bluuebunny/crossref_metadata_2025 huggingface dataset:
Political events and mood among young physicians: a prospective cohort study
Authors: Frank Elena , Nallamothu Brahmajee K , Zhao Zhuo , Sen Srijan
Published: December 2019

Objective

To study the effects of recent political events on mood among young physicians.

Design

Prospective cohort study.

Setting

United States medical centres.

Participants

2345 medical interns provided longitudinal mood data as part of the Intern Health Study between 2016 and 2018.

Main outcome measures

Mean mood score during the week following influential political and non-political events as compared with mean mood during the preceding four week control period.

Results

We identified nine political events and eight non-political events for analysis. With the start of internship duties in July, the mean decline in mood for interns was −0.30 (95% confidence interval −0.33 to −0.27, t=−17.45, P<0.001). The decline in mood was of similar magnitude following the 2016 presidential election (mean mood change −0.32, 95% confidence interval −0.45 to −0.19, t=−4.73, P<0.001) and subsequent inauguration (mean mood change −0.25, 95% confidence interval −0.37 to −0.12, t=−3.93, P<0.001). Further, compared with men, women reported greater mood declines after both the 2016 election (mean gender difference 0.31, 95% confidence interval 0.05 to 0.58, t=2.33, P=0.02) and the inauguration (mean gender difference 0.25, 95% confidence interval 0.01 to 0.49, t=2.05, P=0.04). Overall, there were statistically significant changes in mood following 66.7% (6/9) of political events assessed. In contrast, none of the non-political events included in the analysis were statistically significantly associated with a change in mood.

Conclusions

Macro level factors such as politics may be correlated with the mood of young doctors. This finding signals the need for further evaluation of the consequences of increasing entanglement between politics and medicine moving forward for young physicians and their patients.
Exposure to tobacco marketing in bars predicts subsequent use of multiple tobacco products among non-tobacco-using college students
Authors: Herrera Ana Laura , Pasch Keryn E , Marti C Nathan , Loukas Alexandra , Perry Cheryl
Published: December 2019

Background

Due to other marketing restrictions, one venue where tobacco companies concentrate their marketing efforts to reach young adults is bars/nightclubs.

Objective

This study examined the relationship between exposure to tobacco marketing in bars/nightclubs and number of alternative tobacco/nicotine products used 6 months later among college students.

Methods

Participants were 1,406 students aged 18–29 years old who reported going to bars or nightclubs at least rarely (M age=21.95; 67% female; 46% non-Hispanic white). Students completed an online survey in fall 2014/spring 2015 (wave 1) and again 6 months later (wave 2). Multilevel Poisson regression models were used to assess the relationship between exposure to three types of marketing at bars/nightclubs at wave 1 (tobacco/nicotine product advertisements; free samples; industry representatives) and number of tobacco products used (range=0–5) at wave 2, controlling for school type (2 year vs 4 year), age, sex, race/ethnicity and frequency of bar visits. An interaction between the number of wave 1 products and each marketing variable was tested.

Results

Greater exposure to free samples and tobacco industry representatives at bars/nightclubs predicted a greater number of products used 6 months later, but only among wave 1 non-tobacco users and not among tobacco users. Exposure to advertisements at bars/nightclubs did not predict the number of products used 6 months later.

Conclusion

Tobacco companies claim that marketing is targeted to those who already use the product, not to non-users. However, the current study indicates tobacco marketing in bars and nightclubs may encourage use among non-users and has no influence on current users.
Exit lane allocation with the lane-based signal optimization method at isolated intersections
Authors: Tang Qinrui , Sohr Alexander
Published: December 2019

In signal optimization problems, incompatible movements are usually in either of two states: predecessor or successor. However, if the exit lane is well allocated, the incompatible movements merging at the same destination arm can exist in parallel. The corresponding longer green duration is expected to increase the capacity of intersections. This paper aims to solve the exit lane allocation problem with the lane-based method by applying the three states among incompatible movements at conventional signalized intersections. After introducing auxiliary variables, the problem is formulated as a mixed integer programming and can be solved using a standard branch-and-cut algorithm. In addition to the exit lane allocation results, this proposed method can also determine the cycle length, green duration, start of green, and signal sequence. The results show that the proposed method can obtain a higher capacity than that without the exit lane allocation. The pavement markings are further suggested for safety.
The effect of apelin-13 on gastric ischemia/reperfusion injury: the roles of sensory nerves and vagus nerve
Authors: Birsen İlknur , İzgüt-Uysal V. Nimet , Soylu Hakan , Üstünel İsmail
Published: December 2019

