bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Performance Floating Slab Track: Design and Construction Improvements Based on Lessons Learned from Prototype Slabs
Authors: Rajaram Shankar , Nelson James Tuman
Published: January 2019

The Northgate Link extension of the Sound Transit’s Link light-rail transit system subway tunnels under the University of Washington must meet stringent vibration thresholds as agreed between Sound Transit and the university to protect vibration-sensitive research labs. To meet the vibration thresholds the design team developed a 5 Hz floating slab track with an ultra-straight rail as the appropriate solution. Considering that such a solution pushes the engineering envelope, a 440-foot prototype section with 5 Hz floating slab track and a 1000-foot section of un-isolated track with milled rail were installed in the University Link tunnels to test the design. The performances of both prototype sections were evaluated during pre-revenue service and revenue service of the University Link. Based on the performance evaluation, the design of the floating slab track was refined, and the construction tolerances were tightened. The design refinements focused on improving vibration isolation performance, including stiffer rail fasteners, slightly softer support pads, and slightly heavier slabs. The construction specifications included limits on rail undulation consistent with European standards for high-speed track, EU Type 1 rail welding standards, and implementation of a frequency response pass/fail criteria on the installed slabs. This paper provides the details of the design changes, the construction tolerances, and preliminary performance results.
The Geography and Equity of Crowdsourced Public Participation for Active Transportation Planning
Authors: Griffin Greg P. , Jiao Junfeng
Published: January 2019

Transportation planners increasingly use new forms of online public participation alongside traditional in-person approaches, including crowdsourcing tools capable of encouraging geographically specific input. Digital involvement may be particularly valuable in exploring methods to plan at a megaregional scale. Research is beginning to address digital inequalities, recognizing that broadband and smartphone access may restrict opportunities for disadvantaged groups. However, the geography and equity of participation remain pragmatic issues for practice and research. This paper reviews the geography and equity of the participation methods in Austin, Texas for active transportation (bicycling and pedestrian) through three approaches to co-produce informed plans: in-person meetings, public participation geographic information system (PPGIS), and an emerging smartphone platform that logs trips and encourages input on route quality. In addition to spatial analysis with standard deviational ellipses, we include qualitative case analysis to contextualize the geographic and equity implications of different participation approaches. Results show that both online techniques resulted in a larger geography for participation than in-person meetings, with the regional PPGIS covering the most area. However, review of the income levels in each area shows that use of the smartphone-based crowdsourcing platform was aligned with lowest-income areas. This study shows that online participation methods are not homogeneous regarding geography or equity. In some contexts, smartphone applications can help reach lower-income communities, even when compared with in-person meetings. Crowdsourcing tools can be valuable approaches to increase geography and equity of public participation in transportation planning.
An institutional analysis of China’s South-to-North water diversion
Authors: Wang Mark , Li Chen
Published: January 2019

The availability of and demand for water in China is an extreme case of uneven distribution in time and space. In response, the South to North Water Diversion (SNWD) project, the largest inter-basin water transfer scheme in the world, channels large amounts of fresh water from the Yangtze River in southern China to the more arid and industrialised north. In order to keep the SNWD project running smoothly, a comprehensive governance system has been implemented and innovative institutional arrangements have been created to facilitate the transfer of water itself. By taking the SNWD project’s Middle Route as one case study and drawing on primary and secondary data, this article examines the project’s emerging institutional arrangements. The article outlines the establishment of new institutions for the SNWD project with high administrative rankings at both central and local levels, the encouragement of inter-department cooperation, the adoption of a market mechanism and the integration of market functions into administrative functions. We argue that these institutional arrangements have to some extent overcome common challenges in water governance in China, including an engineering-heavy approach and what Chinese commentators have traditionally called the problem of water being managed by multiple government ministries and municipal authorities as the common metaphor of ‘nine dragons managing the water’. Our findings have significant implications for understanding the continuing evolution of water governance in China.
Effects of operational parameters on bio-oil production from biomass
Authors: Üresin Ersin , Gülsaç Işıl Işık , Budak Mustafa Salih , Ünsal Mehmet , Özgür Büyüksakallı Kader , Aksoy Parvana , Sayar Aslı , Ünlü Namık , Okur Osman
Published: January 2019

In this study, the production of bio-oil from the pyrolysis of furniture sawdust, waste lubricating oil and their mixtures were investigated under certain operating conditions in the presence of lime and zeolites, by using a laboratory scale horizontal tubular reactor placed in a furnace. The main focus was to investigate the mutual effect of lime and commercial zeolite on the amount of the bio-oil production from furniture sawdust and waste lubricating oil. The selected operating parameters were pyrolysis temperatures and heating rate of 300°C and 650°C and flash heating or gradual heating rate (30°C/min). Additionally, three different additives were tested as catalysts; namely, lime (CaO), commercial zeolite (4A) and a natural zeolite (klinoptilolite). The amount of the produced bio-oil was analyzed by gas chromatography–flame ionization detector. The distribution of solid, liquid and gaseous products was determined for each operational condition. It was seen that the amount of the bio-oil was influenced by the amounts of sawdust and zeolite in the mixture. Experimental results showed that higher temperatures were more effective for the higher bio-oil amount. Additionally, heating rate was quite significant at 300°C whereas it has a minor effect on the bio-oil amount at 650°C. The highest bio-oil yield was obtained for the mixture of sawdust and waste lubricating oil in the presence of both lime and commercial zeolite with flash heating rate at 650°C.
Detection of waste dumping locations in landfill using multi-temporal Landsat thermal images
Authors: Gill Jasravia , Faisal Kamil , Shaker Ahmed , Yan Wai Yeung
Published: January 2019

