bluuebunny/crossref_metadata_2025 huggingface dataset:
Introducing Lightning Threat Messaging Using the GOES-16 Day Cloud Phase Distinction RGB Composite
Authors: Elsenheimer Cynthia B. , Gravelle Chad M.
Published: August 2019

In 2001, the National Weather Service (NWS) began a Lightning Safety Awareness Campaign to reduce lightning-related fatalities in the United States. Although fatalities have decreased 41% since the campaign began, lightning still poses a significant threat to public safety as the majority of victims have little or no warning of cloud-to-ground lightning. This suggests it would be valuable to message the threat of lightning before it occurs, especially to NWS core partners that have the responsibility to protect large numbers of people. During the summer of 2018, a subset of forecasters from the Jacksonville, Florida, NWS Weather Forecast Office investigated if messaging the threat of cloud-to-ground (CG) lightning in developing convection was possible. Based on previous CG lightning forecasting research, forecasters incorporated new high-resolution Geostationary Operational Environmental Satellite (GOES)-16 Day Cloud Phase Distinction red–green–blue (RGB) composite imagery with Multi-Radar Multi-Sensor isothermal reflectivity and total lightning data to determine if there was enough confidence to message the threat of CG lightning before it occurred. This paper will introduce the Day Cloud Phase Distinction RGB composite, show how it can add value for short-term lightning forecasting, and provide an operational example illustrating how fusing these datasets together may be able to provide confidence and extend the lead time when messaging the threat of cloud-to-ground lightning before it occurs.
The Impact of Hours of Advance Notice on Protective Action in Response to Tornadoes
Authors: Krocak Makenzie J. , Ripberger Joseph T. , Jenkins-Smith Hank , Silva Carol
Published: August 2019

As numerical modeling methods and forecasting technologies continue to improve, people may start to see more specific severe weather timing and location information hours before the event occurs. While studies have investigated response actions on the warning time scales, little work has been done to understand what types of actions residents will take given 4–8 h of advance notice for a possible tornado. This study uses data from the 2018 Severe Weather and Society Survey, an annual survey of U.S. adults, to begin analyzing response actions and how those responses differ with either 4 or 8 h of advance notice. Results show that response actions are largely the same between the two time periods. The small differences that do exist show that sheltering behaviors are more common with 4 h of advance notice whereas monitoring behaviors are more common with 8 h of notice. In addition, respondents claimed they would “wait and see” more often in the 8-h category, indicating they would seek additional information before deciding how to respond. Perhaps more important than the types of actions that respondents identify is the increase in those who are unsure of how to react or would choose to do nothing when given 8 h of notice. Respondents may be anchored to the current system and may not have considered all of the possible actions they can take given more time. Therefore, we emphasize the need for education campaigns as technology, forecasts, and desired responses continue to evolve.
Blessed among All Women: The Missionary Virgin, Identity and Territory in Patagonia
Authors: Nicoletti María Andrea , Barelli Ana Inés
Published: August 2019

After the creation of the Diocese of Viedma (1953), in Northern Patagonia, there took place the dedication to the Missionary Virgin, promoted by the Diocese’s second Bishop, Monsignor Miguel Hesayne (1975–1993). In the midst of the military dictatorship (1976–1983), he appointed her Patron Saint of Río Negro, a province that at the time belonged to the Diocese of Viedma. He followed the teachings of the Second Vatican Council, especially the Puebla Document, which considers the Virgin Mary as the patron saint of the Americas, with the dedication of the Virgin of Guadalupe. Hesayne sought to identify his Diocese with a female figure with indigenous features, like the Virgin of Guadalupe. In conceiving the Missionary Virgin deprived of ornaments and royal attributes, the bishop aimed to reflect his pastoral of the “option for the poor,” thus bringing attention to the marginalized groups and peripheral spaces of the province, and also attributing a new meaning to its social and territorial identity.
Nonlinear interphase effects on plastic hardening of nylon 6/clay nanocomposites: A computational stochastic analysis
Authors: Yaghoubi Vahid , Silani Mohammad , Zolfaghari Hossein , Jamshidian Mostafa , Rabczuk Timon
Published: August 2019

In this paper, the nonlinear effect of interphase properties on the macroscopic plastic response of nylon 6/clay nanocomposites is investigated by applying a stochastic analysis on a multiscale computational model of nanocomposites. The mechanical behavior of interphase is described with respect to that of the matrix by a weakening coefficient. The interphase thickness and properties are considered as the stochastic inputs and the hardening modulus and hardening exponent describing the plastic hardening characteristics of the nanocomposite are the random outputs. The stochastic analysis consists of three procedures including (i) model selection using Akaike information criterion, (ii) uncertainty propagation using Latin Hypercube sampling in conjunction with chi-square test, and (iii) sensitivity analysis using Sobol indices. The results indicate that the exponential hardening model best describes the flow stress–plastic strain response of the nanocomposite. It is also shown that increasing the clay content generally increases the plastic hardening rate of the nanocomposite up to 4% clay content. Besides, the hardening characteristics of the nanocomposite are more sensitive to the weakening coefficient than the interphase thickness.
Association Between Self-Reported Hypertension and Antihypertensive Medication Use and Cardiovascular Disease–Related Events and Expenditures Among Patients Diagnosed With Hypertension
Authors: Baker-Goering Madeleine M. , Howard David H. , Will Julie C. , Beeler Asay Garrett R. , Roy Kakoli
Published: August 2019

