bluuebunny/crossref_metadata_2025 huggingface dataset:
Circular Economy in the Electronic Products Sector: Material Flow Analysis and Economic Impact of Cellphone E-Waste in Mexico
Authors: Cordova-Pizarro Daniela , Aguilar-Barajas Ismael , Romero David , Rodriguez Ciro A.
Published: March 2019

The circular economy (CE) model has become highly relevant in recent years, with the electronics industry being one of the sectors that has considered its application. Despite only a limited amount of literature being available on waste electric and electronic equipment (e-waste) in Mexico, the Mexican Government, academic institutions, and electronics industry have coordinated efforts to implement the CE in the country. This study evaluates the current technical and economic situation of cellphone e-waste generated in Mexico by surveying and analyzing the main actors that influence the management of this waste and using a material flow analysis. Extensive fieldwork was conducted in order to quantify the extent of cellphone e-waste processing in both formal and informal channels. The study of printed circuit boards in cellphones shows that the total value of cellphone e-waste materials ranges between $11.277 and $12.444 million USD per year in Mexico. However, a value of only $0.677 million USD is recycled through formal channels. After characterizing the remanufacturing and recycling CE loops, we conclude that the potential for improvement and advancing towards a CE model is significant
Landslides Susceptibility Assessment Based on GIS Statistical Bivariate Analysis in the Hills Surrounding a Metropolitan Area
Authors: Sestraș Paul , Bilașco Ștefan , Roșca Sanda , Naș Sanda , Bondrea Mircea V. , Gâlgău Raluca , Vereș Ioel , Sălăgean Tudor , Spalević Velibor , Cîmpeanu Sorin M.
Published: March 2019

In the highly populated analysed territory, the expansion of the construction zones and the pressure imposed on the slopes by the housing and transport infrastructure led to the appearance and reactivation of mass movement processes that affects the population and the environment. The purpose of this study consist in applying the principles of bivariate statistical analysis in order to determine the dynamic potential of a territory, taking into account the statistical relationship between the independent variables represented by predisposing and triggering factors of landslides (slope, geology, land use etc.) and dependent variables, in this case: landslides. The identification of the degree of validation of the results was determined by calculating the AUROC (Area under the Receiver Operating Characteristic) value, whose value of 0.854 highlights the representativeness of the chosen model. The analysis of landslides susceptibility highlights the inclusion of the territory represented by the hills surrounding Cluj-Napoca metropolitan area, Romania, on the classes of spatial occurrence of these processes.
Size, Internationalization, and University Rankings: Evaluating and Predicting Times Higher Education (THE) Data for Japan
Authors: McAleer Michael , Nakamura Tamotsu , Watkins Clinton
Published: March 2019

International and domestic rankings of academics, academic departments, faculties, schools and colleges, institutions of higher learning, states, regions, and countries are of academic and practical interest and importance to students, parents, academics, and private and public institutions. International and domestic rankings are typically based on arbitrary methodologies and criteria. Evaluating how the rankings might be sensitive to different factors, as well as forecasting how they might change over time, requires a statistical analysis of the factors that affect the rankings. Accurate data on rankings and the associated factors are essential for a valid statistical analysis. In this respect, the Times Higher Education (THE) World University Rankings represent one of the three leading and most influential annual sources of international university rankings. Using recently released data for a single country, namely Japan, the paper evaluates the effects of size (specifically, the number of full-time-equivalent (FTE) students, or FTE (Size)) and internationalization (specifically, the percentage of international students, or IntStud) on academic rankings using THE data for 2017 and 2018 on 258 national, public (that is, prefectural or city), and private universities. The results show that both size and internationalization are statistically significant in explaining rankings for all universities, as well as separately for private and non-private (that is, national and public) universities, in Japan for 2017 and 2018.
Searching for New Directions for Energy Policy: Testing the Cross-Effect of Risk Perception and Cyberspace Factors on Online/Offline Opposition to Nuclear Energy in South Korea
Authors: Wang Jaesun , Kim Seoyong
Published: March 2019

In the internet age, a considerable amount of information about risk events and objects is shared in cyberspace. Since online and offline spaces are not discrete, there is a cross-effect in which perceptual or attitudinal factors in cyberspace influence offline actions, while offline attitudes affect online actions. However, few studies have examined this cross-effect. In the present study, the intention to engage in online or offline behaviors opposing nuclear energy was the dependent variable. The independent variables included risk perception factors (i.e., perceived risk, perceived benefit, trust, knowledge, and stigma) in the risk perception paradigm, and cyber factors (i.e., self-efficacy in cyberspace, involvement on the internet, trust in cyberspace, conformity to online opinion, and belief in online rumors) in the cyberpsychology paradigm. Our findings offer evidence for the cross-effect of online or offline predictors on online/offline behaviors opposing nuclear energy. All the variables in the cyberspace paradigm influenced offline opposition, while those in the risk perception paradigm affected online opposition. Moreover, the five online-related risk perception variables played a significant role in moderating the relationships of predictors in the risk perception paradigm with offline opposition.
A Methodology for Determining the Profitability Index of Real Estate Initiatives Involving Public–Private Partnerships. A Case Study: The Integrated Intervention Programs in Rome
Authors: Battisti Fabrizio , Campo Orazio
Published: March 2019