The disposal of solid waste in a conventional landfill is inevitably associated with potential adverse environmental impacts, resulting in the migration of landfill gas and offensive odors on the surrounding areas. In addition to the obnoxious fumes and hazardous leachate, heat generation is continuously observed within the landfill during the aerobic and anaerobic phases. Despite the negative impacts, such “heat generation” phenomenon can turn into valuable information to aid in detecting unauthorized landfill activities and tracing unrecorded dumping regions. The spatial distribution of waste buried under the ground can be approximated and revealed through measuring the ground surface heat flux. In this study, we demonstrate how to utilize thermal remote sensing techniques to measure the land surface temperature (LST), which can aid in outlining the waste dumping regions within a landfill. The Jeleeb Al-Shuyoukh landfill, located in Kuwait, was used to demonstrate the proposed method, where the record of the exact dumping location was missing during the Gulf war. Ten-year Landsat Thematic Mapper(TM)/Enhanced Thematic Mapper Plus (ETM+) images (1985–1994) were acquired and processed in order to compute the LST within the landfill. Through combining the multi-temporal LST contours and overlay analysis, the most probable dumping regions within the landfill were outlined. A probability map was created to indicate the possible location of waste dumping within the studied landfill. With reference to the 50 boreholes drilled by the Environmental Protection Authority of Kuwait, our results derived during the summer and winter seasons both yielded an overall accuracy of 72%.
Conservative Fluid Management After Sepsis Resuscitation: A Pilot Randomized Trial
Authors: Semler Matthew W. , Janz David R. , Casey Jonathan D. , Self Wesley H. , Rice Todd W.
Published: January 2019

Rationale:

The feasibility and clinical outcomes of conservative fluid management after sepsis resuscitation remain unknown.

Objectives:

To evaluate the effect of a conservative fluid management protocol on fluid balance and intensive care unit (ICU)-free days among patients with sepsis.

Methods:

In a single-center phase II/III randomized trial, we enrolled adults with suspected infection, ≥2 systemic inflammatory response syndrome criteria, and either shock (mean arterial pressure <60 mm Hg or vasopressors) or respiratory insufficiency (mechanical ventilation or oxygen saturation <97% and fraction of inspired oxygen ≥0.3). Patients were randomized 1:1 to usual care or a conservative fluid management protocol. The protocol restricted intravenous fluid administration during shock to treatment of oliguria or increasing vasopressor requirement. In the absence of shock, loop diuretic infusion targeted equal fluid input and output each study day. The primary outcomes were mean daily fluid balance (phase II) and ICU-free days (phase III).

Results:

At the completion of phase II (n = 30), the difference in mean daily fluid balance between groups (−398 mL) was less than the prespecified threshold (−500 mL) and the trial was stopped. Patients in the conservative fluid management (n = 15) and usual care (n = 15) groups experienced similar cumulative fluid input (8450 mL vs 7049 mL; P = .90) of which only 14% was intravenous crystalloid or colloid. Loop diuretic infusion occurred more frequently in the conservative fluid management group (40% vs 0%; P = .02), and cumulative fluid output was 10 645 mL in the conservative fluid management group compared to 6286 mL in the usual care group ( P = .39). Hemodynamic, respiratory, and renal function did not differ between the groups.

Conclusions:

In this phase II trial, a conservative fluid management protocol did not decrease mean daily fluid balance by more than 500 mL among patients with sepsis.

Registration:

Clinicaltrials.gov ; NCT02159079.
Depressive Symptoms Predict Incident Dementia in a Community Sample of Older Adults: Results From the Einstein Aging Study
Authors: Ezzati Ali , Katz Mindy J. , Derby Carol A. , Zimmerman Molly E. , Lipton Richard B.
Published: January 2019

Background:

There is increasing evidence that depressive symptoms are associated with increased risk of cognitive impairment and dementia in older adults. In current study, we aimed to investigate the effect of depressive symptoms on incident Alzheimer disease and all-cause dementia in a community sample of older adults.

Methods:

Participants were 1219 older adults from the Einstein Aging Study, a longitudinal cohort study of community-dwelling older adults in Bronx County, New York. The Geriatric Depression Scale (GDS, 15-item) was used as a measure of depressive symptoms. The primary outcome was incident dementia diagnosed using the Diagnostic and Statistical Manual, Fourth Edition, criteria. Cox proportional hazard models were used to estimate the risk of incident dementia as a function of GDS score for the whole population and also for 2 different time intervals, <3 years and ≥3 years after baseline assessment.

Results:

Among participants, 132 individuals developed dementia over an average 4.5 years (standard deviation [SD] = 3.5) of follow-up. Participants had an average age of 78.3 (SD = 5.4) at baseline, and 62% were women. Among all participants, after controlling for demographic variables and medical comorbidities, a 1-point increase in GDS was associated with higher incidence of dementia (hazard ratio [HR] = 1.11, P = .007). After up to 3 years of follow-up, depressive symptoms were not significantly associated with dementia incidence (HR = 1.09; P = .070). However, after more than 3 years, GDS score was a significant predictor of incident dementia (HR = 1.13, P = .028).

