bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal replacement therapy is independently associated with a lower risk of death in patients with severe acute kidney injury treated with targeted temperature management after out-of-hospital cardiac arrest
Authors:   on behalf of the Korean Hypothermia Network Investigators, Choi Yoon Hee , Lee Dong Hoon , Oh Je Hyeok , Wee Jung Hee , Jang Tae Chang , Choi Seung Pill , Park Kyu Nam
Published: March 2020

Background

The effect of renal replacement therapy (RRT) on the outcomes of severe acute kidney injury (AKI) after out-of-hospital cardiac arrest (OHCA) is uncertain. This study aimed to evaluate the association of RRT with 6-month mortality in patients with severe AKI treated with targeted temperature management (TTM) after OHCA.

Methods

This was a retrospective analysis of a prospectively collected multicentre observational cohort study that included adult OHCA patients treated with TTM across 22 hospitals in South Korea between October 2015 and December 2018. AKI was diagnosed using the Kidney Disease: Improving Global Outcomes criteria. The primary outcome was 6-month mortality and the secondary outcome was cerebral performance category (CPC) at 6 months. Multivariate Cox regression analysis was performed to define the role of RRT in stage 3 AKI.

Results

Among 10,426 patients with OHCA, 1373 were treated with TTM. After excluding those who died within 48 h of return of spontaneous circulation (ROSC) and those with pre-arrest chronic kidney disease, our study cohort comprised 1063 patients. AKI developed in 590 (55.5%) patients and 223 (21.0%) had stage 3 AKI. Among them, 115 (51.6%) were treated with RRT. The most common treatment modality among RRT patients was continuous renal replacement therapy (111 [96.5%]), followed by intermittent haemodialysis (4 [3.5%]). The distributions of CPC (1–5) at 6 months for the non-RRT vs. the RRT group were 3/108 (2.8%) vs. 12/115 (10.4%) for CPC 1, 0/108 (0.0%) vs. 1/115 (0.9%) for CPC 2, 1/108 (0.9%) vs. 3/115 (2.6%) for CPC 3, 6/108 (5.6%) vs. 6/115 (5.2%) for CPC 4, and 98/108 (90.7%) vs. 93/115 (80.9%) for CPC 5, respectively (P = 0.01). The RRT group had significantly lower 6-month mortality than the non-RRT group (93/115 [81%] vs. 98/108 [91%], P = 0.04). Multivariate Cox regression analyses showed that RRT was independently associated with a lower risk of death in patients with stage 3 AKI (hazard ratio, 0.569 [95% confidence interval, 0.377–0.857, P = 0.01]).

Conclusion

Dialysis interventions were independently associated with a lower risk of death in patients with stage 3 AKI treated with TTM after OHCA.
High-resolution Repli-Seq defines the temporal choreography of initiation, elongation and termination of replication in mammalian cells
Authors: Zhao Peiyao A. , Sasaki Takayo , Gilbert David M.
Published: March 2020

Background

DNA replication in mammalian cells occurs in a defined temporal order during S phase, known as the replication timing (RT) programme. Replication timing is developmentally regulated and correlated with chromatin conformation and local transcriptional potential. Here, we present RT profiles of unprecedented temporal resolution in two human embryonic stem cell lines, human colon carcinoma line HCT116, and mouse embryonic stem cells and their neural progenitor derivatives.

Results

Fine temporal windows revealed a remarkable degree of cell-to-cell conservation in RT, particularly at the very beginning and ends of S phase, and identified 5 temporal patterns of replication in all cell types, consistent with varying degrees of initiation efficiency. Zones of replication initiation (IZs) were detected throughout S phase and interacted in 3D space preferentially with other IZs of similar firing time. Temporal transition regions were resolved into segments of uni-directional replication punctuated at specific sites by small, inefficient IZs. Sites of convergent replication were divided into sites of termination or large constant timing regions consisting of many synchronous IZs in tandem. Developmental transitions in RT occured mainly by activating or inactivating individual IZs or occasionally by altering IZ firing time, demonstrating that IZs, rather than individual origins, are the units of developmental regulation. Finally, haplotype phasing revealed numerous regions of allele-specific and allele-independent asynchronous replication. Allele-independent asynchronous replication was correlated with the presence of previously mapped common fragile sites.

Conclusions

Altogether, these data provide a detailed temporal choreography of DNA replication in mammalian cells.
An assessment of adult mosquito collection techniques for studying species abundance and diversity in Maferinyah, Guinea
Authors: Cansado-Utrilla Cintia , Jeffries Claire L. , Kristan Mojca , Brugman Victor A. , Heard Patrick , Camara Gnepou , Sylla Moussa , Beavogui Abdoul H. , Messenger Louisa A. , Irish Seth R. , Walker Thomas
Published: March 2020

Background

Several mosquito collection methods are routinely used in vector control programmes. However, they target different behaviours causing bias in estimation of species diversity and abundance. Given the paucity of mosquito trap data in West Africa, we compared the performance of five trap-lure combinations and Human Landing Catches (HLCs) in Guinea.

Methods

CDC light traps (LT), BG sentinel 2 traps (BG2T), gravid traps (GT) and Stealth traps (ST) were compared in a 5 × 5 Latin Square design in three villages in Guinea between June and July 2018. The ST, a portable trap which performs similarly to a LT but incorporates LEDs and incandescent light, was included since it has not been widely tested. BG2T were used with BG and MB5 lures instead of CO2 to test the efficacy of these attractants. HLCs were performed for 5 nights, but not as part of the Latin Square. A Generalised Linear Mixed Model was applied to compare the effect of the traps, sites and collection times on mosquito abundance. Species identification was confirmed using PCR-based analysis and Sanger sequencing.