Objectives:

Research suggests that persons who are aware of the risk factors for cardiovascular disease (CVD) are more likely to engage in healthy behaviors than persons who are not aware of the risk factors. We examined whether patients whose insurance claims included an International Classification of Diseases, Ninth Revision (ICD-9) code associated with hypertension who self-reported high blood pressure were more likely to fill antihypertensive medication prescriptions and less likely to have CVD-related emergency department visits and hospitalizations (hereinafter, CVD-related events) and related medical expenditures than patients with these codes who did not self-report high blood pressure.

Methods:

We used a large convenience sample from the MarketScan Commercial Database linked with the MarketScan Health Risk Assessment (HRA) Database to identify patients aged 18-64 in the United States whose insurance claims included an ICD-9 code associated with hypertension and who completed an HRA from 2008 through 2012 (n = 111 655). We used multivariate logistic regression analysis to examine the association between self-reported high blood pressure and (1) filling prescriptions for antihypertensive medications and (2) CVD-related events. Because most patients with hypertension will not have a CVD-related event, we used a 2-part model to analyze medical expenditures. The first part estimated the likelihood of a CVD-related event, and the second part estimated expenditures.

Results:

Patients with an ICD-9 code of hypertension who self-reported high blood pressure had a significantly higher predicted probability of filling antihypertensive medication prescriptions (26.5%; 95% confidence interval, 25.7-27.3; P < .001), had a significantly lower predicted probability of a CVD-related event (0.6%, P < .001), and on average spent significantly less on CVD-related events ($251, P = .01) than patients who did not self-report high blood pressure.

Conclusion:

This study affirms that self-knowledge of high blood pressure, even among patients who are diagnosed and treated for hypertension, can be improved. Interventions that improve patients’ awareness of their hypertension may improve antihypertensive medication use and reduce adverse CVD-related events.
Infrastructure imaginaries: The politics of light rail projects in the age of neoliberalism
Authors: Olesen Kristian
Published: August 2019

In the last decade light rail transit systems have become a popular mode of public transport in many cities around the world to upgrade the existing public transportation network, but also, and perhaps more importantly, to support neoliberal urban development strategies. The paper takes its starting point in the growing critical literature discussing the politics of light rail and related transport infrastructure projects in the context of neoliberalism. The paper uses the case of Aalborg, Denmark, to demonstrate how light rail projects are embedded in particular infrastructure imaginaries, which reflect wider political agendas of promoting urban development and economic growth. In the case of Aalborg, the city’s spatial strategies have played an important role in constructing an imaginary of the city as the region’s ‘growth dynamo’, which in turn have led to a growth-fixated conceptualisation of the city’s spatiality, and contributed to rationalising the need for investments in light rail. The paper argues that light rail projects are first and foremost politically rationalised as important investments for facilitating urban development and supporting entrepreneurial city strategies of urban and economic growth, whilst their social objectives of providing affordable public transportation play a less prominent role in the contemporary imaginary of the city.
The power of violins and rose petals: The Eurovision Song Contest as an arena of European crisis
Authors: Pyka Marcus
Published: August 2019

This paper explores the interconnection between European crises and the Eurovision Song Contest, the largest non-sports-related TV show on earth, which has run as an annual music competition of European countries since 1956. The paper explores the development of the actual show, based on existing audio and video recordings, as well as selected aspects of the respective media coverage. Special focus is paid to the creation of the contest in a post-catastrophic Europe, specifically the first show in Lugano in 1956; the apparent decline of the show’s appeal in Western Europe in the 1980s and 1990s; and finally the contest held in Moscow in 2009, when the global financial crisis had just reached Europe. This research shows that ‘crisis’ is less an objective state, but rather a rhetorical strategy to communicate one’s perceptions of the time, illuminating the significance of the Eurovision Song Contest as an arena for European affairs.
First-Time Experience in Owning a Dog Guide by Older Adults with Vision Loss
Authors: Li Kitsum , Kou Jeffrey , Lam Yvonne , Lyons Patricia , Nguyen Susan
Published: August 2019

Introduction:

In spite of the vast amount of literature on pet therapy and dog companionship, limited studies exist on older adults with vision loss and the experience of owning a dog guide. The purpose of this study is to explore the facilitators and barriers of first-time ownership and utilization of a dog guide as experienced by older adults with vision loss.

Methods:

Data were gathered among seven participants using open-ended semistructured telephone interviews. Participants described their experiences related to owning a dog guide. Using phenomenological analysis, themes were extracted from verbatim transcriptions.

Results:

Through constant comparison methods, five themes emerged: increased responsibilities for new dog guide owners, changes in habits and routines, quick human–dog guide bonding, increase in community integration, and enhancement of autonomy through dog guide ownership.