Conclusions:

Our results suggest that depressive symptoms are associated with an increased risk of incident dementia in older adults.
Income Inequality and White-on-Black Racial Bias in the United States: Evidence From Project Implicit and Google Trends
Authors: Connor Paul , Sarafidis Vasilis , Zyphur Michael J. , Keltner Dacher , Chen Serena
Published: January 2019

Several theories predict that income inequality may produce increased racial bias, but robust tests of this hypothesis are lacking. We examined this relationship at the U.S. state level from 2004 to 2015 using Internal Revenue Service–based income-inequality statistics and two large-scale racial-bias data sources: Project Implicit ( N = 1,554,109) and Google Trends. Using a multimethod approach, we found evidence of a significant positive within-state association between income inequality and Whites’ explicit racial bias. However, the effect was small, with income inequality accounting for 0.4% to 0.7% of within-state variation in racial bias, and was also contingent on model specification, with results dependent on the measure of income inequality used. We found no conclusive evidence linking income inequality to implicit racial bias or racially offensive Google searches. Overall, our findings admit multiple interpretations, but we discuss why statistically small effects of income inequality on explicit racial bias may nonetheless be socially meaningful.
Online reverse discourses? Claiming a space for trans voices
Authors: Primo David , Zamperini Adriano , Testoni Ines
Published: January 2019

In recent years, online media have offered to trans people helpful resources to create new political, cultural and personal representations of their biographies. However, the role of these media in the construction of their social and personal identities has seldom been addressed. Drawing on the theoretical standpoint of positioning theory and diatextual discourse analysis, this paper discusses the results of a research project about weblogs created by Italian trans women. In particular, the aim of this study was to describe the ways online resources are used to express different definitions and interpretation of transgenderism, transsexuality and gender transitioning. We identified four main positioning strategies: “Transgender”, “Transsexual before being a woman”, “A woman who was born male” and “Just a normal woman”. We conclude with the political implications of the pluralization of narratives about gender non-conformity. Specifically, we will highlight how aspects of neoliberal discourses have been appropriated and rearticulated in the construction of gendered subjectivities.
Flutter instabilities of cantilevered piezoelectric pipe conveying fluid
Authors: Wang Gang , Shen Jinwei
Published: January 2019

In this article, a nonlinear model was developed for a cantilevered piezoelectric pipe conveying fluid that included geometric nonlinearity and electromechanical coupling. The Galerkin method discretized the system in order to characterize its behavior. Critical flutter velocity and its associated unstable mode can be determined based on linear analysis. Due to the presence of piezoelectric materials, the critical flutter velocity depends on the resistive piezoelectric damping and electromechanical coupling. This added resistive piezoelectric damping tends to decrease the flutter velocity. Comprehensive simulations were also conducted to characterize the post-flutter behaviors. System parameters including amplitude, deformed pipe shape, and collected voltage in piezoelectric materials were calculated. The system will undergo limited cycle oscillation when the fluid velocity passes the flutter velocity. Parametric studies were conducted as well to investigate the system responses under different flow velocities. Physical insights can be collected from these simulation results to conduct piezoelectric pipe design and performance predictions for future pipe vibration control and energy harvesting applications.
The Private Insurance Market: Not Very Big and Not Insuring Much, Either
Authors: Fox Jacqueline
Published: January 2019

Creating a single national health insurance pool is not likely to destabilize the economy by supplanting the private health insurance industry. This industry insures a relatively small percentage of the population and holds very little of the risk such insurance implies. In effect, insurance companies function as middlemen, bundling risk packages to distribute to other, larger companies and so serve a limited purpose. Were insurers to handle claims for a national pool as they do for the Medicare program, any destabilization to the economy more broadly would be further minimized.
Medicaid Waivers: Courts Must Step in When the Exception Becomes the Rule
Authors: Cuello Leonardo
Published: January 2019

Section 1115 of the Social Security Act is misconstrued as a mechanism to foster state flexibility, when in fact it is a narrow pilot program authority. HHS has exceeded the scope of this authority to approve harmful projects. Courts will not grant the agency broad deference when reviewing this abuse of authority.
An Unintended Consequence of Payment Reforms: Providers Avoiding Nonadherent Patients
Authors: Mantel Jessica
Published: January 2019

Payment reforms that link health care providers’ reimbursements to their performance on various metrics incentivize providers to improve the quality and efficiency of care they provide to patients. Unfortunately, these reforms also create strong incentives for providers to reject patients who do not adhere to medical advice. This commentary argues that providers’ avoidance of non-adherent patients flouts the medical profession's commitment to patients’ best interests, undermines patients' trust in health professionals, and aggravates disparities in health. Moreover, the economic incentives under payment reforms that encourage quality and efficiency gains are weakened when providers can escape the financial penalties for poor outcomes by simply firing their non-adherent patients.
The Role of Vildagliptin in Treating Hypertension Through Modulating Serum VEGF in Diabetic Hypertensive Patients
Authors: El-Naggar Abdel Rahman , Zaafar Dalia , Elyamany Mohammed , Hassanin Soha , Bassyouni Atef , Abdel-Latif Hekma
Published: January 2019

Background:

Several trials have reported that dipeptidyl peptidase-4 (DPP-4) inhibitors are used to improve endothelial function in addition to treating type 2 diabetes (T2DM). The current study investigated the effects of vildagliptin, DPP-4 inhibitor, compared to metformin on endothelial function and blood pressure through vascular endothelial growth factor (VEGF) modulation in patients with T2DM and hypertension.