Apelin is a peptide that plays a role in physiological processes such as angiogenesis, apoptosis, and proliferation. The aim of this study was to investigate the role of capsaicin-sensitive afferent neurons and vagus in the effect of apelin against ischemia/reperfusion (I/R) injury. The experimental groups were (1) control, (2) I/R, (3) apelin + I/R, (4) vagotomy + I/R, (5) vagotomy + apelin + I/R, (6) capsaicin + I/R, (7) capsaicin + apelin + I/R, (8) lorglumide + I/R, and (9) lorglumide + apelin + I/R. To test the potential gastroprotective effect of apelin-13, apelin-13 (2 mg/kg i.v.) was administered just before both ischemia and reperfusion. A vagotomy was performed 1 week before I/R in the vagotomized groups; capsaicin (125 mg/kg s.c.) was administrated 2 weeks before I/R in the capsaicin-treated groups and lorglumide (5 mg/kg i.p.) was administered 30 min before I/R in the lorglumide-treated groups. After I/R, a variety parameters in gastric tissue were analyzed. cfos expression was determined in brainstem samples. In the I/R group, the lesion index, myeloperoxidase activity, lipid peroxidation, nitric oxide, and tumor necrosis factor-α increased, and mucosal blood flow, prostaglandin-E2, and calcitonin gene related peptide decreased. Apelin prevented the damaging effects of I/R and increased cfos expression in brainstem areas. Vagotomy, capsaicin, and lorglumide largely eliminated the gastroprotective effects of apelin-13. This study showed that sensory nerves and the vagus play regulatory roles in apelin-induced gastroprotection. Cholecystokinin may play a role in the effect of apelin through sensory neurons.
Bifurcation in Plant-Pest-Natural Enemy Interaction Dynamics with Gestation Delay for Both Pest and Natural Enemy
Authors: Kumar Vijay , Dhar Joydip , Bhatti Harbax Singh
Published: December 2019

During this analysis, as per natural control approach in pest management, a plant-pest dynamics with biological control is proposed, here assuming that the pest and natural enemy are having different levels of gestation delay and harvesting rate of pests by natural enemy follows Holling type-III response function. Boundedness and positivity of the system are studied. Equilibria and stability analysis is carried out for possible equilibrium points. The existence of Hopf bifurcation at interior equilibrium is presented. The sensitivity analysis of the system at interior equilibrium point for model parameters has been explored. Numerical simulations are performed to support our analytic findings.
Black hole magnetospheres in the Born–Infeld theory
Authors: Li Huiquan , Wang Jiancheng
Published: December 2019

We study the force-free electrodynamics on rotating black holes in the Born–Infeld (BI) effective theory. The stream equation describing a steady and axisymmetric magnetosphere is derived. From its near-horizon behavior, we obtain the modified Znajek regularity condition, with which we find that the horizon resistivity in the BI theory is generally not a constant. As expected, the outer boundary condition far away from the hole remains unchanged. In terms of the conditions at both boundaries, we derive the perturbative solution of split monopole in the slow rotation limit. It is interesting to realize that the correction to the solution relies not only on the parameter in the BI theory, but also on the radius (or the mass) of the hole. We also show that the quantum effects can undermine the energy extraction process of the magnetosphere in the nonlinear theory and the extraction rate gets the maximum in the Maxwell theory.
Clustering Categorical Data: A Survey
Authors: Naouali Sami , Ben Salem Semeh , Chtourou Zied
Published: December 2019

Clustering is a complex unsupervised method used to group most similar observations of a given dataset within the same cluster. To guarantee high efficiency, the clustering process should ensure high accuracy and low complexity. Many clustering methods were developed in various fields depending on the type of application and the data type considered. Categorical clustering considers segmenting a dataset in which the data are categorical and were widely used in many real-world applications. Thus several methods were developed including hard, fuzzy and rough set-based methods. In this survey, more than 30 categorical clustering algorithms were investigated. These methods were classified into hierarchical and partitional clustering methods and classified in terms of their accuracy, precision and recall to identify the most prominent ones. Experimental results show that rough set-based clustering methods provided better efficiency than hard and fuzzy methods. Besides, methods based on the initialization of the centroids also provided good results.
A Novel Flash P2P Network Traffic Prediction Algorithm based on ELMD and Garch
Authors: Ji Yimu , Wu Ye , Zhang Dianchao , Yuan Yongge , Liu Shangdong , Zarei Roozbeh , He Jing
Published: December 2019

To improve the quality of service and network performance for the Flash P2P video-on-demand, the prediction Flash P2P network traffic flow is beneficial for the control of the network video traffic. In this paper, a novel prediction algorithm to forecast the traffic rate of Flash P2P video is proposed. This algorithm is based on the combination of the ensemble local mean decomposition (ELMD) and the generalized autoregressive conditional heteroscedasticity (GARCH). The ELMD is used to decompose the original long-related flow into the summation of the short-related flow. Then, the GRACH is utilized to predict the short-related flow. The developed algorithm is tested in a university’s campus network. The predicted results show that our proposed method can further achieve higher accuracy than those obtained by existing algorithms, such as GARCH and Local Mean Decomposition and Generalized AutoRegressive Conditional Heteroskedasticity (LMD-GARCH) while keeping lower computational complexity.
Zinc porphyrin-anthraquinonylimidazole supramolecular dyads
Authors: Sabuzi Federica , Coletti Alessia , Conte Valeria , Floris Barbara , Galloni Pierluca
Published: December 2019