Discussion:

The study results suggest that obtaining a dog guide increased the older adults with vision loss everyday engagement in community activities. The increased confidence in independent mobility may have led participants to engage in activities in unfamiliar environments, thus improving their autonomy, self-esteem, and physical abilities. These changes resulted in increased feelings of independence and freedom for the older adults with vision loss. Participants also revealed positive changes in their daily habits. Due to the increased physical ability and motivation needed to complete activities, making adjustments to owning a dog guide became easier. Furthermore, a human–dog guide bond was prevalent among all seven participants.

Implications for practitioners:

Themes extracted provide health practitioners and dog guide organizations insight into how owning dog guides may empower older adults with vision loss.
Exploring the dominant features of social media for depression detection
Authors: Hussain Jamil , Satti Fahad Ahmed , Afzal Muhammad , Khan Wajahat Ali , Bilal Hafiz Syed Muhammad , Ansaar Muhammad Zaki , Ahmad Hafiz Farooq , Hur Taeho , Bang Jaehun , Kim Jee-In , Park Gwang Hoon , Seung Hyonwoo , Lee Sungyoung
Published: August 2019

Recently, social media have been used by researchers to detect depressive symptoms in individuals using linguistic data from users’ posts. In this study, we propose a framework to identify social information as a significant predictor of depression. Using the proposed framework, we develop an application called the Socially Mediated Patient Portal (SMPP), which detects depression-related markers in Facebook users by applying a data-driven approach with machine learning classification techniques. We examined a data set of 4350 users who were evaluated for depression using the Center for Epidemiological Studies Depression (CES-D) scale. From this analysis, we identified a set of features that can distinguish between individuals with and without depression. Finally, we identified the dominant features that adequately assess individuals with and without depression on social media. The model trained on these features will be helpful to physicians in diagnosing mental diseases and psychiatrists in analysing patient behaviour.
Relational Savoring Reduces Physiological Reactivity and Enhances Psychological Agency in Older Adults
Authors: Borelli Jessica L. , Bond David Kyle , Fox Schuyler , Horn-Mallers Melanie
Published: August 2019

The benefits of savoring interventions for improving mental health have recently been demonstrated with older adults. Using a randomized controlled design involving N = 63 adults (aged 60-90 years), we explore whether relational savoring, a targeted intervention in which participants savor (intensify and prolong) positive emotions associated with the connection experienced with another person, particularly those involving the provision of safe haven/secure base attachment care, is associated with a state of lower cardiovascular reactivity (lower heart rate) during its enactment, as well as greater agency and lower passivity in a post-savoring advice-giving task. We compare all outcomes to participants randomized to a control condition utilized in prior investigations of relational savoring. Results suggest that relational savoring results in lower reactivity and greater agency and passivity. Although preliminary and obtained within a small sample, these findings provide early evidence of the potential of this approach with this population.
Cognitive and Academic Outcomes Following Childhood Cortical Stroke
Authors: Peterson Rachel K. , Williams Tricia S. , McDonald Kyla P. , Dlamini Nomazulu , Westmacott Robyn
Published: August 2019

The majority of pediatric neuropsychological stroke research has focused on perinatal stroke outcomes given its relative frequency. Meanwhile, childhood-onset stroke is under-represented in the literature, resulting in limited knowledge about its neurocognitive sequelae. This retrospective study examined cognitive outcomes in children and youth (n = 27) with childhood arterial ischemic stroke (stroke occurring between 29 days and 18 years of life) isolated to the cortical region. Intellectual, academic, language, visual-perception, visual-motor integration, fine motor coordination, and executive function scores were examined relative to normative means. Results indicate that although these children are doing well in terms of general intellectual ability, they demonstrate lower scores on tasks of processing speed and fine motor coordination. Exploratory analysis also revealed that of the personal and neurologic factors examined, age at stroke was positively correlated with perceptual reasoning and fine motor control, age at assessment was negatively correlated with math calculation abilities, and maternal education was positively correlated with working memory and parent-reported behavioral regulation and impulse inhibition abilities. While neurologic variables were not predictive of cognitive neuropsychological outcomes, those with significant poorer performance had higher rates of medium/large, right-sided lesions with frontal lobe involvement. Our results highlight the overall resilience of the injured developing brain but also the vulnerability of specific cognitive skills within this unique population.
From Economic Abuse to Economic Empowerment: Piloting a Financial Literacy Curriculum With Women Who Have Experienced Domestic and Family Violence
Authors: Warren Amy , Marchant Trudi , Schulze Darcee , Chung Donna
Published: August 2019

Economic abuse as a form of men’s violence against women has only been recently recognized as a form of violence in its own right. It is known to further exacerbate the detrimental long-term impacts of domestic and family violence on women and children. There is evidence to suggest the effectiveness of financial literacy programs in mitigating some of these impacts and improving women’s financial well-being in the longer term; however, there are very few domestic violence–informed, empirically evaluated programs internationally. This article reports the findings of a specialist domestic violence financial literacy curriculum, which was developed and piloted in Western Australia using pre–post measures and focus groups. These findings suggest that such financial literacy programs delivered in refuge settings have effective short-term outcomes among women. Lessons learned from the pilot and the implications for future implementation and scaling up of programs and research are also discussed.
Rerum Novarum: Theological Reasoning for the Public Sphere?
Authors: Daughton Amy
Published: August 2019