In the European Union, real estate initiatives involving public–private partnerships (PPPs) are characterized by the payment of a charge, which is generally used for public purposes (and works). In Italy, since the 1990s, PPPs have also been used to start negotiated initiatives giving the possibility of modifying town planning forecasts. Such initiatives are aimed at increasing the value of private properties and, through the charge, financing public works. This charge was regulated only in 2014 with the change of Article 16, paragraph 4, point d-ter of the Presidential Decree 380/2001 (Consolidated building law) and was named the “extraordinary urbanization contribution” (or simply the “extraordinary contribution”). The extraordinary contribution makes it possible to finance public works with private monetary resources. The amount of the extraordinary contribution is not less than 50% of the capital gain that is produced by real estate initiatives concerning modifications to town planning forecasts. A crucial issue of the this kind of PPPs has always been the appraisal of the capital gain of real estate initiatives due to changes in town planning forecasts. The factors to be considered while evaluating the extraordinary contribution, the appraisal tools and procedures to be used in assessing the capital gain are not indicated at regulatory level. However, an over 20 years’ practice has been consolidating the use of an analytical procedure for the appraisal of the transformation value to be used in evaluating the extraordinary contribution. In this procedure, the evaluation of the profitability index of real estate initiatives appears critical: in fact, the capital gain depends upon this element. At the same time, this topic is substantially neglected by the scientific debate. In this paper, a methodology has been defined, which is structured on the Build-Up Method and allows the profitability index (or rate of return) of a real estate initiative to be evaluated. Through a test, the developed methodology has been used in a case study: the appraisal of the extraordinary contribution in three integrated intervention programs in the city of Rome.
Self-Adaptive Deep Multiple Kernel Learning Based on Rademacher Complexity
Authors: Ren Shengbing , Shen Wangbo , Siddique Chaudry Naeem , Li You
Published: March 2019

The deep multiple kernel learning (DMKL) method has caused widespread concern due to its better results compared with shallow multiple kernel learning. However, existing DMKL methods, which have a fixed number of layers and fixed type of kernels, have poor ability to adapt to different data sets and are difficult to find suitable model parameters to improve the test accuracy. In this paper, we propose a self-adaptive deep multiple kernel learning (SA-DMKL) method. Our SA-DMKL method can adapt the model through optimizing the model parameters of each kernel function with a grid search method and change the numbers and types of kernel function in each layer according to the generalization bound that is evaluated with Rademacher chaos complexity. Experiments on the three datasets of University of California—Irvine (UCI) and image dataset Caltech 256 validate the effectiveness of the proposed method on three aspects.
Preclinical Assessment of a New Polyvalent Antivenom (Inoserp Europe) against Several Species of the Subfamily Viperinae
Authors: García-Arredondo Alejandro , Martínez Michel , Calderón Arlene , Saldívar Asunción , Soria Raúl
Published: March 2019

The European continent is inhabited by medically important venomous Viperinae snakes. Vipera ammodytes, Vipera berus, and Vipera aspis cause the greatest public health problems in Europe, but there are other equally significant snakes in specific regions of the continent. Immunotherapy is indicated for patients with systemic envenoming, of which there are approximately 4000 annual cases in Europe, and was suggested as an indication for young children and pregnant women, even if they do not have systemic symptoms. In the present study, the safety and venom-neutralizing efficacy of Inoserp Europe—a new F(ab’)2 polyvalent antivenom, designed to treat envenoming by snakes in the Eurasian region—were evaluated. In accordance with World Health Organization recommendations, several quality control parameters were applied to evaluate the safety of this antivenom. The venom-neutralizing efficacy of the antivenom was evaluated in mice and the results showed it had appropriate neutralizing potency against the venoms of several species of Vipera, Montivipera, and Macrovipera. Paraspecificity of the antivenom was demonstrated as well, since it neutralized venoms of species not included in the immunization schemes and contains satisfactory levels of total proteins and F(ab’)2 fragment concentration. Therefore, this new polyvalent antivenom could be effective in the treatment of snake envenoming in Europe, including Western Russia and Turkey.
Directed Flow in Microscopic Models in Relativistic A+A Collisions
Authors: Bravina Larissa , Kvasiuk Yurii , Sivoklokov Sergey , Vitiuk Oleksandr , Zabrodin Evgeny
Published: March 2019

Evolution of directed flow of charged particles produced in relativistic heavy-ion collisions at energies 4 ≤ s ≤ 19.6 GeV is considered within two microscopic transport models, ultra-relativistic quantum molecular dynamics (UrQMD) and quark-gluon string model (QGSM). In both models, the directed flow of protons changes its sign at midrapidity from antiflow to normal flow with decreasing energy of collisions, whereas the flows of mesons and antiprotons remain antiflow-oriented. For lighter colliding systems, such as Cu+Cu or S+S, changing of the proton directed flow occurs at lower bombarding energies and for more central topologies compared to a heavy Au+Au system. The differences can be explained by dissimilar production zones of different hadrons and by the influence of spectators. Directed flows of most abundant hadronic species at midrapidity are found to be formed within t = 10–12 fm/c after the beginning of nuclear collision. The influence of hard and soft mean-field potentials on the directed flow is also studied.
On the Causal and Topological Structure of the 2-Dimensional Minkowski Space
Authors: Papadopoulos Kyriakos , Kurt Nazli , Papadopoulos Basil K.
Published: March 2019

