodynamics. Such fluid models are directly applicable to modelling the turbulent evolution of a vast array of astrophysical plasmas, such as the solar corona and the solar wind, the interstellar medium, as well as accretion disks and galaxy clusters. The text can be viewed as a detailed guide to Landau fluid models and it is divided into two parts. Part 1 is dedicated to fluid models that are obtained by closing the fluid hierarchy with simple (non-Landau fluid) closures. Part 2 is dedicated to Landau fluid closures. Here in Part 1, we discuss the fluid model of Chew–Goldberger–Low (CGL) in great detail, together with fluid models that contain dispersive effects introduced by the Hall term and by the finite Larmor radius corrections to the pressure tensor. We consider dispersive effects introduced by the non-gyrotropic heat flux vectors. We investigate the parallel and oblique firehose instability, and show that the non-gyrotropic heat flux strongly influences the maximum growth rate of these instabilities. Furthermore, we discuss fluid models that contain evolution equations for the gyrotropic heat flux fluctuations and that are closed at the fourth-moment level by prescribing a specific form for the distribution function. For the bi-Maxwellian distribution, such a closure is known as the ‘normal’ closure. We also discuss a fluid closure for the bi-kappa distribution. Finally, by considering one-dimensional Maxwellian fluid closures at higher-order moments, we show that such fluid models are always unstable. The last possible non Landau fluid closure is therefore the ‘normal’ closure, and beyond the fourth-order moment, Landau fluid closures are required.
OP34 One-Way Sensitivity Analysis For Cost Effectiveness Analysis
Authors: McCabe Christopher , Awotwe Isaac , Paulden Mike , Sutton Andrew , Hall Peter
Published: December 2019

Introduction

Although stochastic analysis has become the accepted standard for decision analytic cost effectiveness models, deterministic one-way sensitivity analysis continues to be used to meet the needs of decision makers to understand the impact that changing the value taken by one specific parameter has on the results of the analysis. However, there are a number of problems with this approach.

Methods

We review the reasons why deterministic one-way sensitivity analysis will provide decision makers with biased and incomplete information. We then describe a new method - stochastic one-way sensitivity analysis (SOWSA), and apply this to a previously published cost effectiveness analysis, to produce a stochastic tornado diagram and conditional incremental net benefit curve. We then discuss how these outputs should be interpreted and the potential barriers to the implementation of SOWSA.

Results

The results illustrate the shortcomings of the current approaches to deterministic one-way sensitivity analysis. For SOWSA, the expected costs and outcomes are captured, along with the sampled value of the parameter and these are linked to the probability that the parameter takes that value – which can be read off the probability distribution for the parameter used in the stochastic analysis. From these results it is possible to gain insights into probability that a parameter will take a value that will change a decision.

Conclusions

Although a well-used technique, one-way deterministic sensitivity analysis has a number of shortcomings that may contribute to incorrect conclusions being drawn about the importance of certain parameter values on model results. By providing fuller information on uncertainty in model results, it is hoped that the methods here will lead to more informed decision making. Although, as with all developments in the presentation of analytic results to decision makers, care will be required to ensure that the decision makers understand the information provided to them.
OP48 Nursing Requirements In Long-Term Care: A Health Technology Assessment
Authors: Corabian Paula , Yan Charles , Armijo-Olivo Susan , Guo Bing
Published: December 2019

Introduction

The objectives of this study were to systematically review published research on the relationship between nursing staff coverage, care hours, and quality of care (QoC) in long-term care (LTC) facilities; and to conduct a real world evidence (RWE) analysis using Alberta real world data (RWD) to inform policy makers on whether any amendments could be made to current regulations.

Methods

A systematic review (SR) of research evidence published between January 2000 and May 2018 on the relationship between nursing staff coverage, care hours, and QoC in LTC facilities was conducted. Panel data regressions using available RWD from Alberta, Canada, were performed to assess associations between nursing care hours and LTC outcomes. Outcomes of interest included quality indicators related to resident outcomes, hospital admissions, emergency room visits and family satisfaction. Nursing care hours considered in SR and RWE analysis included those provided by registered nurses (RNs) and licensed practical nurses (LPNs).

Results

The SR found inconsistent and poor quality evidence relevant to the questions of interest, indicating a great uncertainty about the association between nursing staff time and type of coverage and QoC. Although some positive indications were suggested, major weaknesses of reviewed studies limited interpretation of SR results. RWE analysis found that impact of care hours on LTC outcomes was heterogeneous, dependent on outcome measurements. There was evidence that total staff, RN, and LPN hours had positive effects on some resident outcomes and magnitude of effect differed for different nursing staff.

Conclusions

No definitive conclusion could be drawn on whether changing nursing staff time or nursing staff coverage models would affect residents’ outcomes based on the research evidence gathered in the SR. RWE analysis helped to fill a gap in the available published literature and allowed policy makers to better understand the impact of revising current regulations based on actual outcomes.