bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Obstructive Sleep‐Disordered Breathing: Updated Polysomnography Practice Patterns
Authors: Friedman Norman R. , Ruiz Amanda G. , Gao Dexiang , Jensen Alexandria , Mitchell Ron B.
Published: April 2019

Objective

To assess the current practice patterns of pediatric otolaryngologists in managing obstructive sleep‐disordered breathing 6 years following the 2011 publication of the clinical practice guideline “Polysomnography for Sleep‐Disordered Breathing prior to Tonsillectomy in Children.”

Study Design

Cross‐sectional survey.

Setting

American Society of Pediatric Otolaryngology (ASPO) members.

Subjects and Methods

An electronic survey to assess ASPO members’ adherence to polysomnography guidelines prior to tonsillectomy.

Results

Forty percent (170 of 427) of ASPO members completed the survey, with 73% in academic practice and 27% in private practice. Snoring represented, on average, 48% of the respondents’ practices. The percentage of respondents who requested a polysomnogram prior to tonsillectomy ≥90% of the time was 55% (n = 94) for Down syndrome, 41% (n = 69) for a child <2 years old, and 29% (n = 49) for obese children. A total of 109 (73%) and 112 (75%) respondents admit at least 90% of the time for a child with Down syndrome and for a child <3 years of age, respectively, but only 52 (35%) have a similar practice for an obese child. Only 37% adhere to the inpatient admission recommendation for children with documented obstructive sleep apnea on polysomnogram.

Conclusion

The current polysomnogram practice patterns for responding pediatric otolaryngologists are not aligned with the clinical practice guideline of the American Academy of Otolaryngology—Head and Neck Surgery Foundation. The threshold for overnight observation when a preoperative polysomnogram has not been performed may be too low. A campaign is necessary to educate clinicians who take care of children with obstructive sleep‐disordered breathing and to obtain more evidence to further define best practice.
Air Pollution and Angioedema
Authors: Kedarisetty Suraj , Jones Evan , Tint Derrick , Soliman Ahmed M. S.
Published: April 2019

Objective

To identify environmental factors that may precipitate angioedema.

Study Design

Case series with chart review.

Setting

An urban tertiary care medical center.

Subjects and Methods

After institutional review board approval was obtained, a chart review of all patients who presented to Temple University Hospital with angioedema from January 2012 to December 2014 was performed. Patient demographics and hospital course were gathered. Environmental data on the dates of presentation, including precipitation, humidity, and air pollution, were obtained from regional Environmental Protection Agency online data banks and used for statistical analysis.

Results

In total, 408 patients, representing 450 episodes of angioedema, met the inclusion criteria for the study. Most patients were female (58%), African American (74%), and on an angiotensin‐converting enzyme inhibitor (ACE‐I) upon presentation (61%). Days with unhealthy levels of air pollution were associated with an increased likelihood of angioedema presentation (odds ratio [OR], 1.82; confidence interval [CI], 1.01‐3.30;P=. 046). Subgroup analysis revealed that elevated ground‐level ozone was the primary air pollutant significantly associated with angioedema presentations (OR, 4.95; CI 1.92‐12.76;P=. 0009). Higher ground‐level ozone was also associated with ACE‐I angioedema presentations (P=. 017) but not with non‐ACE‐I angioedema presentations (P=. 86). Air quality was not predictive of angioedema severity or need for intubation.

Conclusion

Angioedema is a complex, multifactorial disease resulting in potentially life‐threatening complications. This is the first study to demonstrate that higher levels of air pollution, specifically ground‐level ozone, are associated with significantly increased rates of angioedema episodes, although not severity.
Utility of Magnetic Resonance Imaging in Differentiating Cerebrospinal Fluid Leak from Middle Ear Effusion
Authors: Breen Joseph T. , Edwards Colin R. , Cornelius Rebecca S. , Hazenfield J. Michael , Kohlberg Gavriel D. , Samy Ravi N. , Pensak Myles L.
Published: April 2019

Objective

To demonstrate the clinical utility, sensitivity, and specificity of standard magnetic resonance imaging (MRI) sequences in differentiating temporal bone cerebrospinal fluid leaks from all other middle ear effusions.

Study Design

Retrospective imaging review.

Setting

Academic medical center.

Subjects

Patients with cerebrospinal fluid leaks or other middle ear effusions who also underwent MRI.

Methods

Patients were assigned to cerebrospinal fluid leak and other effusion cohorts based on clinical course, findings at surgery/myringotomy, and beta‐2 transferrin fluid analysis. Reviewers blinded to the clinical outcome examined T1‐weighted, T2‐weighted, diffusion‐weighted, fluid‐attenuated inversion recovery (FLAIR), and 3‐dimensional (3D) acquired T2‐weighted MRI sequences. For each sequence, fluid imaged in the temporal bone was graded as either similar or dissimilar in signal intensity to cerebrospinal fluid in the adjacent subarachnoid space. Signal similarity was interpreted as being diagnostic of a leak. Test characteristics in predicting the presence of a leak were calculated for each series.

Results

Eighty patients met criteria (41 leaks, 39 other effusions). The 3D T2 series was 76% sensitive and 100% specific in diagnosing a leak, and FLAIR was 44% sensitive and 100% specific. The T1‐weighted (73% sensitive, 69% specific), T2‐weighted (98% sensitive, 5.1% specific), and diffusion‐weighted (63% sensitive, 66% specific) series were less useful.