Methods:

This study was designed as a randomized controlled parallel study. A total of 120 volunteers were recruited and allocated into 4 groups: healthy volunteers, patients recently diagnosed with hypertension and diabetes, patients treated with captopril for hypertension in addition to metformin, and patients treated with captopril in addition to vildagliptin. The percentage change in body weight was calculated in addition to serum VEGF levels, blood pressure, glycated hemoglobin (HbA1c), total lipid profile, and insulin resistance.

Results:

At the end of the therapeutic period, the results showed that vildagliptin significantly decreased blood pressure and increased serum VEGF levels, while metformin was more effective at lowering body weight. In comparison with metformin, vildagliptin showed a promising action through its antihypertensive effect via elevating VEGF levels and improving physiological angiogenesis and vasculature.

What is new and conclusion:

Vildagliptin showed a promising action through its blood pressure-regulating effect via modulating VEGF levels and improving physiological angiogenesis and vasculature, in addition to improving the lipid profile of patients, while metformin was better in reducing body weight.
Authenticity and the interview: a positive response to a radical critique
Authors: Whitaker Emilie Morwenna , Atkinson Paul
Published: January 2019

We respond to recent discussions of the interview, and the ‘radical critique’ of interviewing, as reiterated in publications by Silverman and Hammersley. Reviewing and extending the critical commentary on the social life of the interview and its implications for qualitative research, we endorse criticism of the Romantic view of the informant as a speaking subject, arguing that the interview does not give access to the interiority or private emotions of social actors. We focus especially on the search for the ‘authentic’ voice of experience and feeling, arguing that the expression of authenticity is performative, and that such interviews need to be analysed for their performative features. The biographical work of the interview demands close, formal analysis, and not mere celebration. The argument is illustrated with a single case-study, derived from an ethnographic study of a social-work service in the UK. We suggest that it is possible to derive constructive responses to the radical critique, by adopting an analytic stance towards respondents’ biographical work, as expressed through extended, qualitative interviewing. The speaker’s use of positioning rhetoric is discussed.
Percutaneous Embolization of an Inferior Mesenteric Artery Aneurysm in a Patient With Type IV Ehlers-Danlos Syndrome
Authors: Rahman Qasim , Naidu Sailen G. , Chong Brian W. , Stone William M.
Published: January 2019

Ehlers-Danlos syndrome (EDS) refers to a group of genetic disorders involving the connective tissues. Type IV EDS impairs type III collagen that is responsible for vessel integrity. Patients with type IV EDS are susceptible to vascular and visceral complications, including aortic aneurysms, pseudoaneurysms, dissections, and spontaneous rupture of internal organs. Treating aneurysms with open surgery versus endovascular techniques each carry a unique risk-to-benefit ratio that must be applied to each individual carefully. We present a patient with type IV EDS who presented with a rapidly growing inferior mesenteric artery aneurysm. The patient was treated with a percutaneous endovascular technique using coils and n-butyl-cyanoacrylate glue.
Reenvisioning Gifted Education in British Columbia: A Qualitative Research Protocol of Policy Analysis in the Context of a Redesigned Curriculum
Authors: Lo C. Owen , Tan Yuen Sze Michelle , Chrostowski Megan , Hu Shun-Fu , Chan Diana , Sue Deanna M. , Wu I-Chen , Li Wei
Published: January 2019

Background:

British Columbia (BC) is undergoing a curriculum migration. While the new curriculum highlights elements inspired by gifted education practices, there has been little conversation on how gifted education should/could be situated in this new curricular context. Moreover, a shift in the field of gifted education toward more inclusive practices aiming to promote gifted learning for all students has emerged. Taken together, this project highlights a unique juncture that invites a critical examination of the current provincial policy on gifted education and presents opportunities for sustaining better alignment between gifted education philosophy and local policies and practices.

Aims:

To examine the epistemic understandings of giftedness reflected in BC gifted education policy and to identify incongruence between this policy and the redesigned curriculum.

Objectives:

(1) To construct a historical and archival account of gifted education policy context in BC, (2) to evaluate the conceptualization of giftedness as reflected in BC policy texts, and (3) to provide insights into how policies and practices might be reconfigured.

Methods:

This project uses a case study method with a focus on evaluation to generate an in-depth account of the policy context and to develop a critical understanding of potential issues. Research participants include two to three provincial-level policy makers, 60 policy linkers, and two policy informers who have expertise in gifted education. Qualitative data include legislative and supplementary documents, interviews, and memos and field notes. Quantitative data will be gathered through the administration of an online survey.