A list of all possible causal relations in the two-dimensional Minkowski space M is exhausted, based on the duality between timelike and spacelike in this particular case, and thirty topologies are introduced, all of them encapsulating the causal structure of M. Generalisations of these results are discussed, as well as their significance in a discussion on spacetime singularities.
Deficient Incorporation of Rabies Virus Glycoprotein into Virions Enhances Virus-Induced Immune Evasion and Viral Pathogenicity
Authors: Li Chunfu , Zhang Hongliang , Ji Lina , Wang Xiao , Wen Yongjun , Li Guangpeng , Fu Zhen F. , Yang Yang
Published: March 2019

Previous studies have shown that wild-type (wt) rabies virus (RABV) evades the host immune response by restricting expression of glycoprotein (G), which blocks activation of dendritic cells (DCs) and induces production of virus-neutralizing antibodies (VNAs). In the present study, wt RABVs not only restricted G expression but also reduced incorporation of G into mature virions compared with laboratory-adapted viruses. A recombinant RABV expressing triple G was used to further determine whether G expression relates to incorporation. The recombinant virus showed higher expression and incorporation of G and activated more DCs than the virus that expressed a single copy of G. Removal of G from viruses using subtilisin or Dithiothreitol (DTT)/ Nonidet P-40 (NP40) almost completely abolishes DC activation and VNA production. Consequently, these G-depleted viruses cause lethal infection in mice. Thus, wt RABVs can subvert DC-induced antiviral immune response and maintain pathogenicity by decreasing G expression in infected cells and G incorporation into virions.
Inclusion of Antibodies to Cell Culture Media Preserves the Integrity of Genes Encoding RL13 and the Pentameric Complex Components During Fibroblast Passage of Human Cytomegalovirus
Authors: Ourahmane Amine , Cui Xiaohong , He Li , Catron Meaghan , Dittmer Dirk P. , Al Qaffasaa Ahmed , Schleiss Mark R. , Hertel Laura , McVoy Michael A.
Published: March 2019

Propagation of human cytomegalovirus (CMV) in cultured cells results in genetic adaptations that confer improved growth in vitro and significant attenuation in vivo. Mutations in RL13 arise quickly, while mutations in the UL128-131A locus emerge later during fibroblast passage and disrupt formation of a glycoprotein complex that is important for entry into epithelial and endothelial cells. As CMV replicates in the context of host antibodies in vivo, we reasoned that antibodies might mitigate the accumulation of adaptive mutations during cell culture passage. To test this, CMV in infant urine was used to infect replicate fibroblast cultures. One lineage was passaged in the absence of CMV-hyperimmuneglobulin (HIG) while the other was passaged with HIG in the culture medium. The former lost epithelial tropism and acquired mutations disrupting RL13 and UL131A expression, whereas the latter retained epithelial tropism and both gene loci remained intact after 22 passages. Additional mutations resulting in single amino acid changes also occurred in UL100 encoding glycoprotein M, UL102 encoding a subunit of the helicase/primase complex, and UL122 encoding the Immediate Early 2 protein. An epitheliotropic RL13+/UL131A+ virus was isolated by limiting dilution in the presence of HIG and expanded to produce a working stock sufficient to conduct cell tropism experiments. Thus, production of virus stocks by culture in the presence of antibodies may facilitate in vitro experiments using viruses that are genetically more authentic than previously available.
Numerical Simulation of 2-D Solitary Wave Run-Up over Various Slopes Using a Particle-Based Method
Authors: Jeong Se-Min , Park Ji-In , Park Jong-Chun
Published: March 2019

The present paper covers the numerical prediction of the propagation and run-up of a solitary wave over non-flat seabed with various slope angles using a refined MPS (moving particle simulation) method. In the refined method, the corrected gradient model, new staggered divergence-free model, moving-particle wall boundary treatment, and the sub-particle scale turbulence model are applied to obtain more stable and precise results. The simulation results by the developed method are compared with experimental results, and both results were in good agreement. Especially, it can be seen that the complicated and fully-nonlinear behavior of the free-surface motion during the turbulent processes of build-up, break-down, and overturning of the waves are well reproduced by the developed method.
A New Water Governance Model Aimed at Supply–Demand Management for Irrigation and Land Development in the Mendoza River Basin, Argentina
Authors: Salomón-Sirolesi Mario , Farinós-Dasí Joaquín
Published: March 2019

This study aimed at achieving an organizational solution for improving the governance of water and land use and, consequently, improving the supply–demand water balance. Related modeling applied to diverse scenarios focus on water and land use development in the Mendoza River basin. A strategic analysis of water organization was performed using causal analysis, producing a Strategic Map (SM) and designing a Balanced Scorecard (BS). To assess the basin’s water resources supply and demand, the Water Evaluation and Planning (WEAP) model was applied to the Administrative Management Units existing in the basin, taking into consideration the water availability and the granted water rights. The application of the organizational and governance model to various scenarios referring to 2030 show that by reordering allocations and water use criteria, implementing a better farm irrigation water management, improving capacity building of existing human resources, and adopting more adequate hard- and software for dams and canal management, it will be possible to accommodate demand in 2030 better than at present despite climate change impacts on demand and supply. In addition, users’ participation will be enhanced.
Study of the Effects of Land Use on Hydrochemistry and Soil Microbial Diversity
Authors: Zhang Hongying , Gao Zongjun , Shi Mengjie , Fang Shaoyan , Xu Hailong , Cui Yechen , Liu Jiutan
Published: March 2019