Contemporary Catholic Social Teaching has increasingly come to bear on the moral and political horizons of our interdependent lives, seeking to address the nature and purpose of our common striving for human flourishing. Frequently, Rerum Novarum is identified as an origin point for CST as a distinctive thread within the deeper tradition of Catholic theology attentive to justice and the common good. The focus on justice in labour practices, especially living wages and social participation, demonstrates its contemporary relevance, but can it contribute to the public debate on such issues, beyond the framework of its particular convictions? This article suggests that Rerum Novarum offers theological reasoning in and for the public sphere by way of its insistence on the social bond as foundation and task; the role of political and cultural plurality in formation and action; and a rich vision of public life as morally participatory for all.
Anti-windup disturbance suppression control of feedback linearizable systems with application to hypersonic flight vehicles
Authors: An Hao , Wu Qianqian
Published: August 2019

This paper deals with the anti-windup control problem for a class of feedback linearizable systems subject to external disturbances and constrained actuators. The original system is approximately feedback linearized into a tractable form with additive mismatched disturbances. A baseline disturbance suppression control is built on the combination of a disturbance observer and a compensation law. Moreover, this baseline control is strengthened by two anti-windup mechanisms to accommodate the possible input saturation, leading to the anti-windup disturbance suppression control. The resulting control schemes guarantee output tracking errors to be bounded in the presence of input saturation, while the zero steady-state tracking is finally achieved due to the recovery property. The proposed methods are applied to the longitudinal tracking control of hypersonic flight vehicles to highlight their efficiency and superiority.
Being Bullied Is Associated With Depression Among Malaysian Adolescents: Findings From a Cross-Sectional Study in Malaysia
Authors: Abd Razak Mohamad Aznuddin , Ahmad Noor Ani , Abd Aziz Fazly Azry , Jamaluddin Rasidah , Sidik Sherina Mohd , Awaluddin S. Maria , Ibrahim Nurashikin , Tan LeeAnn , Sooryanarayana Rajini
Published: August 2019

Limited evidence on the association of being bullied with depression among adolescents was found in Malaysia. This study aimed to determine the association of being bullied and depression among Malaysian school-going adolescents. Data from the National Health and Morbidity Survey 2017, a cross-sectional study conducted from March to May 2017, was analyzed using descriptive and multiple logistic regression analysis. A validated tool, the Depression, Anxiety, and Stress Scale-21 was used to categorize those with moderate or higher levels of depressive symptoms as having depression. A total of 27 399 school-going adolescents participated and 18.3% were found depressed. Adolescents of Indian ethnicity (adjusted odds ratio [aOR] = 2.02, P < .001), those with parents living apart (aOR = 1.41, P < .001), and those who were being bullied (aOR = 2.98, P < .001) were more likely to have depression. This study demonstrated the association between being bullied and having depression. Comprehensive preventive strategies should be implemented taking into consideration the findings from this study.
Convergences of Joint, Positive Interactions and Regulation in Collaborative Learning
Authors: Isohätälä Jaana , Näykki Piia , Järvelä Sanna
Published: August 2019

This qualitative study explores the convergences of small groups’ joint, positive interactions and regulation in social interaction during collaborative learning. We analyzed the video-recorded social interactions of five groups of student teachers during environmental science tasks. We examined the frequency and functions of the situations in which joint participation and positive socioemotional interaction converged with regulation (planning, monitoring, and evaluating) in social interaction. The results show that when groups planned, monitored, or evaluated their learning, they participated more jointly in social interaction and showed more socioemotional support than in interactions with no observed regulation. The situations in which these elements converged served three functions: establishing agreement, responding to challenges or mistakes, and discussing strengths and weaknesses. The results suggest that the convergences of joint, positive interactions and regulation in social interaction can serve a function that is meaningful for collaborative learning progress.
Quantity and Quality of Parental Utterances and Responses to Children With Hearing Loss Prior to Cochlear Implant
Authors: Su Pumpki L. , Roberts Megan Y.
Published: August 2019

This study investigated the extent to which parental language input to children with hearing loss (HL) prior to cochlear implant (CI) differs from input to children with typical hearing (TH). A 20-min parent–child interaction sample was collected for 13 parent–child dyads in the HL group and 17 dyads in the TH group during free play. Ten minutes were transcribed and were coded for four variables: (a) overall utterances, (b) high-quality utterances, (c) utterances in response to child communicative acts (i.e., overall responses), and (d) high-quality utterances in response to child communicative acts (i.e., high-quality responses). Differences were detected for both quantity and quality of parental language input across the two groups. Early language skills correlated with three out of the four parental variables in both groups. Post hoc analyses suggested that the lower rate of high-quality responses in parents of children with HL could be attributed to lower intelligibility of child communication.
Application of rich in β-glucan flours and preparations in bread baked from frozen dough
Authors: Andrzej Kurek Marcin , Małgorzata Moczkowska , Sabina Karp , Horbańczuk Olaf K , Rodak Ewelina
Published: August 2019