Conclusions

MRI, with attention to 3D T2 and FLAIR series, is a noninvasive and highly specific test for diagnosing cerebrospinal fluid leak in the setting of an indeterminate middle ear effusion.
Short-term and Long-term Exposure of the MucilAir™ Model to Polycyclic Aromatic Hydrocarbons
Authors: Cervena Tereza , Vrbova Kristyna , Rossnerova Andrea , Topinka Jan , Rossner Pavel
Published: April 2019

Cells grown in monocultures are widely used to model lung tissue. As a result of these culture conditions, these cells exhibit poor morphological similarity to those present in in vivo lung tissue. MucilAir™, a 3-D in vitro model comprising human basal, goblet and ciliated cells, represents a fully differentiated respiratory epithelium that can be used as an alternative and a more realistic system. The aim of our study was to compare the effects of short-term and long-term exposure to two polycyclic aromatic hydrocarbons (PAHs) — benzo[a]pyrene (B[a]P) and 3-nitrobenzanthrone (3-NBA) — using MucilAir as a model of human lung tissue. Two concentrations (0.1 μM and 1 μM) were tested at three time points (24 hours, 7 days and 28 days). Several aspects were assessed: cytotoxicity (lactate dehydrogenase (LDH) release), integrity of the cell layer (transepithelial electrical resistance (TEER)), induction of oxidative stress (reactive oxygen species production) and changes in the expression of selected genes involved in PAH metabolism ( CYP1A1 and AKR1C2) and the antioxidant response ( ALDH3A1, SOD1, SOD2, GPX1, CAT, HMOX1 and TXNRD1). The results showed that exposure to B[a]P caused a spike in LDH release at day 5. Exposure to 3-NBA caused a number of spikes in LDH release, starting at day 5, and a decrease in TEER after 11 days. CYP1A1 gene expression was upregulated after the 7-day and 28-day B[a]P exposures, as well as after the 24-hour and 7-day 3-NBA exposures. HMOX1 and SOD1 were downregulated after both 24-hour PAH treatments. HMOX1 was upregulated after a 1-week exposure to 3-NBA. There were no significant changes in the messenger RNA (mRNA) levels of AKR1C2, ALDH3A1, TXNRD1, SOD2, GPX1 or CAT. These results illustrate the potential use of this 3-D in vitro lung tissue model in studying the effects of chronic exposure to PAHs.
Is growth improving employment quality in India? Evidence of widening subnational inequality
Authors: Moktan Anamika
Published: April 2019

One of the biggest challenges faced by India today is to generate quality employment. Even in areas of rapid per capita income growth, typified by the Gujarat model of neoliberal state-sponsored technological development, there is a substantial and increasing decent work deficit. Across India more generally, the decent work deficit is, in fact, growing along several dimensions, leading to ‘growth without development’ or ‘non-inclusive growth’. This article analyses quality of employment in India across subnational spaces – among states and between rural and urban locations – using three International Labour Organisation decent work dimensions: ‘employment opportunity’, ‘social security benefits’ and ‘social dialogue’. The analysis is based on published government data, for the period 1993–1994 to 2011–2012 – the period covered by the liberalisation experiment. The conclusion is that economic growth has not contributed significantly to employment quality. Although employment opportunity is significantly higher in the developed states, coverage of social security benefits and scope for social dialogue among regular salaried/wage workers are significantly less in these areas than in underdeveloped regions. Indeed, employment opportunity is significantly higher in rural areas, and the condition of workers in urban areas is not significantly better than in rural locations. Furthermore, over time, the difference in quality of employment across subnational spaces has either increased or remained stagnant.

JEL Codes: J00, J81, J21, 018.
School Health Policy Implementation: Facilitators and Challenges
Authors: Cygan Heide , Tribbia Carly , Tully Jamie
Published: April 2019

Schools are uniquely positioned to impact student health and academic outcomes through health and wellness policies. The purpose of this study was to describe factors influencing implementation of school health and wellness policies, specifically those focused on physical activity and nutrition. In-depth, stakeholder interviews were conducted with key informants at eight Chicago Public Schools (K–eighth grade). Data were analyzed using summative content analysis. Two themes were identified, facilitators and challenges to policy implementation. Facilitators included district support and motivation (internal and external). Challenges included limited school nurse availability, breaking tradition and budget. The external community and wellness team composition fell within both themes. Specific strategies are suggested to build upon policy implementation facilitators and overcome challenges. While school nurses play an integral role in student health and wellness, further research is needed to understand school nurse impact on student health and academic outcomes through school health policy.
Does the Use of Magnetic Resonance Imaging Scan in Occult and Suspected Metastatic Pathological Neck of Femur Fractures Affect the Choice of Surgical Intervention?
Authors: Budair Basil , Al-Tibi Mohammad , Boutefnouchet Tarek
Published: April 2019

Background:

Magnetic resonance imaging (MRI) is often employed as the diagnostic modality of choice in occult and suspected pathological femoral neck fractures. We evaluated the clinical utility of MRI scan in this patient population.

Method:

Retrospective observational analysis of cases with a radiologically occult or suspected metastatic pathological neck of femur fracture.