The objectives of this study were to compare the influence of land use, to determine which land has an impact on hydrochemistry and to clarify the impact of land use on soil microbial diversity and the correlation between hydrochemistry and soil microbial diversity. The impacts were assessed through chemical and biological data from 4 land-use groups. The results showed that soil microbial diversity and water chemical composition were different under different land uses. There was a strong correlation between the main hydrochemical components under different land uses, and the M03 had the highest correlation. The Shannon index was the largest for M01, the Simpson index was the smallest for M01, and the Chao1 and Ace indexes were the largest for M02. Actinobacteria, Proteobacteria and Acidobacteria were the dominant bacteria with different land uses, and some bacteria were present or absent depending on the land use. It was found that the soil CO2 content was different with different land uses. Soil CO2 content, hydrochemistry and soil microbial species were related to each other. A heatmap analysis showed that the F− and soil CO2 content showed a strong correlation with soil microorganisms and that the dominant bacteria were positively correlated. Under different land uses, hydrochemistry, soil CO2 and soil microorganisms interact with one another.
Bouncing Back and Jumping Forward: Scoping the Resilience Landscape of International Sports Events And Implications for Events and Festivals
Authors: Shipway Richard , Miles Lee
Published: March 2019

The purpose of this conceptual article is to critically scope the resilience landscape to help better understand how future studies on international sports events and venues could be informed by existing work in disaster management and resilience studies. The article suggests that within
the differing benchmarks currently used to define and classify major international sports events, at present crises and disaster management considerations are largely ignored or underestimated. The article reviews previous research in crisis and disaster management, highlighting the potential
for closer synergies between both sport and events studies and crisis and disaster management fields. It contributes new knowledge through the introduction of an international sports events (ISEs) resilience continuum to assist with better understanding resilience. The broader implications
for events and festivals are highlighted. Although the interdisciplinary study of crisis, disasters, and emergency management has become increasingly sophisticated, the identification of synergies and useful concepts in relation to both sport and events studies to inform these areas is still
at an early stage of development. This article adds to the limited body of knowledge on sports events resilience, and in doing so highlights potential avenues for future research in both sport and events, in terms of both theory and practice.
Selected Medical Interventions in Women With a Deleterious Brca Mutation: A Population-Based Study in British Columbia
Authors: Hanley G.E. , McAlpine J.N. , Cheifetz R. , Schrader K.A. , McCullum M. , Huntsman D.
Published: March 2019

Background: We examined the uptake of risk-reducing interventions, including bilateral mastectomy, risk-reducing salpingo-oophorectomy, oral contraceptive pills, tamoxifen, and raloxifene, for the entire population of women with a deleterious BRCA1 or BRCA2 mutation in the Canadian province of British Columbia. Methods: This retrospective population-based study used data available in British Columbia for all women who, between 1996 and 2014, were tested and found to have a BRCA mutation. Rates of risk-reducing interventions stratified according to the type of BRCA mutation and prior history of breast or gynecologic cancer (ovary, fallopian tube, peritoneal) are presented. Cancers diagnosed in women with a BRCA mutation after disclosure of their mutation status are also presented. Results: The final study cohort consisted of 885 patients with a deleterious BRCA1 (n = 474) or BRCA2 (n = 411) mutation. Of the women with no prior breast cancer, 30.8% carrying a BRCA1 mutation and 28.3% carrying a BRCA2 mutation underwent bilateral mastectomy. Of women with no prior gynecologic cancer, 64.7% carrying a BRCA1 mutation and 62.2% carrying a BRCA2 mutation underwent risk-reducing bilateral salpingo-oophorectomy. Rates of chemoprevention with oral contraceptive pills and tamoxifen or raloxifene were low in all groups. In this cohort, 23 gynecologic and 70 breast cancers were diagnosed after disclosure of BRCA mutation status. Conclusions: Our results suggest reasonable uptake of risk-reducing interventions in high-risk women. To minimize the occurrence of breast and ovarian cancer in women with a BRCA1 or BRCA2 mutation, more attention could be paid to ensuring that affected women receive proper counselling and follow-up.
A Case of Nivolumab-Induced Acute-Onset Type 1 Diabetes Mellitus in Melanoma
Authors: Sakaguchi C. , Ashida K. , Yano S. , Ohe K. , Wada N. , Hasuzawa N. , Matsuda Y. , Sakamoto S. , Sakamoto R. , Uchi H. , Furue M. , Nomura M. , Ogawa Y.
Published: March 2019