This study aims to define the changes in the quality of bakery products depending on the β-glucan source and its contribution using bake-off technology. The examined bread was enriched with a 10% addition of oat flour, barley flour, oat fibre preparation, and barley fibre preparation. Bread was tested for rheological parameters, baking performance, hardness and springiness, water content, specific volume, porosity, crust and crumb colour, and β-glucan content. In the executed research, the adverse effect of this component on the formation of gluten network and hardness of the crumb was observed. In the double compression test, it was shown that the highest hardness on the day of baking was characterized by the bread with the addition of barley preparation. The fastest rate of staling was observed in the bread with additional barley flour that was affected by the highest amount of β-glucan. A significant decrease of the β-glucan level was also found during the technological bake-off process, which can be explained by the activity of enzymes.
Good fences make good revenue: An examination of revenue management practices at peer-to-peer accommodations
Authors: Koh Yoon , Belarmino Amanda , Kim Min Gyung
Published: August 2019

While hotel revenue managers utilize tools such as pricing, market segmentation, rate fences, and forecasting to maximize revenue, hosts in peer-to-peer (P2P) accommodations often have limited knowledge and lack the sophisticated pricing tools. Despite online resources for revenue management available, there has yet to be an examination regarding how widely spread these practices are in the P2P accommodation segment. Based on daily best available rates and booking restrictions information for P2P accommodations listed on Airbnb from top 10 cities with highest room inventories in the United States, this study aims to shed light on the current state of revenue management adoption on Airbnb. Utilizing a total of 307,955 Airbnb property’s daily data for 32 months, this study found that there are significant differences in revenue management practices by host characteristics (multi-unit hosts vs. single-unit hosts: Superhosts vs. non-Superhosts) for three revenue management tactics: dynamic pricing, minimum night’s stay, and restricted cancellation, and the hosts practices changes as their experience accumulates.
What does the notion of “sovereignty” mean when referring to the digital?
Authors: Couture Stephane , Toupin Sophie
Published: August 2019

This article analyzes how the notion of “sovereignty” has been and is still mobilized in the realm of the digital. This notion is increasingly used to describe various forms of independence, control, and autonomy over digital infrastructures, technologies, and data. Our analysis originates from our previous and current research with activist “tech collectives” where we observed a use of the notion to emphasize alternative technological practices in a way that significantly differs from a governmental policy perspective. In this article, we review several publications in order to show the difference, if not diverging ways in which the notion is being conceptualized, in particular by different groups. We show that while the notion is generally used to assert some form of collective control on digital content and/or infrastructures, the precise interpretations, subjects, meanings, and definitions of sovereignty can significantly differ.
If I say you’re authentic, then you’re authentic: Power and privilege revealed in travel blogs
Authors: Duffy Andrew
Published: August 2019

A leitmotif in scholarship on travel texts has been themes of power and privilege. It is not clear, however, whether the more populist, egalitarian and non-elitist form of travel media, travel blogs, fits into this pattern. This article considers the role of power in how bloggers press authenticity into service as a marker of value in travel. It argues that they use authenticity to place themselves in a position of privilege and power over the local people they interact with. It identifies three forms of traveller authenticity – experience, existence and expectation – as a framework to study structures of power, privilege and dominance implicit in travel as revealed by its use in travel blogs. These forms of authenticity all demonstrate the traveller’s positioning of the self at the centre of the gaze on others. This has application for future theorising on the label of ‘authenticity’ as a tool of power.
Tumor-Treating Fields Induce RAW264.7 Macrophage Activation Via NK-κB/MAPK Signaling Pathways
Authors: Park Jeong-In , Song Kyung-Hee , Jung Seung-Youn , Ahn Jiyeon , Hwang Sang-Gu , Kim Joon , Kim Eun Ho , Song Jie-Young
Published: August 2019

Objective:

Tumor-treating fields are currently used to successfully treat various cancers; however, the specific pathways associated with its efficacy remain unknown in the immune responses. Here, we evaluated tumor-treating fields–mediated initiation of the macrophage-specific immune response.

Materials and Methods:

We subjected RAW 264.7 mouse macrophages to clinically relevant levels of tumor-treating fields (0.9 V/cm, 150 kHz) and evaluated alterations in cytokine expression and release, as well as cell viability. Additionally, we investigated the status of immunomodulatory pathways to determine their roles in tumor-treating fields–mediated immune activation.

Results and Discussion:

Our results indicated that tumor-treating fields treatment at 0.9 V/cm decreased cell viability and increased cytokine messenger RNA/protein levels, as well as levels of nitric oxide and reactive oxygen species, relative to controls. The levels of tumor necrosis factor α, interleukin 1β, and interleukin 6 were markedly increased in tumor-treating fields–treated RAW 264.7 cells cocultured with 4T1 murine mammary carcinoma cells compared with those in 4T1 or RAW 264.7 cells with or without tumor-treating fields treatment. Moreover, the viability of 4T1 cells treated with the conditioned medium of tumor-treating fields–stimulated RAW 264.7 cells decreased, indicating that macrophage activation by tumor-treating fields effectively killed the tumor cells. Moreover, tumor-treating fields treatment activated the nuclear factor κB and mitogen-activated protein kinase pathways involved in immunomodulatory signaling.