Significance:

This project will uncover the merits, issues, and opportunities of gifted education policy in BC and enhance the connectivity between gifted education philosophy and local policy and practices. The results will further contribute to professional development opportunities for teachers and school districts to help improve their supports for students with advanced learning needs within the new curricular context.
Low‐grade albuminuria in pulmonary arterial hypertension
Authors: Nickel Nils P. , de Jesus Perez Vinicio A. , Zamanian Roham T. , Fessel Joshua P. , Cogan Joy D. , Hamid Rizwam , West James D. , de Caestecker Mark P. , Yang Haichun , Austin Eric D.
Published: January 2019

Low‐grade albuminuria, determined by the urinary albumin to creatinine ratio, has been linked to systemic vascular dysfunction and is associated with cardiovascular mortality. Pulmonary arterial hypertension is related to mutations in the bone morphogenetic protein receptor type 2, pulmonary vascular dysfunction and is increasingly recognized as a systemic disease. In a total of 283 patients (two independent cohorts) diagnosed with pulmonary arterial hypertension, 18 unaffected BMPR2 mutation carriers and 68 healthy controls, spot urinary albumin to creatinine ratio and its relationship to demographic, functional, hemodynamic and outcome data were analyzed. Pulmonary arterial hypertension patients and unaffected BMPR2 mutation carriers had significantly elevated urinary albumin to creatinine ratios compared with healthy controls (P < 0.01; P = 0.04). In pulmonary arterial hypertension patients, the urinary albumin to creatinine ratio was associated with older age, lower six‐minute walking distance, elevated levels of C‐reactive protein and hemoglobin A1c, but there was no correlation between the urinary albumin to creatinine ratio and hemodynamic variables. Pulmonary arterial hypertension patients with a urinary albumin to creatinine ratio above 10 µg/mg had significantly higher rates of poor outcome (P < 0.001). This study shows that low‐grade albuminuria is prevalent in pulmonary arterial hypertension patients and is associated with poor outcome. This study shows that albuminuria in pulmonary arterial hypertension is associated with systemic inflammation and insulin resistance.
Analysis of pulmonary vascular injury and repair during Pseudomonas aeruginosa infection‐induced pneumonia and acute respiratory distress syndrome
Authors: Lindsey Ashley S. , Sullivan Lydia M. , Housley Nicole A. , Koloteva Anna , King Judy A. , Audia Jonathon P. , Alvarez Diego F.
Published: January 2019

Herein we describe lung vascular injury and repair using a rodent model of Pseudomonas aeruginosa pneumonia‐induced acute respiratory distress syndrome (ARDS) during: 1) the exudative phase (48‐hour survivors) and 2) the reparative/fibro‐proliferative phase (1‐week survivors). Pneumonia was induced by intratracheal instillation of P. aeruginosa strain PA103, and lung morphology and pulmonary vascular function were determined subsequently. Pulmonary vascular function was assessed in mechanically ventilated animals in vivo (air dead space, PaO2, and lung mechanics) and lung permeability was determined in isolated perfused lungs ex vivo (vascular filtration coefficient and extravascular lung water). At 48 hours post infection, histological analyses demonstrated capillary endothelial disruption, diffuse alveolar damage, perivascular cuffs, and neutrophil influx into lung parenchyma. Infected animals displayed clinical hallmarks of ARDS, including increased vascular permeability, increased dead space, impaired gas exchange, and decreased lung compliance. Overall, the animal infection model recapitulated the morphological and functional changes typically observed in lungs from patients during the exudative phase of ARDS. At 1 week post infection, there was lung histological and pulmonary vascular functional evidence of repair when compared with 48 hours post infection; however, some parameters were still impaired when compared with uninfected controls. Importantly, lungs displayed increased fibrosis and cellular hyperplasia reminiscent of lungs from patients during the fibro‐proliferative phase of ARDS. Control, sham inoculated animals showed normal lung histology and function. These data represent the first comprehensive assessment of lung pathophysiology during the exudative and reparative/fibro‐proliferative phases of P. aeruginosa pneumonia‐induced ARDS, and position this pre‐clinical model for use in interventional studies aimed at advancing clinical care.
Mathematically Modeling Emotion Regulation Abnormalities During Psychotic Experiences in Schizophrenia
Authors: Strauss Gregory P. , Zamani Esfahlani Farnaz , Visser Katherine Frost , Dickinson Elizabeth K. , Gruber June , Sayama Hiroki
Published: January 2019

Ecological momentary assessment (EMA) was used to examine emotional reactivity and regulation abnormalities during the presence and absence of psychosis. Participants included 28 outpatients with schizophrenia or schizoaffective disorder (SZ) who completed 6 days of EMA. Mathematical models were applied to the EMA data to evaluate stochastic dynamic changes in emotional state and determine how the presence of psychosis influenced the interaction between emotional reactivity and regulation processes across time. Markov chain analysis indicated that although SZ tried to implement emotion regulation strategies frequently during psychotic experiences, those attempts were ineffective at reducing negative emotion from one time point to the next. Network analysis indicated that patients who were less effective at regulating their emotions during psychotic experiences had more dense connections among individual emotions. Findings indicate that psychotic experiences are associated with abnormally strong connections among discrete emotional states that are difficult to regulate despite efforts to do so.
Long-term prognosis of patients with systemic lupus erythematosus-associated pulmonary arterial hypertension: CSTAR-PAH cohort study
Authors: Qian Junyan , Li Mengtao , Zhang Xiao , Wang Qian , Zhao Jiuliang , Tian Zhuang , Wei Wei , Zuo Xiaoxia , Zhang Miaojia , Zhu Ping , Ye Shuang , Zhang Wei , Zheng Yi , Qi Wufang , Li Yang , Zhang Zhuoli , Ding Feng , Gu Jieruo , Liu Yi , Wang Yanhong , Zeng Xiaofeng
Published: January 2019

This study aimed to identify the long-term clinical outcomes and prognostic factors of patients with systemic lupus erythematosus (SLE)-associated pulmonary arterial hypertension (PAH) confirmed by right heart catheterisation.