Results

A total of 10,610 mosquitoes were captured across five traps. ST collected significantly more mosquitoes (7096) than the rest of the traps, but resulted in a higher number of damaged specimens. ST and BG2T collected the highest numbers of Anopheles gambiae (s.l.) and Aedes aegypti mosquitoes, respectively. HLCs captured predominantly An. coluzzii (41%) and hybrids of An. gambiae and An. coluzzii (36%) in contrast to the five traps, which captured predominantly An. melas (83%). The rural site (Senguelen) presented the highest abundance of mosquitoes and overall diversity in comparison with Fandie (semi-rural) and Maferinyah Centre I (semi-urban). Our results confirm the presence of four species for the first time in Guinea.

Conclusions

ST collected the highest number of mosquitoes suggesting this trap may play an important role for mosquito surveillance in Guinea and similar sites in West Africa. We recommend the incorporation of molecular tools in entomological studies since they have helped to identify 25 mosquito species in this area.
Post-traumatic osteoarthritis following ACL injury
Authors: Wang Li-Juan , Zeng Ni , Yan Zhi-Peng , Li Jie-Ting , Ni Guo-Xin
Published: March 2020

Post-traumatic osteoarthritis (PTOA) develops after joint injury. Specifically, patients with anterior cruciate ligament (ACL) injury have a high risk of developing PTOA. In this review, we outline the incidence of ACL injury that progresses to PTOA, analyze the role of ACL reconstruction in preventing PTOA, suggest possible mechanisms thought to be responsible for PTOA, evaluate current diagnostic methods for detecting early OA, and discuss potential interventions to combat PTOA. We also identify important directions for future research. Although much work has been done, the incidence of PTOA among patients with a history of ACL injury remains high due to the complexity of ACL injury progression to PTOA, the lack of sensitive and easily accessible diagnostic methods to detect OA development, and the limitations of current treatments. A number of factors are thought to be involved in the underlying mechanism, including structural factors, biological factors, mechanical factors, and neuromuscular factor. Since there is a clear “start point” for PTOA, early detection and intervention is of great importance. Currently, imaging modalities and specific biomarkers allow early detection of PTOA. However, none of them is both sensitive and easily accessible. After ACL injury, many patients undergo surgical reconstruction of ACL to restore joint stability and prevent excessive loading. However, convincing evidence is still lacking for the superiority of ACL-R to conservative management in term of the incidence of PTOA. As for non-surgical treatment such as anti-cytokine and chemokine interventions, most of them are investigated in animal studies and have not been applied to humans. A complete understanding of mechanisms to stratify the patients into different subgroups on the basis of risk factors is critical. And the improvement of standardized and quantitative assessment techniques is necessary to guide intervention. Moreover, treatments targeted toward different pathogenic pathways may be crucial to the management of PTOA in the future.
Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review
Authors: Choukem Simeon-Pierre , Tochie Joel Noutakdie , Sibetcheu Aurelie T. , Nansseu Jobert Richie , Hamilton-Shield Julian P.
Published: March 2020

Introduction

Recently, childhood and adolescence overweight/obesity has increased disproportionately in developing countries, with estimates predicting a parallel increase in future cardiovascular disease (CVD) burden identifiable in childhood and adolescence. Identifying cardiovascular risk factors (CVRF) associated with childhood and adolescence overweight/obesity is pivotal in tailoring preventive interventions for CVD. Whilst this has been examined extensively in high-income countries, there is scant consistent or representative data from sub-Saharan Africa (SSA).

Objective

This scoping review synthesises contemporary studies on CVRF associated with overweight and obesity in SSA children and adolescents to provide evidence on the current burden of overweight/obesity and CVD in this population.

Methods

We searched MEDLINE and Google Scholar up to July 31, 2019 for observational and experimental studies and systematic reviews addressing childhood and adolescence overweight/obesity and CVRF in SSA without language restriction. Four investigators working in four pairs, independently selected and extracted the relevant data. The methodological quality of all included studies was assessed.

Results

We included 88 studies with a total of 86,637children and adolescents from 20 SSA countries. The risk of bias was low in 62 (70.5%), moderate 18 (20.5%), and high in eight (9%) studies. Overweight/obesity in SSA children and adolescents is rising at an alarming rate. Its main associations include physical inactivity, unhealthy diets, high socio-economic status, gender and high maternal body mass index. Identified CVRF in overweight/obese SSA children and adolescents are mainly metabolic syndrome, hypertension, dyslipidaemia, diabetes and glucose intolerance. There is a dearth of guidelines or consensus on the management of either childhood overweight/obesity or CVRF in overweight/obese SSA children and adolescents.

Conclusion

The current findings suggest an urgent need to review current health policies in SSA countries. Health education and transforming the current obesogenic environment of the SSA child and adolescent into one which promotes physical activity and healthy dietary habits is required.
In vitro propagation of bulblets and LC–MS/MS analysis of isosteroidal alkaloids in tissue culture derived materials of Chinese medicinal herb Fritillaria cirrhosa D. Don
Authors: Chang Hung-Chi , Xie Hui-Min , Lee Maw-Rong , Lin Chiu-Ying , Yip Mei-Kuen , Agrawal Dinesh Chandra , Tsay Hsin-Sheng
Published: March 2020

Background

Fritillaria cirrhosa, an important Chinese medicinal herb, is a Class-III protected and highly exploited species by pharmaceutical industry. Dwindling wild populations of species are unable to meet market demand. Therefore, this study was carried out to develop an in vitro propagation method for bulblet production. Also, the study aimed to carry out LC–MS/MS analysis of tissue culture-derived bulblets and callus for the presence of isosteroidal alkaloids (peimissine, verticine, and verticinone), and compare its quantities with commercially available crude drug samples.