Conclusion:

These results provide critical insights into the mechanisms through which tumor-treating fields affect macrophage-specific immune responses and the efficacy of this method for cancer treatment.
Rhodium(III)-catalyzed one-pot synthesis of flavonoids from salicylaldehydes and sulfoxonium ylides
Authors: Cheng Kang , Chen Jinkang , Jin Licheng , Zhou Jian , Jiang Xinpeng , Yu Chuanming
Published: August 2019

Rh(III)-catalyzed C–H activation of salicylaldehyde followed by an insertion reaction with sulfoxonium ylides and cyclization is applied to the synthesis of flavonoids. This one-pot strategy exhibits good functional group tolerance and gives flavones in moderate-to-good yields.
Modeling customer satisfaction in microfinance sector: A fuzzy Bayesian networks approach
Authors: Lamrani Alaoui Youssef , Tkiouat Mohamed
Published: August 2019

Microfinance refers to the provision of financial services like saving, microcredit, and insurance to the poor who have limited access to traditional banking services with the aim of reducing their poverty. However, in the last decade, the literature stresses that the microfinance institutions focus more on their profit rather than the customer. Numerous methods have been used to model customer satisfaction in microfinance. However, a large majority of these methods is unable to take into account complex interactions and dependencies between variables. They may also find difficulties in handling limited and uncertain knowledge. The objective of this article is to model the effect of microfinance-lending process operations on overall customer satisfaction. We managed to develop a fuzzy Bayesian networks model; such an approach is widely required for modeling complex systems characterized by sparse or uncertain information as well as for conducting the cause and effect analysis.
Combinatorial Action of Triterpenoid, Flavonoid, and Alkaloid on Inflammation
Authors: Sabu Vidya , Peter Jasmine , Sasidharan Nair Aswathy Indira Bai , Krishnan Santhi , Sathyaseelan Suja Lal Preethi , Helen Antony , Radhakrishna Pillai Gopala
Published: August 2019

In the present study, the synergistic effects of BASk, a combination of betulinic acid (B), apigenin (A), and skimmianine (Sk) in the ratio of 1:1:1, were studied to construct a novel drug mixture against inflammation via the TLR4-nuclear factor Kappa light chain enhancer of activated B cells (NFκB) signaling pathway. In silico drug likeness and docking studies recommended 3 bioactive compounds as suitable ligands for drug development. BASk inhibited TLR4 from its dimerization with MD2 and blocked the TLR4 signaling cascade. Reduced nuclear translocation of NFκB inhibited the release of pro-inflammatory mediators (IL-1β and TNF-α), COX-2 expression, and PGE2. Similarly, BASk exerted its protective role by reducing pro-inflammatory mediators and elevating anti-inflammatory cytokine, IL-10. This confirms the inhibiting potential of BASk in the activation of the TLR4-NFκB signaling cascade. Thus, BASk was superior in its anti-inflammatory effect on oxidized low density lipoprotein (ox-LDL) induced human peripheral blood mononuclear cells than its individual components synergistically. Since BASk inhibited COX-2 expression and further release of PGE2, it is a potent therapeutic agent with better efficacy against inflammation because COX-2 is the target site for treating inflammatory diseases. Thus, it can be clearly stated that this innovation will be a breakthrough in the treatment of inflammatory diseases.
Residual platelet reactivity after pre-treatment with ticagrelor prior to primary percutaneous coronary intervention is associated with suboptimal myocardial reperfusion
Authors: Roule Vincent , Heudel Thibaut , Lemaitre Adrien , Bignon Mathieu , Ardouin Pierre , Sabatier Rémi , Blanchart Katrien , Beygui Farzin
Published: August 2019

Background

The evidence of a clinical benefit of P2Y12 inhibitor pre-treatment in primary percutaneous coronary intervention (PCI) and the relation between the level of platelet inhibition and myocardial reperfusion with newer potent P2Y12 inhibitors remain unclear. We aimed to assess the relationship between platelet reactivity at the time of primary PCI after pre-treatment with aspirin and ticagrelor and the post-PCI myocardial blush grade (MBG).

Methods

We prospectively included 61 patients. Platelet reaction units for ticagrelor (PRU) and aspirin reaction units (ARU) were measured using the point-of-care test VerifyNow before PCI. The high on-ticagrelor (PRU >208) and on-aspirin (ARU ⩾ 550) platelet reactivity (HPR and HaPR) were assessed. Patients were divided into two groups according to MBG 3 or <3.

Results

MBG 3 was identified in 28 (46%) patients. Mean PRU was lower in such patients as compared with those with MBG <3 (155.82 ± 90.91 vs. 227.42 ± 65.18; p=0.001) while mean ARU was similar between groups. HPR and HaPR were observed in 30 (49.2%) and 11 patients (18%), respectively. HPR but not HaPR was more frequent in the group with impaired MBG (66.7 vs. 28.6%; p=0.003 and 21.2 vs. 14.3%; p=0.48 respectively).