A multicentre prospective cohort of SLE-associated PAH was established. Baseline and follow-up records were collected. The primary end-point was death. The secondary exploratory end-point was treatment goal achievement (TGA), defined as an integrated outcome.

In total, 310 patients were enrolled from 14 PAH centres. The 1-, 3- and 5-year survival rates were 92.1%, 84.8% and 72.9%, respectively. The 1-, 3- and 5-year TGA rates were 31.5%, 53.6% and 62.7%, respectively. Baseline serositis, 6-min walking distance >380 m and cardiac index ≥2.5 L·min−1·m−2were identified as independent prognostic factors of TGA. Patients with baseline serositis were more likely to reach TGA after intensive immunosuppressive therapy. TGA was identified as a positive predictor of survival in patients with SLE-associated PAH.

TGA was associated with long-term survival, which supports the treat-to-target strategy in SLE-associated PAH. Baseline heart function predicted both survival and treatment goal achievement in patients with SLE-associated PAH. Patients with serositis at baseline tended to benefit from intensive immunosuppressive therapy and have a better clinical outcome.
Telomere length and genetic variant associations with interstitial lung disease progression and survival
Authors: Newton Chad A. , Oldham Justin M. , Ley Brett , Anand Vikram , Adegunsoye Ayodeji , Liu Gabrielle , Batra Kiran , Torrealba Jose , Kozlitina Julia , Glazer Craig , Strek Mary E. , Wolters Paul J. , Noth Imre , Garcia Christine Kim
Published: January 2019

Leukocyte telomere length (LTL),MUC5Brs35705950 andTOLLIPrs5743890 have been associated with idiopathic pulmonary fibrosis (IPF).

In this observational cohort study, we assessed the associations between these genomic markers and outcomes of survival and rate of disease progression in patients with interstitial pneumonia with autoimmune features (IPAF, n=250) and connective tissue disease-associated interstitial lung disease (CTD-ILD, n=248). IPF (n=499) was used as a comparator.

The LTL of IPAF and CTD-ILD patients (mean age-adjusted log-transformed T/S of −0.05±0.29 and −0.04±0.25, respectively) is longer than that of IPF patients (−0.17±0.32). For IPAF patients, LTL <10th percentile is associated with faster lung function decline compared to LTL ≥10th percentile (−6.43% per yearversus−0.86% per year; p<0.0001) and worse transplant-free survival (hazard ratio 2.97, 95% CI 1.70–5.20; p=0.00014). TheMUC5Brs35705950 minor allele frequency (MAF) is greater for IPAF patients (23.2, 95% CI 18.8–28.2; p<0.0001) than controls and is associated with worse transplant-free IPAF survival (hazard ratio 1.92, 95% CI 1.18–3.13; p=0.0091). Rheumatoid arthritis (RA)-associated ILD (RA-ILD) has a shorter LTL than non-RA CTD-ILD (−0.14±0.27versus−0.01±0.23; p=0.00055) and higherMUC5BMAF (34.6, 95% CI 24.4–46.3versus14.1, 95% CI 9.8–20.0; p=0.00025). Neither LTL norMUC5Bare associated with transplant-free CTD-ILD survival.

LTL andMUC5BMAF have different associations with lung function progression and survival for IPAF and CTD-ILD.
Patient-reported outcome measures in the recovery of adults hospitalised with community-acquired pneumonia: a systematic review
Authors: Pick Harry J. , Bolton Charlotte E. , Lim Wei Shen , McKeever Tricia M.
Published: January 2019

Symptomatic and functional recovery are important patient-reported outcome measures (PROMs) in community-acquired pneumonia (CAP) that are increasingly used as trial end-points. This systematic review summarises the literature on PROMs in CAP.

Comprehensive searches in accordance with the PRISMA statement were conducted to March 2017. Eligible studies included adults discharged from hospital following confirmed CAP and reporting PROMs.

15 studies (n=5644 patients) were included; most were of moderate quality. Studies used a wide range of PROMs and assessment tools. At 4–6 weeks post-discharge, the commonest symptom reported was fatigue (45.0–72.6% of patients, three studies), followed by cough (35.3–69.7%) and dyspnoea (34.2–67.1%); corresponding values from studies restricted by age <65 years (two studies) were lower: fatigue 12.1–25.7%, cough 19.9–31.9% and dyspnoea 16.8–27.5%. Functional impairment 4 weeks post-discharge was reported in 18–51% of patients (two studies), while median time to return to normal activities was between 15 and 28 days (three studies).