In this work, the synthesis and spectroscopic characterization of new zinc porphyrin-anthraquinone dyads is proposed. In particular, electron donor units based on zinc meso-tetraphenylporphyrin (ZnTPP) and zinc octaethylporphyrin (ZnOEP) have been coupled with differently substituted anthraquinones as acceptors. The quinone moiety was properly functionalized with imidazole, thus ensuring porphyrin complexation through zinc ion coordination. Accordingly, absorption and emission measurements demonstrated that the coordination occurred, and calculated binding constants were in the range 6.6 [Formula: see text] 10[Formula: see text]–3.9 [Formula: see text] 10[Formula: see text] M[Formula: see text]. Transient absorption spectroscopy for ZnTPP and ZnOEP dyads demonstrated that the electron transfer occurred, with the formation of the corresponding charge separated state, ZnTPP[Formula: see text]-AQ. Moreover, in ZnOEP complexes, a strong correlation between the chain length and flexibility with the charge separated state lifetime was observed.
Learning how to learn: can embedded discussion boards help first-year students discover new learning strategies?
Authors: Ainscough Louise , Leung Richard , Colthorpe Kay
Published: December 2019

Learning anatomy and physiology at university can be challenging, as students need to understand both the language of the discipline and complex topics, such as system integration. Yet learning strategies are rarely taught at university, making it difficult for students to adopt new strategies, if their approach to learning has not been effective or efficient. This study evaluated the use of small-group peer discussion boards as an avenue for sharing learning strategies between students in a first-year anatomy and physiology course. The majority of students (91%) identified strategies from the discussion board worth trying before they completed the midsemester exam. The most frequently reported type of strategy was transforming records. By the end of semester, 76% of students had adopted at least one new strategy; however, these students performed significantly worse on the exam compared with students who did not adopt new strategies. The students who adopted new strategies learned about them from peers (33%), the discussion board (32%), or through self-discovery (32%). The majority of students (83%) found the discussion boards to be useful as a source of new learning strategies and for insight into how others learn. Although the discussion boards provided an avenue for students to learn about new strategies from each other, further guidance from instructors may be required to help students evaluate the effectiveness of these learning strategies.
Investigation of a Mild Solution to Coupled Systems of Impulsive Hybrid Fractional Differential Equations
Authors: Hannabou Mohamed , Khalid Hilal
Published: December 2019

The study of coupled systems of hybrid fractional differential equations requires the attention of scientists for the exploration of their different important aspects. Our aim in this paper is to study the existence and uniqueness of the solution for impulsive hybrid fractional differential equations. The novelty of this work is the study of a coupled system of impulsive hybrid fractional differential equations with initial and boundary hybrid conditions. We used the classical fixed-point theorems such as the Banach fixed-point theorem and Leray–Schauder alternative fixed-point theorem for existence results. We also give an example of the main results.
An Unusual Presentation of T-Cell Lymphoblastic Lymphoma with Isolated Renal Involvement
Authors: Aydın Köker Sultan , Koker Alper , Köksoy Adem Yasin , Kayadibi Yasemin , Gül Şiraz Ülkü , Tekin Emine
Published: December 2019

The clinical presentation of Non-Hodgkin lymphoma (NHL) is frequently associated with the involvement of the abdomen and mediastinal lymphadenopathies, but rarely the kidney, ovaries, and testicles. Here, we report a rare case of T-cell lymphoblastic lymphoma (T-LBL) presenting with bilateral nephromegaly without acute renal failure (ARF) as the first manifestation. A 30-month-old boy was admitted to the department of pediatric nephrology exhibiting abdominal distension. Physical examination revealed bilateral renal palpation up to the inguinal region. Elevated lactate dehydrogenase (LDH) levels were detected in his blood. Bilateral diffuse enlarged kidneys with increased hypoechogenicity were found on abdominal ultrasonography. In the next step, contrast-enhanced computed tomography showed diffusely enlarged kidneys, which were compressing the intestinal bowels and midline structures. Renal biopsy demonstrated precursor T-LBL. We wish to report our patient with renal T-LBL presenting with diffuse renal enlargement, which has rarely been reported in the literature.
Islet1 and Brn3 Expression Pattern Study in Human Retina and hiPSC-Derived Retinal Organoid
Authors: Luo Ziming , Xu Chaochao , Li Kaijing , Xian Bikun , Liu Yuchun , Li Kang , Liu Ying , Rong Huifeng , Tang Mingjun , Hu Dongpeng , Yang Sijing , Ye Meifang , Zhong Xiufeng , Ge Jian
Published: December 2019

This study was conducted to determine the dynamic Islet1 and Brn3 (POU4F) expression pattern in the human fetal retina and human-induced pluripotent stem cell- (hiPSC-) derived retinal organoid. Human fetal eyes from 8 to 27 fetal weeks (Fwks), human adult retina, hiPSC-derived retinal organoid from 7 to 31 differentiation weeks (Dwks), and rhesus adult retina were collected for cyrosectioning. Immunofluorescence analysis showed that Islet1 was expressed in retinal ganglion cells in the fetal retina, human adult retina, and retinal organoids. Unexpectedly, after Fwk 20, Brn3 expression gradually decreased in the fetal retina. In the midstage of development, Islet1 was detected in bipolar and developing horizontal cells. As the photoreceptor developed, the Islet1-positive cone precursors gradually became Islet1-negative/S-opsin-positive cones. This study highlights the distinguishing characteristics of Islet1 dynamic expression in human fetal retina development and proposes more concerns which should be taken regarding Brn3 as a cell-identifying marker in mature primate retina.
Validation of a Risk Equation Predicting Hemodialysis Arteriovenous Fistula Primary Failure in Elderly
Authors: Qian Joyce Z. , McAdams-DeMarco Mara A. , Ng Derek , Lau Bryan
Published: December 2019