Nivolumab, an anti–PD-1 antibody, is now considered an important therapeutic agent in several advanced malignancies. However, immune-related adverse events such as endocrinopathies have been reported with its use. Thyroid disorder and isolated adrenocorticotropic hormone deficiency have frequently been reported as nivolumab-induced immune-related adverse events. Another endocrinopathy is nivolumab-induced type 1 diabetes mellitus (T1DM), described as diabetes mellitus with rapid onset and complete insulin insufficiency, at times leading to fulminant T1DM. We report the case of a 68-year-old woman who developed pancreatic islet–related autoantibody-negative T1DM, possibly induced by nivolumab, under continuous glucocorticoid administration. She was treated with nivolumab for advanced malignant melanoma, concomitant with 10 mg prednisolone daily for thrombophlebitis tapered to 5 mg after 13 courses of nivolumab therapy. At approximately the 27th course of nivolumab therapy, she showed elevated plasma glucose levels despite preserved insulin secretion. A month later, she developed diabetic ketoacidosis. Her insulin secretion decreased and finally was exhausted. She was diagnosed with acute-onset rather than fulminant T1DM because of a rapidly progressive course to diabetic ketoacidosis during just more than 1 week. She is currently receiving insulin replacement. There has been no recurrence of the melanoma. Thus, nivolumab might induce autoimmune diabetes mellitus, with patients having T1DM-sensitive human leucocyte antigen being more susceptible even when receiving glucocorticoids. Physicians should be aware that nivolumab could potentially induce T1DM as a critical immune-related adverse event.
Prognostic Value of Inflammation-Based Markers in Advanced or Metastatic Neuroendocrine Tumours
Authors: Zou J. , Li Q. , Kou F. , Zhu Y. , Lu M. , Li J. , Lu Zhihao , Shen Lin
Published: March 2019

Background: The role of systemic inflammation–based markers remains uncertain in advanced or metastatic neuroendocrine tumours (NETS). Methods: Systemic inflammatory factors, such as levels of circulating white blood cells and other blood components, were combined to yield inflammation-based prognostic scores [high-sensitivity inflammation-based Glasgow prognostic score (hSGPS), neutrophil:lymphocyte ratio (NLR), platelet:lymphocyte ratio (PLR), high-sensitivity inflammation-based prognostic index (hSPI), and prognostic nutritional index (PNI)], whose individual values as prognostic markers were retrospectively determined. Univariate and multivariate analyses were used to examine the association of inflammatory markers with overall survival (OS). Results: The study included 135 patients. Univariate analysis revealed that elevated white blood cell count, elevated neutrophil count, low serum albumin, elevated high-sensitivity C-reactive protein, and elevated hSPI, hSGPS, and NLR scores were significantly associated with worse OS. Multivariate analyses demonstrated that, apart from pathology grade and original site of the tumour, elevated hSPI (p = 0.004) was an independent prognostic factor for worse OS. Conclusions: In the present study, elevated pretreatment hSPI was observed to be an independent predictor of shorter OS in patients with inoperable advanced or metastatic NET. The hSPI might thus provide additional guidance for therapeutic decision-making in such patients.
Efficacy of Second-Line Chemotherapy after a First-Line Triplet in Patients with Metastatic Colorectal Cancer
Authors: Bazarbashi Shouki , Hakoun A. M. , Gad A. M. , Elshenawy M. A. , Aljubran A. , Alzahrani A. M. , Eldali A.
Published: March 2019

Background: Exposing patients with metastatic colorectal cancer (MCRC) to all three active chemotherapeutic agents (oxaliplatin, irinotecan, fluorouracil) has improved survival. The benefit of second-line chemotherapy after a first-line triplet is not clearly defined. We evaluated the efficacy of second-line chemotherapy in patients who had received first-line triplet therapy. Methods: The medical records of patients treated on a prospective trial of first-line triplet therapy were reviewed for second-line treatment. Univariate and multivariate analyses were performed to establish factors of prognostic significance. Results: Of the 53 patients who received first-line triplet therapy, 28 (53%) received second-line chemotherapy [13 men; 8 with a colon primary; mutant KRAS in 10, wild-type in 15, and unknown status in 3; Eastern Cooperative Oncology Group performance status (PS) of 1 in 16 patients, PS 2 in 3, PS 3 in 2, and unknown in 7; involved organs: liver in 17 patients, lung in 16, and peritoneum in 8]. Second-line chemotherapy consisted of XELOX or FOLFOX in 13 patients, XELIRI or FOLFIRI in 12, and single-agent irinotecan in 3. Concurrent bevacizumab was given in 16 patients (57%), and cetuximab, in 2 (7%). Median survival was 28.0 months [95% confidence interval (CI): 22.8 months to 33.2 months] for patients receiving second-line therapy and 23.0 months (95% CI: 13.2 months to 32.8 months) for those not receiving it. Best response was partial in 6 patients (21%), stable disease in 11 (39%), and progressive disease in 11 (39%). Median progression-free survival was 4.8 months (95% CI: 2.4 months to 9.6 months), and overall survival was 15 months (95% CI: 9.6 months to 20.4 months). Conclusions: Second-line chemotherapy after first-line triplet therapy in MCRC is feasible and suggests efficacy comparable to that reported for second-line therapy after a doublet, regardless of the agent used.
Extended Venous Thromboembolism Prophylaxis after Abdominopelvic Cancer Surgery: A Retrospective Review
Authors: Laureano M. , Ebraheem M. , Crowther Mark
Published: March 2019