Results

In vitro seed germination (91%) of F. cirrhosa was achieved on Murashige and Skoog’s basal medium (MSBM) supplemented with 6-benzylaminopurine (1 mg L−1) and α-naphthalene-acetic-acid (0.4 mg L−1). On transfer of germinated seeds from Petri-dishes to glass bottles containing hormone-free MSBM, 37.5% of seedlings developed bulblets after 3 months of incubation. Regeneration and multiplication of bulblets were achieved by culture of transverse sections of bulblets on 1/2 X MSBM. By repeated subcultures at an interval of 2 months, 3072 bulblets weighing 1270 g could be produced at the end of 5th subculture. LC–MS/MS analysis showed a significant presence of peimissine in in vitro bulblets while callus incubated in the dark showed presence of peimissine and verticine.

Conclusion

The study reports an efficient in vitro propagation method of bulblets production of F. cirrhosa and presence of some isosteroidal alkaloids in tissue culture-derived bulblets and callus. The study could be of immense help in production of F. cirrhosa bulblets and callus under laboratory conditions round the year. Also, these results can be used further to investigate production of isosteroidal alkaloids in bioreactors at commercial scale using liquid and cell suspension cultures. Thus, we not only can reduce our dependence on collections from natural habitats, but also can help in in situ conservation of this important species.
Comparative molecular cell-of-origin classification of diffuse large B-cell lymphoma based on liquid and tissue biopsies
Authors: Hunter Ewan , McCord Ronald , Ramadass Aroul S. , Green Jayne , Westra Jurjen W. , Mundt Kirsten , Akoulitchev Alexandre
Published: March 2020

Background

Diffuse large B-cell lymphoma (DLBCL) is a heterogenous blood cancer, but can be broadly classified into two main subtypes, germinal center B-cell-like (GCB) and activated B-cell-like (ABC). GCB and ABC subtypes have very different clinical courses, with ABC having a much worse survival prognosis. It has been observed that patients with different subtypes also respond differently to therapeutic intervention, in fact, some have argued that ABC and GCB can be thought of as separate diseases altogether. Due to this variability in response to therapy, having an assay to determine DLBCL subtypes has important implications in guiding the clinical approach to the use of existing therapies, as well as in the development of new drugs. The current gold standard assay for subtyping DLBCL uses gene expression profiling on formalin fixed, paraffin embedded (FFPE) tissue to determine the “cell of origin” and thus disease subtype. However, this approach has some significant clinical limitations in that it 1) requires a biopsy 2) requires a complex, expensive and time-consuming analytical approach and 3) does not classify all DLBCL patients.

Methods

Here, we took an epigenomic approach and developed a blood-based chromosome conformation signature (CCS) for identifying DLBCL subtypes. An iterative approach using clinical samples from 118 DLBCL patients was taken to define a panel of six markers (DLBCL-CCS) to subtype the disease. The performance of the DLBCL-CCS was then compared to conventional gene expression profiling (GEX) from FFPE tissue.

Results

The DLBCL-CCS was accurate in classifying ABC and GCB in samples of known status, providing an identical call in 100% (60/60) samples in the discovery cohort used to develop the classifier. Also, in the assessment cohort the DLBCL-CCS was able to make a DLBCL subtype call in 100% (58/58) of samples with intermediate subtypes (Type III) as defined by GEX analysis. Most importantly, when these patients were followed longitudinally throughout the course of their disease, the EpiSwitch™ associated calls tracked better with the known patterns of survival rates for ABC and GCB subtypes.

Conclusion

This proof-of-concept study provides an initial indication that a simple, accurate, cost-effective and clinically adoptable blood-based diagnostic for identifying DLBCL subtypes is possible.
Comparison of Annotation Services for Next-Generation Sequencing in a Large-Scale Precision Oncology Program
Authors: Katsoulakis Evangelia , Duffy Jill E. , Hintze Bradley , Spector Neil L. , Kelley Michael J.
Published: March 2020

PURPOSE

Next-generation sequencing (NGS) multigene panel testing has become widespread, including the Veterans Affairs (VA), through the VA National Precision Oncology Program (NPOP). The interpretation of genomic alterations remains a bottleneck for realizing precision medicine. We sought to examine the concordance for pathogenicity determination and clinical actionability of annotation services in NPOP.

METHODS

Unique gene variants were generated from NGS gene panel results using two sequencing services. For each unique gene variant, annotations were provided through N-of-One (NoO), IBM Watson for Genomics (WfG), and OncoKB. Annotations for pathogenicity (all three sources) and actionability (WfG and OncoKB) were examined for concordance. Cohen’s kappa statistic was calculated to measure agreement between annotation services.