Background: Choice of vascular access for older hemodialysis patients presents a special challenge since the rate of arteriovenous fistula (AVF) primary failure is high. The Lok’s risk equation predicting AVF primary failure has achieved good prediction accuracy and holds great potential for clinical use, but it has not been validated in the United States older hemodialysis patients. Methods: We assembled a validation data set of 14,892 patients aged 67 years and older who initiated hemodialysis with a central venous catheter between July 1, 2010, and June 30, 2012, and had a subsequent, incident AVF placement from the United States Renal Data System. We examined the external validity of Lok’s model by applying it to this validation data set. The discriminatory accuracy and calibration were evaluated by the concordance index (C-statistics) and calibration plot, respectively. Results: The observed frequency of AVF primary failure varied from 0.45 to 0.53 in hemodialysis patients in the validation data set. The predicted probabilities of AVF primary failure calculated by using the Lok’s risk equation ranged from 0.08 to 0.61, and 77.8, 40.5, and 51.7% of patients were categorized as having high, intermediate, and low risk of AVF primary failure, respectively. The C-statistics of the Lok’s risk equation in the validation data set was 0.53 (95% CI 0.52–0.54). The predicted probabilities of AVF primary failure corresponded poorly with the observed proportions in the calibration plot. Conclusions: When externally applied to a cohort of U.S. older hemodialysis patients, the Lok’s risk equation exhibited poor discrimination and calibration accuracy. It is invalid to use it to predict AVF primary failure. A more complex model with strong predictors is expected to better serve clinical determination for AVF placement in this population.
Objective evaluation versus subjective evaluation of flexion tests in the pelvic limb of horses
Authors: Azevedo Marcos Da Silva , De La Côrte Flávio Desessards , Pozzobon Ricardo , Dau Stefano Leite , Gallio Miguel
Published: December 2019

The agreement between subjective and objective evaluation methods was studied to identify claudication in the pelvic limbs of horses before and after flexion tests were performed. Twenty-nine horses were equipped with a wireless system of inertial sensors and evaluated during seven times while trotting. Videos were recorded to be evaluated by three veterinarians, with different levels of experience, to evaluate the agreement between the two different methods and between the evaluators. The evaluators and the objective evaluation had a low rate of agreement, with the exception of moderate agreement between the objective evaluation and evaluator 1 to identify lameness after the left total flexion and moderate agreement in evaluating the response to the tests, between objective evaluation and evaluator 2, after rightdistal flexion. This shows that there was a low agreement among the evaluators and between them and the objective evaluation for identifying lameness, measuring the degree of lameness and the response to the flexion tests.
Perceptual Expectations Modulate Low-Frequency Activity: A Statistical Learning Magnetoencephalography Study
Authors: Zhou Ying Joey , Pérez-Bellido Alexis , Haegens Saskia , de Lange Floris P.
Published: December 2019

Perceptual expectations can change how a visual stimulus is perceived. Recent studies have shown mixed results in terms of whether expectations modulate sensory representations. Here, we used a statistical learning paradigm to study the temporal characteristics of perceptual expectations. We presented participants with pairs of object images organized in a predictive manner and then recorded their brain activity with magnetoencephalography while they viewed expected and unexpected image pairs on the subsequent day. We observed stronger alpha-band (7–14 Hz) activity in response to unexpected compared with expected object images. Specifically, the alpha-band modulation occurred as early as the onset of the stimuli and was most pronounced in left occipito-temporal cortex. Given that the differential response to expected versus unexpected stimuli occurred in sensory regions early in time, our results suggest that expectations modulate perceptual decision-making by changing the sensory response elicited by the stimuli.
4. The Giant Sword and the Cross
Authors: Pettit Edward
Published: December 2019

In Chapter 4 the author continues to investigate the symbolism of the giant sword, consulting a variety of extant Anglo-Saxon and Scandinavian swords. Pettit suggests that the sword, both before its melting but especially after melting down to its golden hilt, could also link to the other principal symbol of Easter, the Cross of Christ. Pettit also considers the relevance of certain aspects of Beowulf’s fight with the dragon, such as Beowulf’s companion Wiglaf and the battle-standard that he claims from the dragon’s hoard.
5. Whose Sword Is It, Anyway?
Authors: Pettit Edward
Published: December 2019

Chapter 5 concerns the ownership of the giant sword. Pettit argues that the giant sword could have been the possession of a ‘righteous solar deity’ before Grendel stole it. If so the monser was likely motivated by a desire not only for self-protection but also for sunlight. Pettit likens this to the theft of the lightning-hammer of Þórr, the Norse thunder-god, before highlighting the recurrent theme of thievery in Beowulf. Pettit then concludes with comments on the basis for detecting Germanic myth in the poem, considering the likelihood that it was written in a pre-Viking conquest England.
15. The Sun in the Pike
Authors: Pettit Edward
Published: December 2019