Results:

From a total of 894 femoral neck fractures treated in our institution, 100 patients had and MRI scan pre-operatively for either occult fracture or suspected fracture secondary metastatic disease. Magnetic resonance imaging confirmed the presence of 13 simple fractures. A total of 14 patients had pathological features suggestive of metastasis, of which 12 were clearly visible on plain radiographs. Surgical plan did not change after MRI for any of these pathological fractures.

Conclusion:

Results of this study demonstrate that an MRI scan had an impact on treatment selection only when a simple but radiographically occult fracture is suspected and but not in the context of suspected metastatic pathological fractures.
Piezoelectric sensor–based damage progression in concrete through serial/parallel multi-sensing technique
Authors: K Balamonica , T Jothi Saravanan , C Bharathi Priya , N Gopalakrishnan
Published: April 2019

Structural damage detection using unmanned Structural Health Monitoring techniques is becoming the need of the day with the technologies available presently. Sensors made of Lead Zirconate Titanate materials, due to their simplicity and robustness, are increasingly used as an effective monitoring sensor in Structural Health Monitoring. Continuous monitoring of the structures using Lead Zirconate Titanate sensors often results in a laborious data retrieval process due to the large amount of signal generated. To speed up the data retrieval process, a multi-sensing technique in which the Lead Zirconate Titanate patches are connected in series and parallel is proposed for structural damage detection. The proposed method is validated using an experimental investigation carried out on a reinforced concrete beam embedded with smart Lead Zirconate Titanate sensor units. The beam is subjected to damage, and the location of damage is identified using conductance signatures obtained from patches sensed individually and through multiplexing. This article proposes an effective methodology for selection of patches to be connected in series/parallel to maximise the efficiency of damage detection. Damage quantification using conventional statistical metrics such as root mean square deviation, mean absolute percentage deviation and cross correlations are found to be ineffective in identifying the location of damage from the multiplexed signatures. In turn, dynamic metrics such as moving root mean square deviation, moving mean absolute percentage deviation and moving cross correlation with overlapped moving blocks of data are proposed in the present work and their ability to detect the damage location from multiplexed signatures is discussed.
A $2 Bill or Two $1 Bills: An Experiment that Challenges Standard Protocol
Authors: Mills Sarah
Published: April 2019

The $2 bill is commonly used as a prepaid incentive in survey administration. Despite the widespread use of this incentive, there is no peer-reviewed research into how providing a single $2 bill rather than two $1 bills affects survey response rate. The results are from a mail survey of 2,970 rural landowners in Michigan with identical survey protocols. Half were randomly assigned to receive a single $2 bill and the other half to receive two $1 bills accompanying the questionnaire. I found no statistical difference in the response rates of the two groups. While there may be logistical advantages to using a single $2 bill compared to two $1 bills, this research suggests that the $2 bill is not more effective at inducing survey participation.
Experimental characterization of a reversible heat pump for hybrid and electric vehicles
Authors: Cuevas Cristian , Declaye Sébastien , Lemort Vincent
Published: April 2019

The most performant system for heating in electric and hybrid vehicles is the heat pump. This study proposes a heating system with a reversible heat pump, which works as a conventional air conditioning system in cooling mode and in heating mode it uses a secondary circuit with water/glycol to transfer the heat from the condenser to the heater core located in the air conditioning module. This system was experimentally validated with 61 tests in heating mode and 19 tests in cooling mode. In the heating mode, there is a test which was developed with an ambient temperature of -1ºC with the air circulating through the outdoor unit at a velocity of 3.2 m·s−1, an air flow rate of 388 kg·h−1 supplied to the cabin and the compressor running at 2866 r/min. At these conditions, the air is supplied to the cabin at 41.5ºC, the heating power is 4.2 kW and the COP is 1.9. In the cooling mode, there are tests developed at a condenser supply air temperature of 45.4ºC with a velocity of 5.7 m·s−1. The air is supplied to the vehicle cabin with a temperature of 14.6ºC with a flow rate of 508 kg·h−1, with a cooling capacity of 3.88 kW and a coefficient of performance of 1.8.
Experiences of shame and intellectual disabilities: Two case studies
Authors: Marriott Clare , Parish Caroline , Griffiths Chris , Fish Rebecca
Published: April 2019

Shame is a trans-diagnostic phenomenon that underlies a variety of mental health difficulties. People with intellectual disabilities (IDs) are reported to be one of the most stigmatized and excluded groups in society and are more likely to experience mental health problems than the general population. Consequently, this group may be at a significant risk of shame-related distress. However, there is a lack of research that investigates the experience of shame in people with ID, and there is currently a lack of interventions targeting shame in people with ID. Two case studies were undertaken to document the experiences of stigma, discrimination, and shame in people with ID and to explore how shame may present in this population. Shame was found to be a significant barrier to social inclusion and to contribute towards poor psychological health in people with ID. The development of interventions that specifically target shame in this population is recommended.
Surgical Repair of Distal Triceps Tendon Injuries: Short-term to Midterm Clinical Outcomes and Risk Factors for Perioperative Complications
Authors: Waterman Brian R. , Dean Robert S. , Veera Shreya , Cole Brian J. , Romeo Anthony A. , Wysocki Robert W. , Cohen Mark S. , Fernandez John J. , Verma Nikhil N.
Published: April 2019

Background:

Few large-scale series have described functional outcomes after distal triceps tendon repair. Predictors for operative success and a comparative analysis of surgical techniques are limited in the reported literature.