RESULTS

Among 1,227 NGS results obtained between 2015 and 2017, 1,388 unique variants were identified in 117 genes. The genes with the largest number of variants included TP53 (270), STK11 (92), and CDKN2A (81). The most common cancer type was lung adenocarcinoma (440), followed by colon adenocarcinoma (113). For pathogenic and likely pathogenic variants, there was 30% agreement between WfG and NoO (kappa, −0.26), 76% agreement between WfG and OncoKB (kappa, 0.22), and 42% agreement between NoO and OncoKB (kappa, −0.07). For level 1 drug actionability of gene variant–diagnosis combinations, there was moderate agreement between WfG and OncoKB (96.9%; kappa, 0.44), with 27 combinations identified as level 1 by both services, 58 by WfG alone, and 6 variants by OncoKB alone.

CONCLUSION

There is substantial variability in pathogenicity assessment of NGS variants in solid tumors by annotation services. In addition, there was only moderate agreement in level 1 therapeutic actionability recommendations between WfG and OncoKB. Improvement in the precision of NGS multigene panel annotation is needed.
Maternal B12, Folate and Homocysteine Concentrations and Offspring Cortisol and Cardiovascular Responses to Stress
Authors: Krishnaveni Ghattu V , Veena Sargoor R , Johnson Matt , Kumaran Kalyanaraman , Jones Alexander , Bhat Dattatray S , Yajnik Chittaranjan S , Fall Caroline H D
Published: March 2020

Context

Imbalances in maternal 1-carbon nutrients (vitamin B12, folate) have been shown to be associated with higher offspring cardiometabolic risk markers in India.

Objective

We examined the hypothesis that low plasma vitamin B12 (B12) and high folate and homocysteine concentrations in the mother are associated with higher hypothalamic–pituitary–adrenal axis (cortisol) and cardiovascular responses during the Trier Social Stress Test for Children (TSST-C) in an Indian birth cohort.

Methods

Adolescents (n = 264; mean age: 13.6 years), whose mothers’ plasma B12, folate and total homocysteine concentrations had been measured during pregnancy, completed 5-minutes each of public speaking and mental arithmetic tasks in front of 2 unfamiliar “judges” (TSST-C). Baseline and poststress salivary cortisol concentrations were measured. Heart rate, blood pressure, stroke volume, cardiac output, and total peripheral resistance were measured continuously at baseline, during the TSST-C, and for 10 minutes after the TSST-C using a finger cuff; beat-to-beat values were averaged for these periods, respectively.

Results

Maternal low B12 status (plasma B12 < 150 pmol/L) was associated with greater cortisol responses to stress in the offspring (P < .001). Higher homocysteine concentrations were associated with greater offspring heart rate response (P < .001). After adjustment for multiple comparisons, there were nonsignificant associations between higher maternal folate concentrations and offspring total peripheral resistance response (P = .01).

Conclusion

Our findings suggest that maternal 1-carbon nutritional status may have long-term programming implications for offspring neuroendocrine stress responses.
A Look into Historical Grand Bazaars from the Literature on Shopping Centers
Authors: Bal Faruk , Taşdemir Murat
Published: March 2020

This study aims to shed a light on the question ‘to what degree shopping centers are continuation of Ottoman bazaars?’ by comparing two major shopping places of two different eras from various angles. To this end, locations, architecture, functions and management practices of the two shopping places are compared using related literature in economics. It is obvious that two shopping places have similarities as well as differences. Similarities seem to be the results of their economic functions. Differences, on the other hand, stems mainly from the differences in the economic environments in their time periods. The main functions that shopping centers perform are the same as historical bazaars’. Therefore, the theories in the shopping centers literature explaining the existence of shopping centers are, also, able to explain the existence of historical bazaars.
Peer Bargaining and Productivity in Teams: Gender and the Inequitable Division of Pay
Authors: Pierce Lamar , Wang Laura W. , Zhang Dennis J.
Published: March 2020

Problem description: A recent trend in personnel operations is to reduce hierarchy and allow employee teams to self-manage tasks, responsibilities, and rewards. Yet, we know little about how this arrangement relates to worker productivity and fairness. Academic/practical relevance: We provide the first firm-based evidence that when service teams are allowed to allocate compensation internally, the ensuing peer-bargaining process can generate inequitable outcomes for women. Methodology: We demonstrate this using fixed-effect models to identify productivity and peer-bargaining traits in 932 workers at 32 large Chinese beauty salons. We measure individual productivity through service and prepaid card sales and measure bargaining through the division of team-based commissions. We also build a parsimonious bargaining model to explain our empirical results. Results: Although productivity and bargaining outcomes are positively correlated, female workers consistently receive bargaining outcomes below their productivity level, whereas men are consistently overcompensated. Importantly, we provide evidence that our results can only be explained by a combination of higher prosociality and lower bargaining power in women. We also demonstrate that the resulting inequity is positively correlated with shorter tenure. Managerial implications: Our findings provide unique organizational evidence on how bargaining among peers relates to productivity in service operations. We show that the discriminatory social dynamics observed throughout society are evident in operational designs that delegate decision rights to teams and that the magnitude in these systems is at least as large as that observed in traditional hierarchical pay systems. Managers must anticipate and mitigate this gender-based inequity because it is in and of itself an operational performance issue, and because of the myriad of productivity, retention, and ethical implications that can result from peer-based bargaining.
Seizures: Management in children
Authors: Luff Edward
Published: March 2020

Epilepsy is a common neurological condition and one that school nurses are likely to deal with due to its prevalence in the population. It is therefore important to know how to manage a child having a seizure in the community. Having an appreciation of the long-term management with antiepileptic drugs to try to prevent and control seizures is useful. Children suffering from epilepsy may experience a seizure at any time, often without warning, so an understanding of the correct first aid measures and the use of emergency medication is key. It is also important to know when further medical help is required as well as when it may not be. This article will give a brief overview of the management of seizures in children, covering both prevention and initial management in the community setting.
Sepsis: The importance of knowing the signs and symptoms
Authors: Lepkowska Dorothy
Published: March 2020