Chapter 15 examines the Beowulf-poet’s description of Grendel’s mother as a ‘sword-greedy she-wolf’ of the sea. Pettit proposes that this characterization may identify her, if only fleetingly, as a wolfish fish, perhaps specifically a pike, with an appetite for swords of heavenly light. This idea finds parallel more or less closely in Finnish accounts of a pike’s swallowing of a spark of heavenly fire or of golden eggs from which the sun was formed; in Old Norse accounts of pike that swallowed, or trembled on, swords analogous to Beowulf’s giant sword; in a sun-devouring (and possibly solar-staff-swallowing) wolf-serpent on the Gosforth Cross; in ancient dragons such as the Babylonian Tiamat and Indian Vŗtra; and in the Christian identification of Hell as the mouth of a monstrous sea-creature.
“Thank You for Listening”: An Exploratory Study Regarding the Lived Experience and Perception of Medical Errors Among Those Who Receive Care
Authors: Terry Daniel , Kim Jeong-ah , Gilbert Julia , Jang Sunny , Nguyen Hoang
Published: December 2019

The issue of medical errors, or adverse events caused within a health care context or by a health care provider, is largely under-researched. While the experience and perspective of health care professionals regarding medical errors have been explored, little attention is paid to the health care consumers regarding their perceptions and experiences. Therefore, there is a need to better understand the public’s views on medical errors to enhance patient safety and quality care. The current study sought to examine Australian public perceptions and experiences, especially concerning what errors had occurred, the perceived sources of the errors, and if the errors had been reported. This paper reports the qualitative findings of an online survey for Australian residents who have accessed or received medical services at any time in Australia. Responses from 304 surveys were analyzed and discussed, including demographic information and key themes about medical errors, which were categorized into engagement and patients’ voices being heard, the quality of care being provided, and the system’s accountability. Based on the findings, the study highlights the importance of effective health professional–patient communication, enhanced capacity to deliver high quality care, and improved mechanism for error reporting and resolution where patients feel safe and confident about positive changes being made.
Socioeconomic Well-Being in Early Adulthood Among Repeat Versus One-Time Teenage Mothers
Authors: Cone Joshua N. , Hendrick C. Emily , Owotomo Olusegun , Al-Hamoodah Leila , Maslowsky Julie
Published: December 2019

Teenage mothers are known to be at an elevated risk for poor socioeconomic outcomes in adulthood. However, little is known about the socioeconomic outcomes of mothers who bear multiple children during the teenage years (repeat teenage mothers) compared to one-time teenage mothers. This study examines socioeconomic outcomes in the mid- to late-20s of repeat teenage mothers compared to one-time teenage mothers in a national U.S. sample. Repeat teenage mothers were less likely to graduate high school and more likely to receive public assistance and experience material hardship than one-time teenage mothers in their mid- to late-20s. Lower educational attainment, plus the responsibility of caring for multiple children as a young mother, may make it difficult for repeat teenage mothers to secure economic stability. Additional supports may be necessary to improve long-term socioeconomic outcomes of repeat teenage mothers.
Patient and Provider Perspectives Regarding Enrollment in Head and Neck Cancer Research
Authors: Shuman Andrew G. , Gornick Michele C. , Brummel Collin , Kent Madison , Spector‐Bagdady Kayte , Biddle Elliot , Bradford Carol R. , Brenner J. Chad
Published: December 2019

Objective

The advent of precision oncology complicates how clinicians and participants understand how clinical care and research interface. Here we examine how key stakeholders perceive the utility of, and evaluate the decision to participate in, genomic sequencing head and neck cancer research. The goal of this study was to highlight unique considerations for our community as this type of research proliferates across the country.

Study Design

Prospective multimethod qualitative and quantitative embedded ethics protocol.

Setting

Single‐institution National Cancer Institute–designated academic cancer center.

Subjects and Methods

Multimethod study using paired surveys and semistructured interviews among patients and providers involved in a prospective precision head and neck oncology sequencing protocol (116 survey patient‐participants, response rate 82%) with 18 interviewees.

Results

Participants were generally enthusiastic about enrollment in research, both to help future patients and as a way of giving back to the community. They described reliance on information from and trust in their cancer doctor regarding the decision to participate in research, but paradoxically there was discordance in how doctors and patients reported their respective influence in the decision‐making process. Clinicians also stressed the importance in separating clinical and research‐informed consent processes, although patients did not describe this tension.