Purpose:

To evaluate short-term to midterm functional outcomes after distal triceps tendon repair in a broad patient population and to comparatively evaluate patient-reported outcomes in patients with and without pre-existing olecranon enthesopathy while also assessing for modifiable risk factors associated with adverse patient outcomes and/or revision surgery.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study was a retrospective analysis of 69 consecutive patients who underwent surgical repair of distal triceps tendon injuries at a single institution. Demographic information, time from injury to surgery, mechanism of injury, extent of the tear, pre-existing enthesopathy, perioperative complications, and validated patient-reported outcome scores were included in the analysis. Patients with a minimum of 1-year follow-up were included.

Results:

The most common mechanisms of injury were direct elbow trauma (44.9%), extension/lifting exercises (20.3%), overuse (17.4%), and hyperflexion or hyperextension (17.4%). Eighteen patients were identified with pre-existing symptomatic enthesopathy, and 51 tears were caused by an acute injury. A total of 36 complete and 33 partial tendon tears were identified. Bone tunnels were most commonly used (n = 30; 43.5%), while direct sutures (n = 23; 33.3%) and suture anchors (n = 13; 18.8%) were also used. Perioperative complications occurred in 21.7% of patients, but no patients experienced a rerupture at the time of final follow-up. No statistically significant relationship was found between patient age ( P = .750), degree of the tear ( P = .613), or surgical technique employed ( P = .608) and the presence of perioperative complications.

Conclusion:

Despite the heightened risk of perioperative complications after primary repair of distal triceps tendon injuries, the current series found favorable functional outcomes and no cases of reruptures at short-term to midterm follow-up. Furthermore, age, surgical technique, extent of the tear, and mechanism of injury were not associated with adverse patient outcomes in this investigation. Pre-existing triceps enthesopathy was shown to be associated with increased complication rates.
Queer Integrative Marginalization: LGBTQ Student Integration Strategies at an Elite University
Authors: Chica Christina Marie
Published: April 2019

The author draws on the oral histories of 44 LGBTQ Princeton alumni who graduated from 1960 to 2011 to examine student strategies for negotiating marginal identities when integrating into an elite university. Even with greater LGBTQ visibility and resources at the institutional level, LGBTQ students’ experiences and strategies suggest that we question the larger social narrative of linear progress. Across time, students navigate space by highlighting difference to belong as queer students in explicitly LGBTQ circles or muting difference to belong as token queer students in heteronormative circles. Integration of an LGBTQ person does not necessarily mean incorporation of an LGBTQ identity and vice versa. These strategies are largely contingent upon students’ social positions: intersectional identities, structural location, and available models. Student strategies are structurally tempered by queer integrative marginalization: the process of select predominantly elite LGBTQ people’s achieving special status among the heteronormative mainstream.
Who’s In and Who’s Out? Reflections on Our Biblical Understanding of the Gospel
Authors: Butler Phill
Published: April 2019

This article addresses seemingly enigmatic passages of Scripture dealing with membership (who is in or out?), mastery (how much knowledge is required for entry into the kingdom?), and method (what are appropriate ways to present the Gospel?). The author raises provocative questions on a range of issues central to Western theology and practice. Designed primarily as a thought-provoking exercise, the article encourages leaders and their colleagues to reconsider implications for Christian mission. The article points to the need for truth as it is set in the context of God’s expansive grace.
For the Gospel’s Sake: The Rise of the Wycliffe Bible Translators and the Summer Institute of Linguistics
Authors: Baker Dwight P.
Published: April 2019

Boone Aldridge provides an insider’s perspective on the outsize role William Cameron Townsend played in shaping the ethos and objectives of the Wycliffe Bible Translators and Summer Institute of Linguistics. He gives particular attention to organizational challenges posed by the mission’s dual or blended structure and to WBT/SIL’s responses to internal and external pressures. Despite a tendency to triumphalism, the volume is richly informed and adds insight into WBT/SIL’s formative first half century.
Rare Bosworth Fracture-Dislocation Variant of an Irreducible Distal Fibula Dislocation of the Ankle Without Fibula Fracture
Authors: Wenxian Png , Mehta Kinjal Vidyut
Published: April 2019

Background:

Irreducible fracture-dislocations of the ankle are rare orthopedic emergencies that should not be missed. The Bosworth fracture-dislocation is a rare fracture where an incarcerated fibula fragment remains locked behind the posterior lateral tubercle of the tibia. We present a case describing a variation of a Bosworth injury, with a dislocation of an intact distal fibula with an associated medial malleolus fracture.

Methods:

Our patient is a 55-year old male who presented to the emergency department with a left ankle injury after being involved in a road traffic accident. Radiographs show a posterior dislocation of an intact distal fibula associated with a fracture of the medial malleolus and disruption of the ankle mortise.

Results:

An attempt to reduce the dislocation at the emergency department under sedation was unsuccessful. The patient was subsequently taken to the operating theatre for manipulation and reduction and application of an external fixator. Definitive fixation was performed successfully a week later.