Objective: Extended prophylaxis against venous thromboembolism (vte) after abdominal or pelvic cancer surgery with low molecular weight heparin (lmwh) is recommended by multiple guidelines. The primary objective of the present study was to assess adherence to that guideline recommendation at tertiary care centres within Hamilton Health Sciences (hhs). Methods: Given that an estimated 70% of the study population would be expected to receive extended prophylaxis, a sample size of 105 patients was calculated. Patients who had undergone abdominal or pelvic surgery for cancer from March 2012 to December 2015 were identified, and data were collected from electronic health records. The primary outcome was prescription of extended vte prophylaxis. Results: Of 105 patients, only 3 received extended vte prophylaxis. Those 3 patients had serous carcinoma of the uterus, transitional cell carcinoma of the bladder, and cecal cancer. Of the 3 patients, 2 were followed by the thrombosis service while in hospital; none of the other 102 patients received any form of extended vte prophylaxis. Conclusions: Based on multiple randomized controlled trials, guidelines suggest lmwh prophylaxis for up to 4 weeks after major abdominal or pelvic cancer surgery. Despite those recommendations, postoperative extended vte prophylaxis is not commonly prescribed at hhs facilities. Next steps will include identification of barriers and an examination of how those barriers could be addressed. Failure to use prophylaxis is not consistent with evidencebased guidelines and is placing patients at risk of vte.
Conditional Approval of Cancer Drugs in Canada: Accountability and Impact on Public Funding
Authors: Andersen S. K. , Penner N. , Chambers A. , Trudeau M.E. , Chan K.K.W. , Cheung Matthew
Published: March 2019

Background: We examined how conditional market approval of cancer pharmaceuticals by Health Canada (hc) affects public funding recommendations by the pan-Canadian Oncology Review (pcodr). We were also interested to see how often hc conditions are enforced. Methods: Health Canada and pcodr databases for 2010–2017 were analyzed for patterns in hc conditional authorization and post-authorization reviews of cancer drugs and for correlation with pcodr reimbursement recommendations. Results: Between 2010 and 2017, pcodr reviewed 105 unique drug–indication pairings; 21% (n = 22) had conditional hc authorization. In all cases, conditional authorization was given on the basis of preliminary data in a surrogate endpoint and was contingent on further data showing benefit in more robust outcome measures (for example, overall survival). Of those 22 drugs, 36% did not have updated data, 36% had updated data that met hc conditions, and 27% had data that met some, but not all, conditions. During the period considered, hc never revoked conditional authorization for failure to meet conditions. None of the 22 drugs was given an unconditional positive recommendation for public reimbursement by pcodr. A conditional recommendation was given to 11 of the drugs (50%), and reimbursement was not recommended for 6 drugs (27%) because of insufficient evidence. Conclusions: One fifth of the cancer drugs reviewed for public reimbursement in Canada were conditionally authorized by hc based on preliminary data. Conditional authorization was associated with a recommendation against public funding by pcodr. No drugs had their conditional market authorization revoked for failure to meet conditions, suggesting that a more robust hc reappraisal framework is needed.
Patient Indications for Mohs Micrographic Surgery: A Clinical Practice Guideline
Authors: Murray Christian , Sivajohanathan D. , Hanna T. P. , Bradshaw S. , Solish N. , Moran B. , Hekkenberg R. , Wei A. C. , Petrella T.
Published: March 2019

Objective: The purpose of the present work was to develop evidence-based indications for Mohs micrographic surgery in patients with a diagnosis of skin cancer. Methods: The guideline was developed by Cancer Care Ontario’s Program in Evidence-Based Care, together with the Melanoma Disease Site Group and the Surgical Oncology Program, through a systematic review of relevant literature, patient- and caregiver-specific consultation, and internal and external reviews. Recommendation 1: Given a lack of high-quality, comparative evidence, surgery (with postoperative or intraoperative margin assessment) or radiation (for those who are ineligible for surgery) should remain the standard of care for patients with skin cancer. Recommendation 2: Mohs micrographic surgery is recommended for patients with histologically confirmed recurrent basal cell carcinoma of the face and is appropriate for primary basal cell carcinomas of the face that are larger than 1 cm, have aggressive histology, or are located on the H zone of the face. Recommendation 3: Mohs micrographic surgery should be performed by physicians who have completed a degree in medicine or equivalent, including a Royal College of Physicians and Surgeons of Canada Specialist Certificate or equivalent, and have received advanced training in Mohs micrographic surgery.
Palliative Care for Cancer Patients Near End of Life in Acute-Care Hospitals across Canada: A Look at the Inpatient Palliative Care Code
Authors: Tung Jasmine , Chadder J. , Dudgeon D. , Louzado C. , Niu J. , Rahal R. , Sinnarajah A.
Published: March 2019