Conclusion

Our study shows that higher PRU and the subsequent HPR at the time of primary PCI, after pretreatment with ticagrelor, are the only correlates of post PCI MBG. These findings support the earliest possible loading with ticagrelor prior to primary PCI.
Medical Supervision of High School Athletics in Chicago: A Follow-up Study
Authors: Jones Nathaniel S. , Wieschhaus Kyle , Martin Brendan , Tonino Pietro M.
Published: August 2019

Background:

High school sports participation in the United States has increased dramatically over the past 25 years. A corresponding increase in the number of injuries has been noted, particularly in contact sports such as football. This has led medical and sports organizations nationwide to advocate for proper medical supervision of athletes at games and practices.

Purpose:

To gather information from Chicago public high schools to gauge how medical supervision for high school sports has changed in 2017 compared with 2003.

Study Design:

Cross-sectional study.

Methods:

Survey questionnaires were sent to the athletic directors of all 99 Chicago public high schools to complete via email. The questionnaire survey contained the same questions as in a survey conducted in 2003 by Tonino and Bollier, with the addition of 4 novel questions relating to emergency action plans (EAPs), automated external defibrillators, concussion management policy, and tackling progression drills.

Results:

The response rate was 66.67% (66/99 schools). Of the 66 responding schools, all with football programs, no school had a physician on the sideline at home games (decrease from 10.6% in 2003), 37.9% had an athletic trainer present (increase from 8.5% in 2003), and 63.6% had a paramedic available (decrease from 89.4% in 2003). In 2017, 65.6% of responding schools had a coach certified in cardiopulmonary resuscitation (CPR) available at practice to handle medical problems, compared with 89.4% in 2003 ( P < .001). Regarding the 4 novel questions, 93.9% of the responding schools had proper tackling progression drills in place, followed by 89.1% who had appropriate EAPs and 93.9% with concussion management protocols, including return-to-play and return-to-learn protocols.

Conclusion:

Although significant improvement was found in athletic trainer coverage, especially at games, physician coverage was lacking and fewer coaches were certified in CPR in 2017 compared with 2003. EAPs and concussion management protocols were present in most Chicago public high schools. Overall, greater medical supervision is needed, which we believe should come in the form of increased athletic training and physician involvement and coverage, given that expert, expedited medical care saves lives.
Acute corneal perforation 1 week following uncomplicated cataract surgery: the implication of undiagnosed dry eye disease and topical NSAIDs
Authors: Ting Darren Shu Jeng , Ghosh Saurabh
Published: August 2019

Dry eye disease is a common ocular surface disease in patients who are undergoing cataract surgery. The significance of dry eye disease is often underestimated or overlooked during preoperative assessment of cataract. We report an 80-year-old patient, with a background of seropositive rheumatoid arthritis and diabetes, who presented with an acute corneal melt and perforation associated with undiagnosed dry eye disease and use of topical ketorolac 1 week following an uncomplicated cataract surgery. The patient underwent repeated corneal gluing for corneal perforation and was subsequently diagnosed and treated for bilateral moderate-severe dry eye disease. This case highlights the importance of meticulous preoperative assessment and management of the ocular surface, especially in patients with systemic diseases such as rheumatoid arthritis and diabetes prior to cataract surgery. The implication of the use of topical nonsteroidal anti-inflammatory drugs following cataract surgery – which might have contributed to the process of corneal melt in our case – is also discussed.
A pilot study of pembrolizumab in smoldering myeloma: report of the clinical, immune, and genomic analysis
Authors: Manasanch Elisabet E. , Han Guangchun , Mathur Rohit , Qing Yun , Zhang Zheng , Lee Hans , Weber Donna M. , Amini Behrang , Berkova Zuzana , Eterovic Karina , Zhang Shaojun , Zhang Jianhua , Song Xingzhi , Mao Xizeng , Morgan Margaret , Feng Lei , Baladandayuthapani Veera , Futreal Andrew , Wang Linghua , Neelapu Sattva S. , Orlowski Robert Z.
Published: August 2019

Multiple myeloma is, in most patients, an incurable cancer. Its precursors can be identified with routine tests setting the stage for early intervention to prevent active myeloma. We investigated the efficacy and safety of pembrolizumab, an antiprogrammed cell death 1 antibody, in smoldering myeloma patients with intermediate/high risk of progression to symptomatic myeloma. Thirteen patients were treated with a median number of 8 cycles. One patient achieved a stringent complete response with bone marrow next-generation sequencing negativity at 10−4 that is ongoing at 27 months (8%); 11 had stable disease (85%), and 1 progressed (8%). Three patients discontinued therapy due to immune-related adverse events: 2 with transaminitis and 1 due to tubulointerstitial nephritis. Immune profiling of bone marrow samples at baseline showed markers associated with a preexisting immune response in the responder compared with nonresponders and features of increased T-cell exhaustion in nonresponders. Consistent with this, transcriptome sequencing of bone marrow samples at baseline revealed an increased interferon-γ signature in the responder compared with the nonresponders. In summary, our results suggest that smoldering myeloma may be immunogenic in a subset of patients, and therapies that enhance antitumor T-cell responses may be effective in preventing its progression. This trial was registered at www.clinicaltrials.gov as #NCT02603887.
Systematic review and meta-analysis of the efficacy and safety of apixaban compared to rivaroxaban in acute VTE in the real world
Authors: Aryal Madan Raj , Gosain Rohit , Donato Anthony , Yu Han , Katel Anjan , Bhandari Yashoda , Dhital Rashmi , Kouides Peter A.
Published: August 2019