Conclusion:

A high index of suspicion is critical for diagnosing a Bosworth fracture-dislocation, as this diagnosis is commonly missed. Early diagnosis and proper surgical anatomic reduction are important to prevent chronic ankle instability and evolution towards ankle arthritis.

Level of Evidence:

Level IV, case study.
Association of Peripheral Vascular Disease With Complications After Total Ankle Arthroplasty
Authors: Conti Matthew S. , Savenkov Oleksandr , Ellis Scott J.
Published: April 2019

Background:

Despite limited evidence, peripheral vascular disease is often cited as a contraindication for total ankle arthroplasty. The purpose of our study was to identify whether peripheral vascular disease in patients undergoing total ankle arthroplasty increased the rate of infection, postoperative irrigation and debridement, or failure of the implant.

Methods:

The PearlDiver Database was used to identify Medicare patients who underwent a total ankle arthroplasty from 2005 to 2014. These data were then analyzed for postoperative infections within 90 days, subsequent irrigation and debridements, and failure of total ankle arthroplasties. A diagnosis of preoperative peripheral vascular disease only included those patients who had peripheral vascular disease as an ICD-9 diagnosis code and underwent a preoperative lower extremity angiogram prior to total ankle arthroplasty. Medical comorbidities were identified using ICD-9 diagnosis codes. Three multivariable logistic regression models were then developed in order to identify risk factors associated with postoperative infections and failure after total ankle arthroplasty.

Results:

A total of 10 698 Medicare patients who underwent a primary total ankle arthroplasty were identified. There were 334 patients who had a postoperative infection within 90 days of their total ankle arthroplasty, and 95 of those patients required an irrigation and debridement. Regression analysis demonstrated that patients with peripheral vascular disease had the greatest risk of developing a postoperative infection within 90 days (OR 2.85, P < .01), requiring an irrigation and debridement postoperatively (OR 4.87, P < .001), and having a total ankle arthroplasty failure at any time point postoperatively (OR 2.51, P < .001).

Conclusions:

Our study suggests that preoperative peripheral vascular disease is a significant risk factor for an acute postoperative infection, postoperative irrigation and debridement, and failure of the implant in Medicare patients undergoing a total ankle arthroplasty.

Level of Evidence:

Level III, therapeutic.
Myeloid translocation gene CBFA2T3 directs a relapse gene program and determines patient-specific outcomes in AML
Authors: Steinauer Nickolas , Guo Chun , Huang Chunfa , Wong Madeline , Tu Yifan , Freter Carl E. , Zhang Jinsong
Published: April 2019

CBFA2T3 is a master transcriptional coregulator in hematopoiesis. In this study, we report novel functions of CBFA2T3 in acute myeloid leukemia (AML) relapse. CBFA2T3 regulates cell-fate genes to establish gene expression signatures associated with leukemia stem cell (LSC) transformation and relapse. Gene set enrichment analysis showed that CBFA2T3 expression marks LSC signatures in primary AML samples. Analysis of paired primary and relapsed samples showed that acquisition of LSC gene signatures involves cell type–specific activation of CBFA2T3 transcription via the NM_005187 promoter by GCN5. Short hairpin RNA–mediated downregulation of CBFA2T3 arrests G1/S cell cycle progression, diminishes LSC gene signatures, and attenuates in vitro and in vivo proliferation of AML cells. We also found that the RUNX1-RUNX1T1 fusion protein transcriptionally represses NM_005187 to confer t(8;21) AML patients a natural resistance to relapse, whereas lacking a similar repression mechanism renders non–core-binding factor AML patients highly susceptible to relapse. These studies show that 2 related primary AML-associated factors, the expression level of CBFA2T3 and the ability of leukemia cells to repress cell type–specific CBFA2T3 gene transcription, play important roles in patient prognosis, providing a paradigm that differential abilities to repress hematopoietic coregulator gene transcription are correlated with patient-specific outcomes in AML.
The method of polarized traces for the 3D Helmholtz equation
Authors: Zepeda-Núñez Leonardo , Scheuer Adrien , Hewett Russell J. , Demanet Laurent
Published: April 2019

We have developed a fast solver for the 3D Helmholtz equation, in heterogeneous, constant density, acoustic media, in the high-frequency regime. The solver is based on the method of polarized traces, a layered domain-decomposition method, where the subdomains are connected via transmission conditions prescribed by the discrete Green’s representation formula and artificial reflections are avoided by enforcing nonreflecting boundary conditions between layers. The method of polarized traces allows us to consider only unknowns at the layer interfaces, reducing the overall cost and memory footprint of the solver. We determine that polarizing the wavefields in this manner yields an efficient preconditioner for the reduced system, whose rate of convergence is independent of the problem frequency. The resulting preconditioned system is solved iteratively using generalized minimum residual, where we never assemble the reduced system or preconditioner; rather, we implement them via solving the Helmholtz equation locally within the subdomains. The method is parallelized using Message Passing Interface and coupled with a distributed linear algebra library and pipelining to obtain an empirical on-line runtime [Formula: see text], where [Formula: see text] is the total number of degrees of freedom, [Formula: see text] is the number of subdomains, and [Formula: see text] is the number of right-hand sides (RHS). This scaling is favorable for regimes in which the number of sources (distinct RHS) is large, for example, enabling large-scale implementations of frequency-domain full-waveform inversion.
Addition of Low-Dose Decitabine to Anti–PD-1 Antibody Camrelizumab in Relapsed/Refractory Classical Hodgkin Lymphoma
Authors: Nie Jing , Wang Chunmeng , Liu Yang , Yang Qingming , Mei Qian , Dong Liang , Li Xiang , Liu Jiejie , Ku Wenjing , Zhang Yan , Chen Meixia , An Xiaojing , Shi Lu , Brock Malcolm V. , Bai Jie , Han Weidong
Published: April 2019