Conclusion

As we enter an era of increasing personalized medicine and targeted therapies, the relationship between clinicians, scientists, and patients plays a larger role in how we individualize and contextualize cancer research. Our data are another step toward the ultimate goal of respecting and protecting patients as participants in head and neck translational oncology.
Examining the power role of Local Authorities in planning for socio-economic event impacts
Authors: Maguire Kelly
Published: December 2019

The socio-economic impacts of events, while mostly positive can often bring many detrimental implications to destinations and communities that host them. The statutory role of Local Authorities in Ireland to authorise and license large scale outdoor public events places Local Authorities in an ideal position to monitor and better manage the socio-economic impacts events can create at local level. This comparative examination draws attention to the current level of planning for the socio-economic impacts of events by Local Authorities at a nationwide level in Ireland. A multi-methodological approach was employed through a quantitative content analysis of Local Authority event management plans and guidelines and qualitative semi-structured interviews with Local Authorities in the Republic of Ireland. The findings drew attention to an overall dearth of socio-economic planning for events by Local Authorities. This lack of planning subsequently highlights a fundamental need for Local Authorities in Ireland to pay greater attention to generating greater levels of socio-economic sustainability in the legal process of planning for event management given their statutory role. This study presents an opportunity for improvement by Local Authorities and Event practitioners not only in Ireland but at International levels.
Better together—Formation of the Mississippi River Health Alliance
Authors: Wilson Trider Mary
Published: December 2019

Two small hospital corporations in neighbouring communities came together with a shared interest in collectively delivering as much care as close to home as possible across their collective geography. While external factors created a sense of urgency for the collaboration, trust-building, communication, and a shared focus on patient care have built a foundation for success without the need to change legal structure.
Swelling response of functionally graded temperature-sensitive hydrogel valves: Analytic solution and finite element method
Authors: Shojaeifard Mohammad , Tahmasiyan Sara , Baghani Mostafa
Published: December 2019

Temperature-sensitive hydrogels are classified as high stretchable materials undertaking large recoverable deformation under thermomechanical loadings. Due to vast applications of these materials in microfluidic valves and stress/deformation discontinuity observed in multi-layered structures, understanding of thermomechanical behavior of functionally graded hydrogels is of great practical interest. In this article, the swelling of these materials is analyzed considering various types of micro-valves including solid cylinder, hollow cylinder, and Jacket-pillar cylinder. Accordingly, analytical solutions are developed for swelling behavior of diverse types of cylinders composed of functionally graded temperature-sensitive hydrogel. The distribution of the cross-link density alters along the radial direction in exponential and linear trends. Besides, finite element analysis is presented to evaluate the proposed analytical solution in different case studies. Then, to account for more realistic environmental conditions, heat transfer equation is also solved along with the mechanical equilibrium equation to propose a novel analytical solution validated by finite element method. Clarifying the micro-valves mechanism and illustrating the capability and accuracy of the analytical method, the effects of material and environmental variables are studied in detail; continuous stress and deformation fields are observed opposed to the multi-layered structures which normally involve stress discontinuity.
Student Bullying in Kuwait Public Schools: How School Administrators and Teachers React
Authors: Alhajeri Salem S. , Alenezi Abdulaziz S.
Published: December 2019

This study aimed to investigate how public school teachers perceive student bullying and how they perceive their own as well as school administrators’ efforts to protect students from bullying. A total of 238 elementary, middle, and high school teachers responded to 18 questions. The study found that student bullying exists in Kuwait public schools, it is more widespread in boys’ schools, and it occurs more in middle schools. Further, the study found a significant relationship between student bullying and school administrators’ efforts to protect students from bullying. A discussion of these results and relevant recommendations for future studies are included.
Emotion and the Psychological Distance of Climate Change
Authors: Chu Haoran , Yang Janet Z.
Published: December 2019

Anchored by construal level theory and appraisal theories of emotion, this study examines whether discrete emotions vary along with perceived psychological distance of climate change impacts. We found that reduced psychological distance perception led to an increase in concrete emotions such as anger, fear, sadness, and guilt. In contrast, increased psychological distance perception led to an increase in hope—an abstract emotion. Compared to anger, anxiety, and hope, fear, guilt, and shame had more limited impact on climate mitigation action and policy support. Trait empathy moderated the effect of psychological distance manipulation on distance perception and emotions.
Imbalances between workforce policy and employment for early childhood graduate teachers: Complexities and considerations
Authors: Gibson Megan , McFadden Amanda , Williams Kate E , Zollo Lyn , Winter Abigail , Lunn Jo
Published: December 2019

Early childhood teachers have a myriad of possible employment options, with birth to eight years degree qualifications preparing graduates to work in a range of early childhood settings, including prior-to-school. At the same time, early childhood workforce policies in Australia, and elsewhere, are increasingly requiring degree-qualified teachers to be employed in prior-to-school settings. A growing number of reports and studies make a compelling case that there is a shortage of early childhood, degree-qualified teachers who are willing to work in prior-to-school settings, including centre-based child care. This conceptual article focuses on the imbalances in workforce policy and employment for early childhood teacher graduates. We examine the complexities and considerations of these imbalances, through exploration of literature and existing research, including small-scale studies and existing graduate destination data (Australian Graduate Survey). The article concludes with a proposed research agenda and suggestions to redress the imbalance of early childhood graduate teachers who are prepared, though seemingly not willing, to operationalise policy requirements for teachers to work in centre-based child care.
Primary Central Nervous System Lymphoma in an Immunocompetent Patient Presenting as Multiple Cerebellar Lesions: A Case Report and Review of Literature
Authors: Galarza Fortuna Gliceida M. , Dvir Kathrin , Febres-Aldana Christopher , Schwartz Michael , Medina Ana Maria
Published: December 2019