Both apixaban and rivaroxaban have been approved for use in acute venous thromboembolism (VTE). Although indirect comparison through network meta-analyses of randomized trials have been performed to compare the efficacy and safety of these agents, further comparison between these agents was lacking until recently. We sought to systematically review and carry out a meta-analysis of studies to further compare apixaban with rivaroxaban from multiple studies done in the real-world settings. Studies comparing rivaroxaban with apixaban in patients with acute VTE were identified through electronic literature searches of MEDLINE, EMBASE, Scopus, and the Cochrane library up to May 2019. Study-specific risk ratios (RRs) were calculated and combined using a random-effects model meta-analysis. In an analysis involving 24 041 patients, recurrent VTE within 6 months occurred in 56 of 4897 patients (1.14%) in the apixaban group and 258 of 19 144 patients (1.35%) in the rivaroxaban group (RR, 0.89; 95% confidence interval [CI], 0.67-1.19; P = .45). Clinically relevant major bleeding occurred in 85 of 11 559 patients (0.74%) in the apixaban group and 350 of 33 909 patients (1.03%) in the rivaroxaban group (RR, 0.73; 95% CI, 0.58-0.93; P = .01). Clinically relevant nonmajor bleeding occurred in 169 of 3417 patients (4.95%) in the apixaban group and 1094 of 12 475 patients (8.77%) in the rivaroxaban group (RR, 0.59; 95% CI, 0.50-0.70; P < .01). Apixaban shows equivalent efficacy in prevention of recurrent VTE but decreased risk of major and minor bleeding events compared with rivaroxaban.
RNA sequencing of transplant-stage idiopathic pulmonary fibrosis lung reveals unique pathway regulation
Authors: Sivakumar Pitchumani , Thompson John Ryan , Ammar Ron , Porteous Mary , McCoubrey Carly , Cantu Edward , Ravi Kandasamy , Zhang Yan , Luo Yi , Streltsov Denis , Beers Michael F. , Jarai Gabor , Christie Jason D.
Published: August 2019

Idiopathic pulmonary fibrosis (IPF), the scarring of lung parenchyma resulting in the loss of lung function, remains a fatal disease with a significant unmet medical need. Patients with severe IPF often develop acute exacerbations resulting in the rapid deterioration of lung function, requiring transplantation. Understanding the pathophysiological mechanisms contributing to IPF is key to develop novel therapeutic approaches for end-stage disease.

We report here RNA-sequencing analyses of lung tissues from a cohort of patients with transplant-stage IPF (n=36), compared with acute lung injury (ALI) (n=11) and nondisease controls (n=19), that reveal a robust gene expression signature unique to end-stage IPF. In addition to extracellular matrix remodelling pathways, we identified pathways associated with T-cell infiltration/activation, tumour development, and cholesterol homeostasis, as well as novel alternatively spliced transcripts that are differentially regulated in the advanced IPF lungversusALI or nondisease controls. Additionally, we show a subset of genes that are correlated with percent predicted forced vital capacity and could reflect disease severity.

Our results establish a robust transcriptomic fingerprint of an advanced IPF lung that is distinct from previously reported microarray signatures of moderate, stable or progressive IPF and identifies hitherto unknown candidate targets and pathways for therapeutic intervention in late-stage IPF as well as biomarkers to characterise disease progression and enable patient stratification.
Germ Cell Tumors in Adolescents and Young Adults
Authors: Fonseca Adriana , Frazier A. Lindsay , Shaikh Furqan
Published: August 2019

Germ cell tumors (GCTs) are rare in childhood, representing only 3.5% of childhood cancers, but a common malignancy in adolescents and young adults (AYAs), accounting for 13.9% of neoplasms in adolescents between age 15 and 19 years. The overall outcomes of patients treated for GCTs are excellent. However, as seen in other cancers, outcomes for AYA patients are significantly worse. Understanding the reasons for this observation has led to different approaches to diagnosis, staging, and treatment. The Malignant Germ Cell International Consortium was created to bring together pediatric, gynecologic, and testicular cancer specialists to promote research initiatives and provide evidence-based approaches in the management of GCTs across different age groups. Collaboration between multiple subspecialties is essential to further understand the disease continuum, the underlying biologic characteristics, and the development of appropriate therapeutic approaches. This review focuses on the unique characteristics of patients with extracranial GCTs in the AYA group.