PURPOSE

Anti–programmed death-1 (PD-1) monotherapy induces a high response rate in patients with relapsed/refractory classic Hodgkin lymphoma (cHL), but complete remission (CR) is infrequently observed. As decitabine is known to boost T-cell function, we assessed the safety and efficacy of anti–PD-1 camrelizumab alone versus decitabine-primed camrelizumab in patients with relapsed/refractory cHL.

METHODS

This two-arm, open-label, phase II study enrolled patients with relapsed/refractory cHL who had received at least two lines of previous therapy. Anti–PD-1 treatment-naïve patients were randomly assigned (1:2) to camrelizumab (200 mg) monotherapy or decitabine (10 mg/d, days 1 to 5) plus camrelizumab (200 mg, day 8) combination therapy every 3 weeks. Patients who were previously treated with anti–PD-1 were assigned combination therapy. Primary end point was CR rate and safety.

RESULTS

Overall, 86 patients were enrolled and evaluated for response, with a median follow-up of 14.9 months. In anti–PD-1–naïve patients, CR rate was 32% (six of 19 patients) with camrelizumab monotherapy versus 71% (30 of 42 patients) who were administered decitabine plus camrelizumab ( P = .003). At the time of analysis, the response duration rate at 6 months was 76% on camrelizumab monotherapy versus 100% on decitabine plus camrelizumab. For patients who were previously treated with anti–PD-1, 28% achieved CR and 24% partial response after decitabine plus camrelizumab. Ten patients maintained a response at more than 6 months and 81% of responders were estimated to have a response at more than 1 year. For both treatments, the most common adverse events were clinically inconsequential cherry hemangiomas and leukocytopenia that were self-limiting.

CONCLUSION

CR rate in patients with relapsed/refractory cHL who were clinically naïve to PD-1 blockade was significantly higher with decitabine plus camrelizumab than with camrelizumab alone. Decitabine plus camrelizumab may reverse resistance to PD-1 inhibitors in patients with relapsed/refractory cHL.
Role of septins in microbial infection
Authors: Van Ngo Hoan , Mostowy Serge
Published: April 2019

Septins are widely recognized as a component of the cytoskeleton that is essential for cell division, and new work has shown that septins can recognise cell shape by assembling into filaments on membrane regions that display micrometer-scale curvature (e.g. at the cytokinetic furrow). Moreover, infection biology studies have illuminated important roles for septins in mediating the outcome of host–microbe interactions. In this Review, we discuss a selection of mechanistic insights recently gained from studying three infection paradigms: the rice blast fungus Magnaporthe oryzae, the poxvirus family member vaccinia virus and the Gram-negative bacterium Shigella flexneri. These studies have respectively discovered that higher-order septin assemblies enable fungal invasion into plant cells, entrap viral particles at the plasma membrane and recognize dividing bacterial cells for delivery to lysosomes. Collectively, these insights illustrate how studying septin biology during microbial infection can provide fundamental advances in both cell and infection biology, and suggest new concepts underlying infection control.
Editorial Information 2018
Authors: Office Editorial
Published: April 2019

Editorial Information 2018
Do analytically-oriented supply chains better manage risks?
Authors: Alvarenga Murilo Zamboni , De Oliveira Marcos Paulo Valadares , Filho Hélio Zanquetto , Dos Santos Washington Romão
Published: April 2019

Risk management has emerged as a field of operations management research due to the greater exposure of organizations to internal and external risks, as a result of globalization, outsourcing, reduction in the number of suppliers, and the need to improve cost and inventory management. Although this subject has received attention in recent years, the relationship between analytical orientation and supply chain risk management is little explored. Thus, this research verifies the impact of analytical orientation over supply chain risk management. A questionnaire was applied with micro, small and medium-sized firms of Brazilian Southeast region, obtaining 111 responses. The structural equation modeling was used for analysis and the main conclusions indicate that analytical orientation has a strong and significant impact over supply chain risk management. In this sense, those supply chains that are more analytical manage their risks better, resulting in lower perception of uncertainty.
Principal-agent problems in implementation of Ghana’s health insurance scheme
Authors: Kipo-Sunyehzi Daniel Dramani
Published: April 2019

Principal-agent relationship exists between health service providers and their authority and clients. It asserts that health service providers as ‘imperfect agents’ of the authority and clients will take actions that aim to maximise profits at the expense of authority and clients (principal). The situation is possible when reimbursement is based on fee-for-service or a diagnosis-related groups. It looks at relationships between health service providers as agents and health insurance authority, and clients as principals in areas of provision of health services, supply of drugs, medicines and reimbursement. Results showed the private health service providers prescribed more drugs and medicines for clients towards profit maximisation (agency) than their public counterparts. Also, it was found that the public health service providers continued to provide health services and drugs despite health insurance authority indebtedness to them exhibiting more stewardship towards health insurance authority. It recommends strict regulations in tariffs/vetting claims and prompt reimbursement.
Sustainable practices in the coffee supply chain in the cerrado mineiro region, Brazil
Authors: Silva Warley Henrique da , Guarnieri Patrícia , Carvalho José Márcio
Published: April 2019