Primary central nervous system (CNS) lymphoma (PCNSL) is an uncommon extranodal non-Hodgkin lymphoma often presenting as a single brain lesion within the CNS. On histopathological evaluation of PCNSL a positive CD10, which is frequently observed in systemic diffuse large B-cell lymphoma, is present in approximately 10% of PCNSL. We describe a case of CD10-positive PCNSL presenting with multiple posterior fossa enhancing lesions in an immunocompetent older woman with a history of breast cancer successfully treated by the RTOG 0227 protocol consisting of pre-irradiation chemotherapy with high-dose methotrexate, rituximab, and temozolomide for 6 cycles, followed by low-dose whole-brain radiation and post-irradiation temozolomide.
Predicting the artificial immunity induced by RUTI® vaccine against tuberculosis using universal immune system simulator (UISS)
Authors: Pennisi Marzio , Russo Giulia , Sgroi Giuseppe , Bonaccorso Angela , Parasiliti Palumbo Giuseppe Alessandro , Fichera Epifanio , Mitra Dipendra Kumar , Walker Kenneth B. , Cardona Pere-Joan , Amat Merce , Viceconti Marco , Pappalardo Francesco
Published: December 2019

Background

Tuberculosis (TB) represents a worldwide cause of mortality (it infects one third of the world’s population) affecting mostly developing countries, including India, and recently also developed ones due to the increased mobility of the world population and the evolution of different new bacterial strains capable to provoke multi-drug resistance phenomena. Currently, antitubercular drugs are unable to eradicate subpopulations of Mycobacterium tuberculosis (MTB) bacilli and therapeutic vaccinations have been postulated to overcome some of the critical issues related to the increase of drug-resistant forms and the difficult clinical and public health management of tuberculosis patients. The Horizon 2020 EC funded project “In Silico Trial for Tuberculosis Vaccine Development” (STriTuVaD) to support the identification of new therapeutic interventions against tuberculosis through novel in silico modelling of human immune responses to disease and vaccines, thereby drastically reduce the cost of clinical trials in this critical sector of public healthcare.

Results

We present the application of the Universal Immune System Simulator (UISS) computational modeling infrastructure as a disease model for TB. The model is capable to simulate the main features and dynamics of the immune system activities i.e., the artificial immunity induced by RUTI® vaccine, a polyantigenic liposomal therapeutic vaccine made of fragments of Mycobacterium tuberculosis cells (FCMtb). Based on the available data coming from phase II Clinical Trial in subjects with latent tuberculosis infection treated with RUTI® and isoniazid, we generated simulation scenarios through validated data in order to tune UISS accordingly to STriTuVaD objectives. The first case simulates the establishment of MTB latent chronic infection with some typical granuloma formation; the second scenario deals with a reactivation phase during latent chronic infection; the third represents the latent chronic disease infection scenario during RUTI® vaccine administration.

Conclusions

The application of this computational modeling strategy helpfully contributes to simulate those mechanisms involved in the early stages and in the progression of tuberculosis infection and to predict how specific therapeutical strategies will act in this scenario. In view of these results, UISS owns the capacity to open the door for a prompt integration of in silico methods within the pipeline of clinical trials, supporting and guiding the testing of treatments in patients affected by tuberculosis.
A computational approach based on the colored Petri net formalism for studying multiple sclerosis
Authors: Pernice Simone , Pennisi Marzio , Romano Greta , Maglione Alessandro , Cutrupi Santina , Pappalardo Francesco , Balbo Gianfranco , Beccuti Marco , Cordero Francesca , Calogero Raffaele A.
Published: December 2019

Background

Multiple Sclerosis (MS) is an immune-mediated inflammatory disease of the Central Nervous System (CNS) which damages the myelin sheath enveloping nerve cells thus causing severe physical disability in patients. Relapsing Remitting Multiple Sclerosis (RRMS) is one of the most common form of MS in adults and is characterized by a series of neurologic symptoms, followed by periods of remission. Recently, many treatments were proposed and studied to contrast the RRMS progression. Among these drugs, daclizumab (commercial name Zinbryta), an antibody tailored against the Interleukin-2 receptor of T cells, exhibited promising results, but its efficacy was accompanied by an increased frequency of serious adverse events. Manifested side effects consisted of infections, encephalitis, and liver damages. Therefore daclizumab has been withdrawn from the market worldwide. Another interesting case of RRMS regards its progression in pregnant women where a smaller incidence of relapses until the delivery has been observed.

Results

In this paper we propose a new methodology for studying RRMS, which we implemented in GreatSPN, a state-of-the-art open-source suite for modelling and analyzing complex systems through the Petri Net (PN) formalism. This methodology exploits: (a) an extended Colored PN formalism to provide a compact graphical description of the system and to automatically derive a set of ODEs encoding the system dynamics and (b) the Latin Hypercube Sampling with PRCC index to calibrate ODE parameters for reproducing the real behaviours in healthy and MS subjects.To show the effectiveness of such methodology a model of RRMS has been constructed and studied. Two different scenarios of RRMS were thus considered. In the former scenario the effect of the daclizumab administration is investigated, while in the latter one RRMS was studied in pregnant women.