Sepsis is a life-threatening reaction to an infection and can be particularly difficult to identify in young children, Dorothy Lepkowska explains
BOAS PRÁTICAS DE ENFERMAGEM NA ASSISTÊNCIA AO PARTO NORMAL: REVISÃO DE LITERATURA
Authors: Santos Carvalho Silas , Da Silva e Silva Camila
Published: March 2020

Introdução: O uso das boas práticas na assistência ao parto normal tem demonstrado impacto positivo no prognóstico materno e neonatal. Objetivo: O presente estudo objetivou refletir sobre as boas práticas de enfermagem na assistência ao parto normal por meio de uma revisão integrativa da literatura. Materiais e Métodos: Trata-se de um estudo do tipo revisão integrativa da literatura, em que foram selecionadas e analisadas as publicações realizadas entre os anos de 2015 e 2019 disponíveis na Biblioteca Virtual em Saúde (BVS) a respeito das boas práticas de enfermagem na assistência ao parto normal em consonância com as recomendações da Organização Mundial de Saúde (OMS). Procedeu-se a busca utilizando os descritores: “humanização da assistência”, “parto normal”, “cuidados de enfermagem” e “enfermagem obstétrica”, de forma isolada e combinada. Após a seleção segundo os critérios de inclusão 13 artigos compuseram a análise. Resultados: Compuseram a análise 14 artigos. Os estudos confirmam a importância do uso das boas práticas na assistência ao parto normal para um melhor prognóstico materno e neonatal, embora outros tenham evidenciado necessidade de implementação com conscientização e responsabilização de cada profissional devendo haver participação ativa das instituições de saúde. Conclusão: É primordial que os enfermeiros incorporem as boas práticas na assistência ao parto, bem como soluções efetivas dos entraves para sua implementação, baseando as políticas e as práticas de saúde nas melhores evidências disponíveis, promovendo a efetividade e a segurança das intervenções, implicando em mudança de comportamento, superação de barreiras e preenchimento de lacunas do conhecimento.
Modeling and experimental characterization of a dual-wavelength Bi-doped fiber laser with cascaded cavities
Authors: Nemova Galina , Jin Xian , Chen Lawrence R. , Firstov Sergei V. , Sezerman Omur
Published: March 2020

We present a comprehensive theoretical and experimental investigation of a dual-wavelength, bismuth-doped fiber (BDF) laser operating near 1700 nm based on cascaded cavities. The BDF provides optical gain from 1650 nm to 1800 nm when pumped at 1550 nm. The linear laser cavity is defined by a 90% fiber mirror on one end and two fiber Bragg gratings (FBGs) with two lengths of BDF in cascade on the other. The laser can operate at either wavelength alone, or both wavelengths simultaneously by simple adjustment of the pump power. We develop a model based on rate equations and radiation transport equations for two level BDF lasers which we then extend to the case for cascaded cavities. Experimental results agree with simulations.
All optic-fiber coupled plasmon waveguide resonance sensor using ZrS2 based dielectric layer
Authors: Ma Jinying , Liu Kun , Jiang Junfeng , Xu Tianhua , Wang Shuang , Chang Pengxiang , Zhang Zhao , Zhang Jiahang , Liu Tiegen
Published: March 2020

We developed an all optic-fiber coupled plasmon waveguide resonance (CPWR) sensor using a zirconium disulfide (ZrS2) based dielectric layer. The dielectric constants of ZrS2 were obtained using first-principles calculations. The theoretical model of the proposed sensor was established based on the transfer matrix method, leading to the optimization of the parameters in the sensor. The sensor was fabricated by depositing a gold layer of 35 nm on the fiber core and immobilizing the ZrS2 layer on the gold layer via physical adsorption method. An experimental setup was implemented for measuring the refractive index. The sensor with two cycles showed the best performance, with a sensitivity of higher than 8000 nm/RIU.
Off-axis conics as base surfaces for freeform optics enable null testability
Authors: Takaki Nick , Papa Jonathan C. , Bauer Aaron , Rolland Jannick P.
Published: March 2020

When conducting interferometric tests of freeform optical surfaces, additional optical components, such as computer-generated holograms or deformable mirrors, are often necessary to achieve a null or quasi-null. These additional optical components increase both the cost and the difficulty of interferometric tests of freeform optical surfaces. In this paper, designs using off-axis segments of conics as base surfaces for freeforms are explored. These off-axis conics are more complex base surfaces than typically-used base spheres but remain null-testable. By leveraging off-axis conics in conjunction with additional orthogonal polynomial departures, designs were found with up to an order-of-magnitude of improvement in testability estimates relative to designs that use base spheres. Two design studies, a three-mirror telescope and a wide field-of-view four-mirror telescope, demonstrate the impact of using off-axis conics as the base surface.
Highly elliptical core fiber with stress-induced birefringence for mode multiplexing
Authors: Corsi Alessandro , Ho Chang Jun , Wang Ruohui , Wang Lixian , Ann Rusch Leslie , LaRochelle Sophie
Published: March 2020

We report the polarization-maintaining properties of a highly
elliptical core fiber surrounded by a trench that was designed to
optimize the modal effective indices and bending loss for a total of
five spatial modes (10 channels). In addition to the asymmetric core
structure, the birefringence of the fiber is increased by the thermal
stress introduced during the fabrication. The results show a modal
birefringence larger than