The incorporation of sustainable practices in the supply chain management (SCM) has become recurrent in the business environment, resulting from a social reflection on the need to seek new development alternatives. In this context, the objective of this paper is to verify the existence of sustainable practices throughout the supply chain of coffee in the Cerrado Mineiro Region (CMR) and to understand the effects of this adoption regarding Green SCM.  This paper focus on the relationship between producers and collective organizations, such as cooperatives and development foundations. To this end, a case study was carried out with the representatives of the supply chain members in CMR, which included coffee producers, cooperatives and a development foundation. It was verified the predominance of practices focused on environmental issues, followed by social and, finally, economic ones. It is also highlighted that the data identified allow us to understand that the development of sustainable strategies can bring positive effects to the agents studied. Considering that these aspects, evidently, improve the relationship of supply chain members, making it more collaborative. The results contribute to the systemic understanding of the way in which sustainability has been incorporated and operationalized in coffe supply chains in CMR.
Combating Cholera
Authors: Hsueh Brian Y. , Waters Christopher M.
Published: April 2019

Cholera infections caused by the gamma-proteobacterium Vibrio cholerae have ravaged human populations for centuries, and cholera pandemics have afflicted every corner of the globe. Fortunately, interventions such as oral rehydration therapy, antibiotics/antimicrobials, and vaccines have saved countless people afflicted with cholera, and new interventions such as probiotics and phage therapy are being developed as promising approaches to treat even more cholera infections. Although current therapies are mostly effective and can reduce disease transmission, cholera outbreaks remain deadly, as was seen during recent outbreaks in Haiti, Ethiopia, and Yemen. This is due to significant underlying political and socioeconomic complications, including shortages of vaccines and clean food and water and a lack of health surveillance. In this review, we highlight the strengths and weaknesses of current cholera therapies, discuss emerging technologies, and argue that a multi-pronged, flexible approach is needed to continue to reduce the worldwide burden of cholera.
Trends in Medicare base payment rates for hospital discharges, 2009-2018
Authors: Rapp Zachary , Egeland Ryan , David Frank S.
Published: April 2019

Background: Under the inpatient prospective payment system (IPPS), Medicare assigns hospital discharges to medical severity-adjusted diagnosis related groups (MS-DRGs), and determines a fixed payment amount for each discharge based on its MS-DRG that is adjusted annually based on providers’ reported costs. Trends in these capitated reimbursement rates may affect the incentive for manufacturers to develop drugs and devices used in inpatient care, as well as the predilection of customers (hospitals) to purchase them.

Methods: In this descriptive study, we analyzed the growth of inflation-adjusted MS-DRG base payment rates to acute care hospitals from 2009 to 2018.

Results: Inflation-adjusted base reimbursement rates for MS-DRGs in continuous existence from 2009 to 2018 (N=211) had a median best-fit compound annual growth rate (CAGR) of -0.26%. Medical MS-DRGs exhibited a more negative median best-fit CAGR than surgical ones. Among surgical MS-DRGs, those related to musculoskeletal diagnoses had a larger median best-fit CAGR that was statistically significant compared with those associated with digestive or infectious disease diagnoses.

Conclusions: The majority of MS-DRG base payment rates for inpatient discharges have failed to keep pace with inflation, and this negative growth is more pronounced in certain clinical areas. The relationship between these reimbursement trends and decision-making by manufacturers and hospitals warrants further study.
Óleo essencial de citronela (Poaceae) e seus componentes para controle do brasileirinho (Coleoptera: Chrysomelidae) em olerícolas
Authors: Milléo Julianne , Antunes Carlos Henrique , Pettres Elis Borges , Ayub Ricardo Antonio , Farago Paulo Vitor
Published: April 2019