Conclusions

We propose a new computational methodology to study RRMS disease. Moreover, we show that model generated and calibrated according to this methodology is able to reproduce the expected behaviours.
Investigation of the host transcriptional response to intracellular bacterial infection using Dictyostelium discoideum as a host model
Authors: Kjellin Jonas , Pränting Maria , Bach Frauke , Vaid Roshan , Edelbroek Bart , Li Zhiru , Hoeppner Marc P. , Grabherr Manfred , Isberg Ralph R. , Hagedorn Monica , Söderbom Fredrik
Published: December 2019

Background

During infection by intracellular pathogens, a highly complex interplay occurs between the infected cell trying to degrade the invader and the pathogen which actively manipulates the host cell to enable survival and proliferation. Many intracellular pathogens pose important threats to human health and major efforts have been undertaken to better understand the host-pathogen interactions that eventually determine the outcome of the infection. Over the last decades, the unicellular eukaryote Dictyostelium discoideum has become an established infection model, serving as a surrogate macrophage that can be infected with a wide range of intracellular pathogens. In this study, we use high-throughput RNA-sequencing to analyze the transcriptional response of D. discoideum when infected with Mycobacterium marinum and Legionella pneumophila. The results were compared to available data from human macrophages.

Results

The majority of the transcriptional regulation triggered by the two pathogens was found to be unique for each bacterial challenge. Hallmark transcriptional signatures were identified for each infection, e.g. induction of endosomal sorting complexes required for transport (ESCRT) and autophagy genes in response to M. marinum and inhibition of genes associated with the translation machinery and energy metabolism in response to L. pneumophila. However, a common response to the pathogenic bacteria was also identified, which was not induced by non-pathogenic food bacteria. Finally, comparison with available data sets of regulation in human monocyte derived macrophages shows that the elicited response in D. discoideum is in many aspects similar to what has been observed in human immune cells in response to Mycobacterium tuberculosis and L. pneumophila.

Conclusions

Our study presents high-throughput characterization of D. discoideum transcriptional response to intracellular pathogens using RNA-seq. We demonstrate that the transcriptional response is in essence distinct to each pathogen and that in many cases, the corresponding regulation is recapitulated in human macrophages after infection by mycobacteria and L. pneumophila. This indicates that host-pathogen interactions are evolutionary conserved, derived from the early interactions between free-living phagocytic cells and bacteria. Taken together, our results strengthen the use of D. discoideum as a general infection model.
Profile and outcome of patients with upper gastrointestinal bleeding presenting to urban emergency departments of tertiary hospitals in Tanzania
Authors: Rajan Shaffin S. , Sawe Hendry R. , Iyullu Asha J. , Kaale Dereck A. , Olambo Nancy A. , Mfinanga Juma A. , Weber Ellen J.
Published: December 2019

Background

Upper gastrointestinal bleeding (UGIB) is a common emergency department (ED) presentation with high morbidity and mortality. There is a paucity of data on the profile and outcome of patients who present with UGIB to EDs, especially within limited resource settings where emergency medicine is a new specialty. We aim to describe the patient profile, clinical severity and outcomes of the patients who present with UGIB to the ED of tertiary referral hospitals in Tanzania.

Methods

This was a prospective cohort study of consecutive adult (≥18 years) patients presenting to the EDs of Muhimbili National Hospital (ED-MNH) and MUHAS Academic Medical Centre (ED-MAMC), in Tanzania with non-traumatic upper gastrointestinal bleeding (UGIB) from July 2018 to December 2018. Patient demographic data, clinical presentation, and ED and hospital management provided were recorded. We used the clinical Rockall score to assess disease severity. The primary outcome of 7- day mortality was summarized using descriptive statistics. Regression analysis was performed to identify predictors of mortality.

Results

During the study period, 123 patients presented to one of the two EDs with an UGIB. The median age was 42 years (Interquartile range (IQR) 32–64 years), and 87 (70.7%) were male. Hematemesis with melena was the most frequently encountered ED complaint 39 (31.7%). Within 7 days, 23 (18.7%) patients died and one-third 8 (34.8%) of these died within 24 h. There were no ED deaths. About 65.1% of the patients had severe anemia but only 60 (48.8%) received blood transfusion in the ED. Amongst those with history of (h/o) esophageal varices 7(41.2%) did not receive octreotide. Upper GI endoscopy, was performed on 46 (37.4%) patients, of whom only 8 (17.4%) received endoscopy within 24 h (early UGI endoscopy). All patients who received early UGI endoscopy had a low or moderate clinical Rockall score i.e. < 3 and 3–4. No patient with scores of > 4 received early UGI endoscopy. Age > 40 years was a significant independent predictor of mortality (OR = 7.00 (95% CI 1.7–29.2). Having a high clinical Rockall score of ≥ 4 was a significant independent predictor of mortality (OR = 6.4 (95% CI 1.8–22.8).

Conclusions

In this urban ED in Sub-Saharan Africa, UGIB carried a high mortality rate. Age > 40 years and clinical Rockall score ≥ 4 were independent predictors of higher mortality. Future studies should focus on evaluating how to improve access to UGI endoscopy so as to improve outcomes.