Substantial morbidity is reported by patients up to 6 weeks post-discharge. There is weak methodological consistency across existing studies. A core set of PROMs for use in future studies is suggested.
Degeneration of saccular hair cells caused by MITF gene mutation
Authors: Du Yi , Ren Li-li , Jiang Qing-qing , Liu Xing-jian , Ji Fei , Zhang Yue , Yuan Shuo-long , Wu Zi-Ming , Guo Wei-Wei , Yang Shi-Ming
Published: January 2019

Background

Waardenburg syndrome (WS) is the consequence of an inherited autosomal dominant mutation which causes the early degeneration of intermediate cells of cochlear stria vascularis (SV) and profound hearing loss. Patients with WS may also experience primary vestibular symptoms. Most of the current WS studies did not discuss the relationship between WS and abnormal vestibular function. Our study found that a spontaneous mutant pig showed profound hearing loss and depigmentation. MITF-M, a common gene mutation causes type WS which affect the development of the intermediate cell of SV, was then identified for animal modeling.

Results

In this study, the degeneration of vestibular hair cells was found in pigs with MITF-M. The morphology of hair cells in vestibular organs of pigs was examined using electron microscopy from embryonic day E70 to postnatal two weeks. Significant hair cell loss in the mutant saccule was found in this study through E95 to P14. Conversely, there was no hair cell loss in either utricle or semi-circular canals.

Conclusions

Our study suggested that MITF-M gene mutation only affects hair cells of the saccule, but has no effect on other vestibular organs. The study also indicated that the survival of cochlear and saccular hair cells was dependent on the potassium release from the cochlear SV, but hair cells of the utricle and semi-circular canals were independent on SV.
Morphological analysis of sigmoid sinus anatomy: Clinical applications to neurotological surgery
Authors: Van Osch Kylen , Allen Daniel , Gare Bradley , Hudson Thomas J. , Ladak Hanif , Agrawal Sumit K.
Published: January 2019

Objectives

The primary objective of this study was to use high-resolution micro-CT images to create accurate three-dimensional (3D) models of several intratemporal structures, and to compare several surgically important dimensions within the temporal bone. The secondary objective was to create a statistical shape model (SSM) of a dominant and non-dominant sigmoid sinus (SS) to provide a template for automated segmentation algorithms.

Methods

A free image processing software, 3D Slicer, was utilized to create three-dimensional reconstructions of the SS, jugular bulb (JB), facial nerve (FN), and external auditory canal (EAC) from micro-CT scans. The models were used to compare several clinically important dimensions between the dominant and non-dominant SS. Anatomic variability of the SS was also analyzed using SSMs generated using the Statismo software framework.

Results

Three-dimensional models from 38 temporal bones were generated and analyzed. Right dominance was observed in 74% of the paired SSs. All distances were significantly shorter on the dominant side ( p < 0.05), including: EAC – SS (dominant: 13.7 ± 3.4 mm; non-dominant: 15.3 ± 2.7 mm), FN – SS (dominant: 7.2 ± 1.8 mm; non-dominant: 8.1 ± 2.3 mm), 2nd genu FN – superior tip of JB (dominant: 8.7 ± 2.2 mm; non-dominant: 11.2 ± 2.6 mm), horizontal distance between the superior tip of JB – descending FN (dominant: 9.5 ± 2.3 mm; non-dominant: 13.2 ± 3.5 mm), and horizontal distance between the FN at the stylomastoid foramen – JB (dominant: 5.4 ± 2.2 mm; non-dominant: 7.7 ± 2.1). Analysis of the SSMs indicated that SS morphology is most variable at its junction with the transverse sinus, and least variable at the JB.

Conclusions

This is the first known study to investigate the anatomical variation and relationships of the SS using high resolution scans, 3D  models and statistical shape analysis. This analysis seeks to guide neurotological surgical approaches and provide a template for automated segmentation and surgical simulation.
Role of childhood adversities and environmental sensitivity in the development of post-traumatic stress disorder in war-exposed Syrian refugee children and adolescents
Authors: Karam Elie G. , Fayyad John A. , Farhat Claudia , Pluess Michael , Haddad Youmna C. , Tabet Caroline C. , Farah Lynn , Kessler Ronald C.
Published: January 2019

Background

Increased post-traumatic stress disorder (PTSD) rates have been documented in children exposed to war. However, the contribution of childhood adversities and environmental sensitivity to children's responses to adversities and trauma are still far from settled.

Aims

To evaluate the relative roles of war, childhood adversities and sensitivity in the genesis of PTSD.

Method

Data on childhood adversities and sensitivity was collected from 549 Syrian refugee children in Lebanon. PTSD symptoms were assessed using the PTSD Reaction Index.

Results

Although childhood adversities, war events and sensitivity were all significantly related to PTSD in bivariate analyses, multivariate analyses showed that childhood adversities were the most important variable in predicting PTSD. The effect of war on PTSD was found to be dependent on the interplay between childhood adversities and sensitivity, and was most prominent in highly sensitive children with lower levels of adversities; in sensitive children experiencing high levels of adversities, the effects of war exposure on PTSD were less pronounced.

Conclusions

When considering the effects of war on PTSD in refugee children, it is important to take account of the presence of other adversities as well as of children's sensitivity. Sensitive children may be more vulnerable to the negative effects of war exposure, but only in contexts that are characterised by low childhood adversities.