10

−
4

for all guided spatial modes. The
mode stability to bending is evaluated by selectively
exciting/detecting each spatial mode while perturbing the fiber. This
few-mode polarization-maintaining fiber is of interest for
multiple-input multiple-output (MIMO)-free mode division multiplexing
transmission systems.
Sub-nanosecond-speed frequency-reconfigurable photonic radio frequency switch using a silicon modulator
Authors: Xie Yiwei , Zhuang Leimeng , Jiao Pengcheng , Dai Daoxin
Published: March 2020

Radio frequency (RF) switches are essential for implementing routing of RF signals. However, the increasing demand for RF signal frequency and bandwidth is posing a challenge of switching speed to the conventional solutions, i.e., the capability of operating at a sub-nanosecond speed or faster. In addition, signal frequency reconfigurability is also a desirable feature to facilitate new innovations of flexible system functions. Utilizing microwave photonics as an alternative path, we present here a photonic implementation of an RF switch providing not only the capability of switching at a sub-nanosecond speed but also options of frequency doubling of the input RF signals, allowing for flexible output waveforms. The core device is a traveling-wave silicon modulator with a device size of

0.2
  
mm
×
1.8
  
mm

and a modulation bandwidth of 10 GHz. Using microwave frequencies, i.e., 15 GHz and 20 GHz, as two simultaneous RF input signals, we experimentally demonstrated their amplitude and frequency switching as well as that of the doubled frequencies, i.e., 30 GHz and 40 GHz, at a switching frequency of 5 GHz. The results of this work point to a solution for creating high-speed RF switches with high compactness and flexibility.
Teaching by media ecology: Epiphanies and revelations
Authors: Plugh Michael
Published: March 2020

This article is an autobiographical account of the author’s early encounters with media ecology, and an elaboration of the differences in learning about media ecology vs. learning by media ecology. Several examples of teaching by media ecology are explored, including lessons about the biases of media, orality and literacy, and the systems approach connected to media ecological explorations.
Sexual participation within fan cultures: Considering a sex toy as a mode of reception for The Shape of Water
Authors: Falvey Eddie
Published: March 2020

This article considers how the purchase and use of film-inspired sex toys interacts with current understandings of fan practice. Using existing critical frameworks, including Jonathan Gray’s work on fan-made paratexts, this article will consider how these toys operate as paratextual engagements with The Shape of Water that reify some of the queer elements that have been adopted by a portion of the film’s fandom. It is this article’s position that the devices in question offer fascinating (if not entirely unprecedented) forms of textual engagement that suggest a continuation of the film’s defence of queer love through their enabling of tentraphilic masturbation. It is the aim of this article to consider how the pleasures offered by such devices can be understood in relation to established and emerging forms of fan practice, whilst illustrating one of the more unique forms of reception operating beyond the realm of licensed ephemera.
Trends in Sociodemographic Disparities in Colorectal Cancer Staging and Survival: A SEER–Medicare Analysis
Authors: Liang Peter S. , Mayer Jonathan D. , Wakefield Jon , Trinh-Shevrin Chau , Kwon Simona C. , Sherman Scott E. , Ko Cynthia W.
Published: March 2020

INTRODUCTION:

Race, ethnicity, and socioeconomic status are known to influence staging and survival in colorectal cancer (CRC). It is unclear how these relationships are affected by geographic factors and changes in insurance coverage for CRC screening. We examined the temporal trends in the association between sociodemographic and geographic factors and staging and survival among Medicare beneficiaries.

METHODS:

We identified patients 65 years or older with CRC using the 1991–2010 Surveillance, Epidemiology, and End Results–Medicare database and extracted area-level sociogeographic data. We constructed multinomial logistic regression models and the Cox proportional hazards models to assess factors associated with CRC stage and survival in 4 periods with evolving reimbursement and screening practices: (i) 1991–1997, (ii) 1998–June 2001, (iii) July 2001–2005, and (iv) 2006–2010.

RESULTS:

We observed 327,504 cases and 102,421 CRC deaths. Blacks were 24%–39% more likely to present with distant disease than whites. High-income areas had 7%–12% reduction in distant disease. Compared with whites, blacks had 16%–21% increased mortality, Asians had 32% lower mortality from 1991 to 1997 but only 13% lower mortality from 2006 to 2010, and Hispanics had 20% reduced mortality only from 1991 to 1997. High-education areas had 9%–12% lower mortality, and high-income areas had 5%–6% lower mortality after Medicare began coverage for screening colonoscopy. No consistent temporal trends were observed for the associations between geographic factors and CRC survival.

DISCUSSION:

Disparities in CRC staging and survival persisted over time for blacks and residents from areas of low socioeconomic status. Over time, staging and survival benefits have decreased for Asians and disappeared for Hispanics.
Timing of Performing Endoscopic Retrograde Cholangiopancreatography and Inpatient Mortality in Acute Cholangitis: A Systematic Review and Meta-Analysis
Authors: Du Lijun , Cen Mengsha , Zheng Xia , Luo Liang , Siddiqui Ali , Kim John J.
Published: March 2020

OBJECTIVES:

Although early biliary drainage improves outcomes in patients with acute cholangitis, the optimal time to perform endoscopic retrograde cholangiopancreatography (ERCP) is controversial. Our aim was to evaluate the impact of timing of ERCP on mortality in hospitalized patients with acute cholangitis.