Hospitals play an important role in the care of patients with advanced cancer: nearly half of all cancer deaths occur in acute-care settings. The need for increasing access to palliative care and related support services for patients with cancer in acute-care hospitals is therefore growing. Here, we examine how often and how early in their illness patients with cancer might be receiving palliative care services in the 2 years before their death in an acute-care hospital in Canada. The palliative care code from inpatient administrative databases was used as a proxy for receiving, or being referred for, palliative care. Currently, the palliative care code is the only data element routinely collected from patient charts that allows for the tracking of palliative care activity at a pan-Canadian level. Our findings suggest that most patients with cancer who die in an acute-care hospital receive a palliative designation; however, many of those patients are identified as palliative only in their final admission before death. Of the patients who received a palliative designation before their final admission, nearly half were identified as palliative less than 2 months before death. Findings signal that delivery of services within and between jurisdictions is not consistent, that the palliative care needs of some patients are being missed by physicians, and that palliative care is still largely seen as end-of-life care and is not recognized as an integral component of cancer care. Measuring the provision of system-wide palliative care remains a challenge because comprehensive national data about palliative care are not currently reported from all sectors. To advance measurement and reporting of palliative care in Canada, attention should be focused on collecting comparable data from regional and provincial palliative care programs that individually capture data about palliative care delivery in all health care sectors.
Prevalence of Human T Cell Lymphotropic Virus 1 Infection in Canada
Authors: Amar L. , Le M. , Ghazawi F. M. , Rahme E. , Segal A. , Netchiporouk E. , Popradi G. , Moreau L. , Roshdy O. , Sasseville D. , Litvinov Ivan
Published: March 2019

Human T cell lymphotropic virus 1 (htlv-1) is a bloodborne retrovirus that infects at least 5–20 million people around the world [...]
Integrating Primary Care Providers through the Seasons of Survivorship
Authors: Chaput Genevieve , Sussman J.
Published: March 2019

Traditionally, the role of primary care providers (pcps) across the cancer care trajectory has focused on prevention and early detection. In combination with screening initiatives, new and evolving treatment approaches have contributed to significant improvements in survival in a number of cancer types. For Canadian cancer survivors, the 5-year survival rate is now better than it was a decade ago, and the survivor population is expected to reach 2 million by 2031. Notwithstanding those improvements, many cancer survivors experience late and long-term effects, and comorbid conditions have been noted to be increasing in prevalence for this vulnerable population. In view of those observations, and considering the anticipated shortage of oncology providers, increasing reliance is being placed on the primary care workforce for the provision of survivorship care. Despite the willingness of pcps to engage in that role, further substantial efforts to elucidate the landscape of high-quality, sustainable, and comprehensive survivorship care delivery within primary care are required. The present article offers an overview of the integration of pcps into survivorship care provision. More specifically, it outlines known barriers and potential solutions in five categories: (1) Survivorship care coordination; (2) Knowledge of survivorship; (3) pcp-led clinical environments; (4) Models of survivorship care; (5) Health policy and organizational advocacy.
Building Capacity in Cancer Knowledge Translation through Catalyst Grants
Authors: O’Brien Mary , Grunfeld E.
Published: March 2019

The field of knowledge translation (kt) seeks to understand how to apply findings derived from research to clinical practice to benefit the population [...]
The Oncology Association of Naturopathic Physicians Principles of Care Guidelines
Authors: Seely Dugald , Verma S.
Published: March 2019

A high prevalence of complementary and integrative medicine use is common for patients living with cancer. [...]
OPTIMISATION OF GRILLAGE-TYPE FOUNDATIONS/PAMATŲ SIJYNO OPTIMIZAVIMAS
Authors: Belevičius Rimantas , Valentinavičius Saulius
Published: March 2019

Suformuluoti pamatų sijyno optimizavimo uždavinių matematiniai modeliai, pasiūlyti jų sprendimo algoritmai. Išspręsti trys uždaviniai: lenkimo momentų, atraminių reakcijų minimizavimo ir bendras reakcijų ir lenkimo momentų minimizavimo uždavinys. Statikos uždavinys sprendžiamas baigtinių elementų metodu. Panaudotas paprastas dviejų mazgų lenkiamo strypo elementas su dviem laisvumo laipsniais mazge. Jautrumo atramų postūmiams analizė atlikta analitiškai. Optimizavimui taikytos tiesinio matematinio programavimo procedūros. Kadangi optimizavimo uždavinys yra aiškiai netiesinis, programoje įdiegtas iteracinis interaktyvus patikslinimo procesas, leidžiantis keisti atramų postūmius taip, kad optimizavimo procedūros numatymai reikiamu tikslumu atitiktų baigtinių elementų metodo sprendinius. Pirmųjų dviejų tipų uždaviniai suformuluoti griežtai, o bendrajam momentų/reakcijų optimizavimo uždaviniui taikytos tam tikros inžinerinės prielaidos. Pateikti visų trijų optimizavimo uždavinių sprendiniai įvairioms pamatų sijoms.
Nonlinear Mixed Modes in Red Giants
Authors: Weinberg Nevin N. , Arras Phil
Published: March 2019

Turbulent motions in the convective envelope of red giants excite a rich spectrum of solar-like oscillation modes. Observations by CoRoT and Kepler have shown that the mode amplitudes increase dramatically as the stars ascend the red giant branch, i.e., as the frequency of maximum power, ν
max, decreases. Most studies nonetheless assume that the modes are well described by the linearized fluid equations. We investigate to what extent the linear approximation is justified as a function of stellar mass M and ν
max, focusing on dipole mixed modes with frequency near ν
max. A useful measure of a mode’s nonlinearity is the product of its radial wavenumber and its radial displacement, k

r

ξ

r
(i.e., its shear). We show that

, implying that the nonlinearity of mixed modes increases significantly as a star evolves. The modes are weakly nonlinear (