Resumo. Este estudo teve como objetivo obter uma formulação atrativa à base de óleo de citronela e seus componentes voláteis para captura de Diabrotica speciosa (Germar). Três experimentos sequenciais foram realizados em culturas de abobrinha ou pepino. Os insetos foram coletados por armadilhas de garrafa PET com três aberturas laterais, contendo um volume de 200 ml de cada formulação, suspensas a 10 cm do nível do solo numa área experimental de 30 m2. No primeiro experimento foram testados óleo de citronela em 1, 2 e 4%. No segundo investigou-se também a ação de citronelal, citronelol e geraniol a 1%. E, o citronelol a 0,5, 1 e 2% foi testado no terceiro experimento. Como resultado observou-se que a formulação contendo citronelol a 0,5% foi estatisticamente superior às demais. Outros insetos foram capturados pelas armadilhas como coleópteros Diabrotica viridula (Fabricius)e Astylus variegatus (Germar), e também exemplares de Diptera, Hemiptera e Hymenoptera. Considerando a alta demanda por alimentos orgânicos e da preocupação com o ambiente e a saúde, a emulsão a base de citronelol em 0,5% cumpre adequadamente o seu objetivo, garantindo uma boa capacidade atrativa para D. speciosa. Esta formulação pode ser usada paralelamente com outros métodos alternativos para reduzir a presença desse inseto nas culturas.Citronella (Poaceae) essential oil and its components for the control of brasileirinho (Coleoptera: Chrysomelidae) in vegetable cropsAbstract. The present study aimed to get an attractive formulation of oil-based citronella and its volatile components to capture Diabrotica speciosa (Germar). Three sequential experiments were performed in zucchini or cucumber crops. The insects were collected in PET bottle traps with three lateral apertures, containing a volume of 200 ml of each formulation, suspended 10 cm above the ground level in an experimental area of 30 m2. In the first experiment citronella essential oil was tested at 1, 2 and 4%. In the second experiment the action of citronellal, citronellol and geraniol at 1% were investigated. Furthermore, citronellol at 0.5, 1 and 2% has been tested in the third experiment. As a result it was observed that the formulation containing 0.5% citronellol was statistically higher than the other tested formulations. Other insects were captured by the traps as the beetles of Diabrotica viridula (Fabricius)and Astylus variegates (Germar), and also copies of Diptera, Hemiptera and Hymenoptera. Considering the high demand for organic food, and concern for the environment and health, the citronellol emulsion at 0.5% adequately fulfilled its goal, ensuring a good attractive capacity for D. speciosa. This formulation can be used simultaneously with other alternative methods to reduce the presence of such insects in crops.
In Vitro Starch and Protein Digestibility of Disease Specific Nutrition Formulations
Authors: SRIGIRIPURA CHANDAN VINAY , KOTEBAGILU NAMRATHA PAI , UROOJ ASNA
Published: April 2019

Nutritional supplements are used in the management of diseases. The composition and form of nutrients in the supplements depend on the altered needs and gastrointestinal function of patients. The nutrition label of the supplements lacks information on the in vitro digestibility of nutrients which ultimately decides the availability of nutrients for absorption. Various factors that influence digestibility and availability include source of the nutrient, gut functionality, processing, physicochemical properties in the food matrix and inter-nutrient interactions. This study aimed at analyzing the in vitro starch and protein digestibility of six commercially available food formulations used in various disease conditions. The starch digestibility index (SDI) ranged from 64.47 ± 1.92 to 82.35 ± 2.71 and rapidly available glucose (RAG) from 26.06 ± 0.61 to 44.23 ± 0.38g per 100g. Dietary fiber content was inversely related with SDI (r - 0.845). The protein digestibility ranged from 41.42 ± 2.67 - 96.84 ± 1.01%. Formulations containing isolated forms of whey, casein and soy protein had a higher digestibility than in combinations. Besides information on the nutrient content, specifying the digestion characteristics of disease specific commercial formulations will help in their judicious use in meeting the nutritional requirements in various disease conditions.
Beetroot Supplementation on Non - Alcoholic Fatty Liver Disease Patients
Authors: SRIVASTAVA SHIKHA , SIDDIQI ZEBA , SINGH TARUNA , BALA LAKSHMI
Published: April 2019

Nonalcoholic fatty liver disease (NAFLD) has emerged as one of the most common chronic liver diseases worldwide. The pathogenesis of this disease is closely related to obesity and insulin resistance. Beetroot is proposed to have hepatoprotective and hypolipidemic effects due to the presence of active compound betaine. The aim of this study was to evaluate the therapeutic effect of beetroot supplementation in patients with NAFLD. The present study was a case-control prospective study in which 40 cases and 40 controls with NAFLD were advised to follow a lifestyle modification along with prescribed treatment but in cases, beetroot powder supplementation was also given orally for 12 weeks. The clinical, symptoms, biochemical parameters, and ultrasonography measured were recorded at baseline and after 12 weeks post beetroot supplementation. Beetroot powder supplementation improved clinical symptoms, significant reduction in liver enzymes and lipid profiles, as well as significant reduction in liver size as compared to controls. We did not find any significant effect of beetroot supplementation on fatty liver grade. The supplementation of beetroot powder for 12 weeks showed a hepatoprotective effect in NAFLD subjects. Further long- term studies are recommended to assess beetroot powder supplementation effect on the grade of fatty liver.
Optimization of Process Paramaters of Parboiled Black Rice Using Response Surface Methodology
Authors: WIDYASAPUTRA REZA , SYAMSIR ELVIRA , BUDIJANTO SLAMET
Published: April 2019

Black rice is well known as healthy food. Nowadays, some people try to change their diet with this rice. However, it still has a problem with long preparation time and hard texture. Parboiling is a hydrothermal process that changes rice starch from crystalline to amorphous. The parboiling process of rice consists of soaking in sodium citrate solution, high-pressure cooking, freezing-thawing and drying. The aim of this research was to find the optimum condition from three processing variables: concentration of sodium citrate (0, 2, 5 and 5%, w/v), cooking period in an autoclave (5, 10 and 15 min) and a number of freeze-thaw cycles (1, 2.5 and 4). The optimum condition was achieved with 3.8% sodium citrate concentration, 5 min cooking in an autoclave, and 3.8 freeze-thaw cycles. This optimum condition resulted in parboiled black rice with 25.84 min cooking time, 4.93 total colour difference 101.80 N hardness of cooked rice, 49.04 N chewiness of cooked rice, 5.32 kg rice grain hardness.