METHODS:

We searched PubMed, EMBASE, and The Cochrane Library (until February 2019) for studies evaluating the impact of timing of ERCP (<24, <48, and <72 hours from hospitalization) on outcomes in patients with acute cholangitis. The primary outcome was in-hospital mortality.

RESULTS:

Fourteen observational studies, including 84,063 patients (mean age = 66 ± 18), met the study criteria. The overall pooled in-hospital mortality with acute cholangitis was 1.9% (95% confidence interval [CI] 1.8%–7.6%), which increased to 4.3% (95% CI 1.8%–8.7%) when administrative database studies were excluded. In 9 studies, ERCP performed <24 compared with ≥24 hours decreased in-hospital mortality (odds ratio [OR] = 0.81, 95% CI 0.73–0.90; I
2 = 0%). In 8 studies, ERCP performed <48 compared with ≥48 hours decreased in-hospital mortality (OR = 0.57, 95% CI 0.51–0.63; I
2 = 0%). In 4 studies, ERCP performed <72 compared with ≥72 hours decreased in-hospital mortality (OR = 0.32, 95% CI 0.15–0.68; I
2 = 0%). Furthermore, hospital stay was reduced in patients receiving ERCP <24 compared with ≥24 hours (mean difference [MD] = 3.2 days, 95% CI 2.3–4.1; I
2 = 78%), <48 compared with ≥48 hours (MD = 3.6 days, 95% CI 2.1–5.1; I
2 = 98%), and <72 compared with ≥72 hours (MD = 4.1 days, 95% CI 0.9–7.3; I
2 = 63%).

DISCUSSION:

In observational studies, earlier ERCP performed in patients with acute cholangitis, even urgently performed <24 hours from presentation, was associated with reduced mortality. A randomized trial evaluating the impact of urgent ERCP on outcomes is needed.
Regiones para vivir. Índice sintético de calidad de vida departamental
Authors: Burbano Espinosa Carolina , Londoño Martinez Harold Herney , Pérez Carlos Andrés
Published: March 2020

Este trabajo presenta el diseño y cálculo del índice sintético de Calidad de Vida (ISCV) para 23 departamentos colombianos en 2016, a partir de la metodología de análisis de componentes principales. Los resultados evidencian la gran heterogeneidad de condiciones de entorno entre estos entes territoriales, y así mismo permiten orientar y priorizar programas y políticas públicas que podrían contribuir de forma más efectiva a mejorar la calidad de vida en cada región. En términos del índice, las primeras posiciones de los departamentos de Cundinamarca, Valle del Cauca y Atlántico están demostrando que sus habitantes pueden disfrutar de mejores condiciones de vida.
Análisis de un sistema productivo agrícola en el Caribe: tecnología de producción, patrón de costos e indicadores económicos de la producción de ahuyama
Authors: Orozco Guerrero Alfonso Rafael , Correa Alvarez Ender Manuel , Martinez Reina Antonio Maria , Silva Acosta Gabriel Ernesto , Tordecilla Zumaque Lilibet , Rodriguez Pinto Maria Del Valle
Published: March 2020

La investigación tuvo como finalidad revelar los aspectos socioeconómi-cos, productivos y tecnológicos del Caribe colombiano tomando como referencia el cultivo de ahuyama en la región. Para ello, se diseñaron y aplicaron encuestas estructuradas y complementariamente se realizaron talleres para la determinación de patrones de costos e indicadores econó-micos del cultivo. La información se analizó utilizando métodos multiva-riados como la distancia de Gower y el agrupamiento jerárquico de Ward. Los resultados revelan un bajo nivel en la tecnología local de producción; asimismo el cultivo presenta una baja dependencia de agroinsumos y los costos de producción son compatibles con la realidad económica del pe-queño productor
Enfoques Teóricos Sobre Unificación Monetaria en MERCOSUR y Lecciones Derivadas de la Experiencia de la Unión Europea
Authors: Hurtado Briceño Alberto José , Zerpa de Hurtado Sadcidi , Mora Mora José U.
Published: March 2020

La integración monetaria corresponde al proceso mediante el cual un conjunto de países previamente integrados adoptan una moneda común. Desde 1987, antes de la creación del Mercado Común del Sur (Mercosur), se plantea la necesidad de avanzar en los acuerdos que permitan lograr la unificación monetaria de esta región y se han sugerido distintos enfo-ques teóricos acerca de cómo lograrlo. En este sentido, el presente artí-culo tiene como propósito ampliar las contribuciones teóricas realizadas acerca del tema y contribuir al debate sobre las alternativas a seguir para la construcción de la moneda única en el mercado común suramericano. Para ello se realiza una revisión de la literatura sobre el origen y los en-foques teóricos planteados a la integración monetaria del Mercosur y se analizan las lecciones que ha dejado la integración europea al acuerdo re-gional suramericano.
pensamiento y gestión, N.° 46ISSN 1657-6276http://dx.doi.org/10.14482/pege.46.7615Situación de la investigación y su desarrollo en el Perú: reflejo del estado actual de la universidad peruana
Authors: Cervantes Liñán Luis Claudio , Bermúdez Díaz Ludisleydis , Pulido Capurro Víctor
Published: March 2020