) for

and strongly nonlinear (

) for

, with only a mild dependence on M over the range we consider (1.0–2.0 M
⊙). A weakly nonlinear mixed mode can excite secondary waves in the stellar core through the parametric instability, resulting in enhanced, but partial, damping of the mode. By contrast, a strongly nonlinear mode breaks as it propagates through the core and is fully damped there. Evaluating the impact of nonlinear effects on observables such as mode amplitudes and linewidths requires large mode network simulations. We plan to carry out such calculations in the future and investigate whether nonlinear damping can explain why some red giants exhibit dipole modes with unusually small amplitudes, known as depressed modes.
The First NuSTAR Observation of 4U 1538–522: Updated Orbital Ephemeris and a Strengthened Case for an Evolving Cyclotron Line Energy
Authors: Hemphill Paul B. , Rothschild Richard E. , Cheatham Diana M. , Fürst Felix , Kretschmar Peter , Kühnel Matthias , Pottschmidt Katja , Staubert Rüdiger , Wilms Jörn , Wolff Michael T.
Published: March 2019

We have performed a comprehensive spectral and timing analysis of the first NuSTAR observation of the high-mass X-ray binary 4U 1538−522. The observation covers the X-ray eclipse of the source, plus the eclipse ingress and egress. We use the new measurement of the mid-eclipse time to update the orbital parameters of the system and find marginally significant evolution in the orbital period, with

. The cyclotron line energy is found to be approximately 1.2 keV higher than RXTE measurements from 1997 to 2003, in line with the increased energy observed by Suzaku in 2012 and strengthening the case for secular evolution of 4U 1538−522’s CRSF. We additionally characterize the behavior of the iron fluorescence and emission lines and line-of-sight absorption as the source moves into and out of eclipse.
The Next Generation Fornax Survey (NGFS). V. Discovery of a Dwarf–Dwarf Galaxy Pair at z = 0.30 and Its Characterization Using Deep VLT/MUSE Observations
Authors: Johnston Evelyn J. , Eigenthaler Paul , Puzia Thomas H. , Ordenes-Briceño Yasna , Taylor Matthew A. , Alamo-Martínez Karla , Côté Patrick , Galaz Gaspar , Grebel Eva K. , Hilker Michael , Lançon Ariane , Mieske Steffen , Sánchez-Janssen Ruben , Rong Yu
Published: March 2019

We report the detection of a pair of dwarf galaxies at z = 0.30 that may be in the early stages of an interaction. Both galaxies have stellar masses of <109
M
⊙ and display a projected separation of ∼29 kpc and a physical separation of ∼240 kpc. Evidence of ongoing star formation has been found in both galaxies, with neither one showing an enhanced star formation rate that would be expected if they were already interacting. One galaxy displays a disturbed morphology but shows ordered gas rotation, which may reflect a previous minor merger event in the recent history of that system. The nearest spectroscopically confirmed neighbor lies at a distance of 38 Mpc. These results indicate that these dwarf galaxies have no neighboring massive galaxies; however, with the data available we have been unable to determine whether these galaxies are isolated in the field or belong to a group of low-mass galaxies. As a detection of a rare dwarf–dwarf pair beyond the local universe, this system provides an uncommon opportunity to explore the properties of galaxy groups in the low-galaxy mass regime as a function of redshift.
HBV Reactivation during Direct-Acting Antiviral Therapy in Hepatitis B and C Coinfected Patients Undergoing Haemodialysis
Authors: Wang Jing , Hu Chunhua , Chen Yi , Liu Zhengwen , Yu Qiang , Yang Shujuan , Dong Jun , Yang Yuan , Wu Yuchao , Ren Danfeng , Yao Naijuan , Guo Dandan , Tian Zhen , Zhao Yingren , Chen Tianyan , He Yingli , Liu Jinfeng
Published: March 2019

Background

There have been increasing reports of HBV reactivation in HBV and HCV coinfected patients with direct-acting antiviral (DAA) treatment. The potential risk of HBV reactivation in patients undergoing haemodialysis has also been noted. There is a lack of data pertaining to the reactivation risk during DAA treatment in those coinfected patients with end-stage renal disease who are undergoing haemodialysis.

Methods

HBV–HCV-coinfected patients were screened from 178 persons at two blood purification centres in China and received sofosbuvir (200 mg) combined with daclatasvir (60 mg) daily. The risk and pattern of HBV reactivation during DAA treatment was retrospectively analysed.

Results

HBV reactivation occurred in 45.5% (5/11) of the HBV–HCV-coinfected patients undergoing haemodialysis during DAA treatment, which was much higher than the reported rates in the general population of coinfected patients. Five patients with HBV reactivation were all positive for hepatitis B surface antigen (HBsAg) before DAA treatment. Three patients (27.3%) had mild hepatitis fares due to HBV reactivation, but no patients had severe hepatitis or hepatic failure. Compared with the four patients who were HBsAg- at the baseline, the risk of HBV reactivation in HBsAg+ patients was greater (71.4% versus 0; c2=5.238; P=0.061), although the difference was not statistically significant.

Conclusions

A significant proportion of HBV–HCV-coinfected patients undergoing haemodialysis developed HBV reactivation after DAA therapy. The risk of HBV reactivation was greater in HBsAg+ patients than in those patients who were HBsAg- but anti-HBc+ or HBV DNA+.