Declaration of interest

None.
Atypical septate junctions maintain the somatic enclosure around maturing spermatids and prevent premature sperm release inDrosophilatestis
Authors: Dubey Pankaj , Kapoor Tushna , Gupta Samir , Shirolikar Seema , Ray Krishanu
Published: January 2019

Tight junctions prevent paracellular flow and maintain cell polarity in an epithelium. These junctions are also required for maintaining the blood-testis-barrier, which is essential for sperm differentiation. Septate junctions in insects are orthologous to the tight junctions. In Drosophila testis, major septate junction components co-localize at the interface of germline and somatic cells initially and then condense between the two somatic cells in a cyst after germline meiosis. Their localization is extensively remodeled in subsequent stages. We find that characteristic septate junctions are formed between the somatic cyst cells at the elongated spermatid stage. Consistent with previous reports, knockdown of essential junctional components- Discs-large-1 and Neurexin-IV- during the early stages, disrupted sperm differentiation beyond the spermatocyte stage. Knockdown of these proteins during the final stages of spermatid maturation caused premature release of spermatids inside the testes, resulting in partial loss of male fertility. These results indicate the importance of maintaining the integrity of the somatic enclosure during spermatid coiling and release in Drosophila testis. It also highlights the functional similarity with the tight junction proteins during mammalian spermatogenesis.
Maintenance of cell fates and regulation of the histone variant H3.3 by TLK kinase inCaenorhabditis elegans
Authors: Shibata Yukimasa , Seki Yoshiyuki , Nishiwaki Kiyoji
Published: January 2019

Cell-fate maintenance is important to preserve the variety of cell types that are essential for the formation and function of tissues. We previously showed that the acetylated histone−binding protein BET-1 maintains cell fate by recruiting the histone variant H2A.z. Here, we report that Caenorhabditis elegans TLK-1 and the histone H3 chaperone CAF1 prevent the accumulation of histone variant H3.3. In addition, TLK-1 and CAF1 maintain cell fate by repressing ectopic expression of transcription factors that induce cell-fate specification. Genetic analyses suggested that TLK-1 and BET-1 act in parallel pathways. In tlk-1 mutants, the loss of SIN-3, which promotes histone acetylation, suppressed a defect in cell-fate maintenance in a manner dependent on MYST family histone acetyltransferase MYS-2 and BET-1. sin-3 mutation also suppressed abnormal H3.3 incorporation. Thus, we propose a hypothesis that the regulation and interaction of histone variants play crucial roles in cell-fate maintenance through the regulation of selector genes.
DrosophilaIMP regulates Kuzbanian to control the timing of Notch signalling in the follicle cells
Authors: Fic Weronika , Faria Celia , St Johnston Daniel
Published: January 2019

The timing of Drosophila egg chamber development is controlled by a germline Delta signal that activates Notch in the follicle cells to induce them to cease proliferation and differentiate. Here we report that follicle cells lacking the RNA-binding protein IMP go through one extra division due to a delay in the Delta-dependent S2 cleavage of Notch. The timing of Notch activation has previously been shown to be controlled by cis-inhibition by Delta in the follicle cells, which is relieved when the miRNA pathway represses Delta expression. imp mutants are epistatic to Delta mutants and give an additive phenotype with belle and dicer mutants, indicating that IMP functions independently of both cis-inhibition and the miRNA pathway. We find that the imp phenotype is rescued by over-expression of Kuzbanian, the metalloprotease that mediates the Notch S2 cleavage. Furthermore, Kuzbanian is not enriched at the apical membrane in imp mutants, accumulating instead in late endosomes. Thus, IMP regulates Notch signalling by controlling the localisation of Kuzbanian to the apical domain, where Notch cleavage occurs, revealing a novel regulatory step in the Notch pathway.
CDK5RAP3, a UFL1 substrate adaptor, is critical for liver development
Authors: Yang Rui , Wang Huanmin , Kang Boxi , Chen Bin , Shi Yaoyao , Yang Shuchun , Sun Lihong , Liu Yufang , Xiao Weidi , Zhang Tao , Yang Juntao , Zhang Ye , Zhu Mingzhao , Xu Ping , Chang Yongsheng , Jia Yuyan , Huang Yue
Published: January 2019

Protein modification by ubiquitin and ubiquitin-like proteins (UBLs) regulates numerous biological functions. The UFM1 system, a novel UBL conjugation system, is implicated in mouse development and hematopoiesis. However, its broad biological functions and working mechanisms remain largely elusive. CDK5RAP3, a possible ufmylation substrate, is essential for epiboly and gastrulation in zebrafish. Herein, we report a critical role of CDK5RAP3 in liver development and hepatic functions. Cdk5rap3 knockout mice displayed prenatal lethality with severe liver hypoplasia, as characterized by delayed proliferation and compromised differentiation. Hepatocyte-specific Cdk5rap3 knockout mice suffered post-weaning lethality, due to serious hypoglycemia and impaired lipid metabolism. Depletion of CDK5RAP3 triggered endoplasmic reticulum stress and activated unfolded protein responses in hepatocytes. We detected the in vivo interaction of CDK5RAP3 with UFL1, the defined E3 ligase in ufmylation. Notably, loss of CDK5RAP3 altered the ufmylation profile in liver cells, suggesting that CDK5RAP3 serves as a novel substrate adaptor for this UBL modification. Collectively, our study identifies CDK5RAP3 as an important regulator of ufmylation and suggests the involvement of ufmylation in mammalian development.