La promulgación de la Ley n.° 30220 prioriza el desarrollo de la investigación sin tener en cuenta las capacidades reales de las universidades y, en general, del Perú, para el desarrollo de la investigación científica, el desarrollo tecnológico y la innovación. En el 2016 solo existían 3374 investigadores en el Perú, de los cuales 2192 (65 %) son docentes investigadores que desarrollan actividades de investigación, los que representan el 2,6 % del total de docentes universitarios del Perú. Esto impacta en la baja producción científica de las universidades, ya que solo 32 (22,4 %) de las 143 universidades existentes en el Perú tienen una producción científica diferente de cero. Este trabajo tiene como objetivo analizar la situación de la investigación y el desarrollo en el Perú, en comparación con otros países de la región que son miembros de la Organización para la Cooperación y el Desarrollo Económicos (OCDE).
A Survey on Multi-Scale Medical images Fusion Techniques: Brain Diseases
Authors: YOUSIF AHMED , Omar Zaid Bin , Sheikh Usman Ullah
Published: March 2020

Brain diseases such as degenerative (alzheimer's disease), neoplastic disease (brain tumor like sarcoma, glioma) are considered an interesting topic areas in the medical image fusion diagnosis. Pixel-level image fusion techniques are designed to combine multiple/multi-scale input images into a fused image, which is expected to be more informative for human or machine perception as compared to any of the input images.  Since they are difficult to be summarized ; survey paper are characterized by (1) medical image definition , brain diseases challenges , analysis a various techniques for multi-scale image fusion with its own modalities, fusion rule, fusion strategy and dis-advantage ,Whilst used a database of medical images for medical Harvard School (brain diseases) which contains various groups of co-registered multi-modal images including MRI/CT, MRI/PET and PET/SPECT and MRI (T1/T2) images.
Effects of Balance Training on Physical Fitness in Youth and Young Athletes: A Narrative Review
Authors: Gebel Arnd , Prieske Olaf , Behm David G. , Granacher Urs
Published: March 2020

Balance training (BT) is a well-established training type in many sports and is used to improve postural control. There is evidence that performance enhancements after BT can even translate to other physical fitness measures such as muscle strength and jump performance. Accordingly, this narrative review summarizes the effects of BT on balance performance in youth/young athletes and describes how acute and chronic BT-specific adaptations translate to other physical fitness outcomes. In addition, recent findings on sequencing effects of balance and strength training will be reported. Finally, established dose-response relationships with BT in youth will be presented together with a progression sequence.
Closure to “Discussion of ‘The Flow Index of Clays and Its Relationship with Some Basic Geotechnical Properties’ by G. Spagnoli, M. Feinendegen, L. Di Matteo, and D. A. Rubinos”
Authors: Spagnoli G. , Feinendegen M. , Di Matteo L. , Rubinos D.
Published: March 2020

Considering the recent article on Flow Index and the basic correlation with some geotechnical parameters such as liquid limit, plastic limit, plasticity index, Cation Exchange Capacity, Specific Surface Area, Activity, and water uptake by Spagnoli et al. (2019), the authors reply to the discussers regarding their interesting comments.
Leveraging integrative research for inclusive innovation: urine diversion and re-use in agriculture
Authors: Schreiber Tatiana , Opperman Shaina , Nace Kim , Pallmeyer Audrey N. , Love Nancy , Hardin Rebecca
Published: March 2020

This report describes the evolution of a qualitative research design used in a study that integrated academic and non-academic expertise and involved multiple stakeholders concerned with the diversion of human urine from the waste stream for its re-use in agriculture. The study took place in two regions of the U.S., New England and the Upper Midwest (most specifically Vermont and Michigan) and suggests the importance of ethnographic perspectives in a participatory action research framework going forward. This manuscript presents a novel mix of researchers, from a grassroots organization to R1 University teams, and explores the perspectives of a wide range of research participants with whom we conferred to understand whether and how fertilizers made from nutrients recovered from diverted urine might be accepted, adapted, and scaled in agricultural use. Our manuscript thus articulates new territory for such interpretive social science work (focus groups, interviews and participant observations) neither within basic ethnographic research, nor within the kind of “rapid ethnography” widely used in business, engineering and international development fields. We describe how our research process entailed the modifications of our methods, and we consider the overlapping and sometimes opposed knowledges and attitudes of multiple stakeholders who are crucial to the uptake and scale of such new technologies for closing loops in our waste and water processing infrastructures and our food production systems. To best leverage these diverse knowledges, we suggest incremental steps for teams like ours towards an inclusive research process.
Ballistic performance of the steel-aluminium metal laminate panel for armoured vehicle
Authors: Abdullah Shahrum , Abdullah M. F. , M Jamil W. N.
Published: March 2020

This paper presents the ballistic performance of the joining lightweight metal laminated panel consists of high strength steel and aluminium alloy for armoured vehicle application. Composite laminates trend in military industry present excellent performance in terms of lightweight material due to the improvement vehicle manoeuvrability, without sacrificing the performance and safety. The combination of   aluminium plate and high strength steel offer the good potential for reducing the vehicle weight and improving the ballistic resistance. Ar500 and Al7075-T6 were chosen in designing laminated panel to achieve intended 20-30% weight reduction. Joining between these two materials have been investigated using both brazing method and adhesive bonding method. The adhesive bonding involved two types of material which is epoxy and polyurethane. Mechanical tests such as bending tests, drop weight tests and ballistic tests were performed to assess the strength of the laminated panel. Results showed that polyurethane bonded laminate panel through adhesion process exhibited 75% higher strength that that through the brazing process after performing impact test. Meanwhile, the penetration patterns found numerically are nearly similar to that from the ballistic tests and thus has validated the finite element models developed. The study on application of this laminated plate shall be extended using higher level of threat for hard armour vehicle panel.