bluuebunny/crossref_metadata_2025 huggingface dataset:
Through the Gaps of My Fingers: Genre, Femininity, and Cringe Aesthetics in Dramedy Television
Authors: Havas Julia , Sulimma Maria
Published: May 2018

Concentrating on the series “Girls” (2012–2017), “Fleabag” (2016), and “Insecure” (2016–), this article examines the female-centered dramedy as a current genre of U.S.-American television culture with specific investments in gendered value hierarchies. The article explores the format’s dominant narrative and aesthetic practices with specific focus on prestige dramedy’s “cringe” aesthetics. Cringe is increasingly mobilized as a mode of political expression following the format’s privileging of female subjectivities. As such, cringe is tasked with negotiating the tensions between drama and comedy on one hand and intersectional relations of identity politics on the other. Character “complexity,” embedded in ideological themes around identity, modifies the “comedy” in cringe and becomes associated with the more prestigious dramatic mode, this way governing the texts’ appeal to cultural value. The article demonstrates the ways the female-centered cringe dramedy expresses its politicization and “complexity” via disturbing gendered expectations of mediated femininity, and specifically body and sexuality politics.
Practice Patterns of Fenestrated Aortic Aneurysm Repair: Nationwide Comparison of Z-Fen Adoption at Academic and Community Centers Since Commercial Availability
Authors: Wiske Clay , Lee Jason T. , Rockman Caron , Veith Frank J. , Cayne Neal , Adelman Mark , Maldonado Thomas
Published: May 2018

Context:

Over the past decade, a number of endovascular approaches have evolved to treat aortic aneurysms with anatomy that is not amenable to traditional endovascular repair, although the optimal practice and referral patterns remain in question. The Zenith fenestrated (Z-Fen) endograft (Cook Medical) represents the first commercially available fenestrated graft product in the United States.

Objective:

We aim to quantify practice patterns in Z-Fen use during the first 5 years of commercial availability, and we identify predictors of high and low uptake.

Design, Setting, and Patients:

This is a retrospective review of complete order records for Z-Fen endografts since June 2012. We performed univariate and multivariate regressions of predictors that surgeons and centers would be in the top and bottom quartiles of annual Z-Fen use.

Results:

Since June 15, 2012, 744 surgeons have been trained to use Z-Fen, and 4133 cases have been performed at 409 trained centers. The average annual number of cases per trained surgeon was 4.46 [95% confidence interval (CI), 3.58-5.70]; however, many surgeons performed few or no cases following training, and there was a skew toward users with low average annual volumes (25th percentile 1.23, 50th percentile 2.35, 75th percentile 4.93, and 99th percentile 33.29). Predictors of high annual use in the years following training included academic center (aOR 5.87, P = .001) and training within the first 2 years of availability (aOR 46.23, P < .001).

Conclusion:

While there is literature supporting the safety and efficacy of Z-Fen, adoption has been relatively slow in an era when the vast majority of vascular surgeons have advanced endovascular skills. Given the training and resources required to use fenestrated or branched aortic endovascular devices, referral patterns should be determined and training should be focused on centers with high expected volumes.
CLOF: Contribution-level-based opportunistic flooding for multihop wireless networks
Authors: Byeon Seunggyu , Park Sejin , Seo Hyung-Yoon , Kim Jong-Deok
Published: May 2018

In this study, we propose a contribution-level-based opportunistic flooding for multihop wireless networks. Traditional flooding techniques typically use fixed routing and predetermined relay nodes based on the assumption of fixed and reliable links. However, because of the inherent instability of wireless links, these approaches typically lead to fragile and unreliable broadcasting. To overcome this problem, we adopt an opportunistic routing where the relay node is determined by the transmission result. In addition, we introduce a new criterion: a contribution level defined as packet infectiousness, and it represents the transmission priority. Namely, contribution level implies the degree of contagiosity determined by the distribution of uninfected entities. It also falls with an increase in the number of infected entities. Thus, the contribution level of a node is initially determined by the number of neighbors and distances to the neighbors. Once a node receives a packet, it waits a certain amount of time according to the initial priority. The node changes its own contribution level when it overhears a packet while waiting. If the contribution level reaches near zero, it discards the received packet such that unnecessary duplicates are removed. Consequently, higher reliability and efficiency can be achieved.
A real-time wireless wearable electroencephalography system based on Support Vector Machine for encephalopathy daily monitoring
Authors: Zhang Qing , Wang Pingping , Liu Yan , Peng Bo , Zhou Yufu , Zhou Zhiyong , Tong Baotong , Qiu Bensheng , Zheng Yishan , Dai Yakang
Published: May 2018

Wearable electroencephalography systems of out-of-hospital can both provide complementary recordings and offer several benefits over long-term monitoring. However, several limitations were present in these new-born systems, for example, uncomfortable for wearing, inconvenient for retrieving the recordings by patients themselves, unable to timely provide accurate classification, and early warning information. Therefore, we proposed a wireless wearable electroencephalography system for encephalopathy daily monitoring, named as Brain-Health, which focused on the following three points: (a) the monitoring device integrated with electroencephalography acquisition sensors, signal processing chip, and Bluetooth, attached to a sport hat or elastic headband; (b) the mobile terminal with dedicated application, which is not only for continuous recording and displaying electroencephalography signal but also for early warning in real time; and (c) the encephalopathy’s classification algorithm based on intelligent Support Vector Machine, which is used in a new application of wearable electroencephalography for encephalopathy daily monitoring. The results showed a high mean accuracy of 91.79% and 93.89% in two types of classification for encephalopathy. In conclusion, good performance of our Brain-Health system indicated the feasibility and effectiveness for encephalopathy daily monitoring and patients’ health self-management.
Trends in Pediatric Traumatic Upper Extremity Amputations
Authors: Vakhshori Venus , Bouz Gabriel J. , Mayfield Cory K. , Alluri Ram K. , Stevanovic Milan , Ghiassi Alidad
Published: May 2018

Background: Traumatic upper extremity amputation in a child can be a life-altering injury, yet little is known about the epidemiology or health care costs of these injuries. In this study, using the Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Database (KID), we assess these trends to learn about the risk factors and health care costs of these injuries. Methods: Using the HCUP KID from 1997 to 2012, patients aged 20 years old or younger with upper extremity traumatic amputations were identified. National estimates of incidence, demographics, costs, hospital factors, patient factors, and mechanisms of injury were assessed. Results: Between 1997 and 2012, 6130 cases of traumatic upper extremity amputation occurred in children. This resulted in a $166 million cost to the health care system. Males are 3.4 times more likely to be affected by amputation than females. The most common age group to suffer amputation is in older children, aged 15 to 19 years old. The frequency of amputation has declined 41% from 1997 to 2012. The overwhelming majority of amputations (92.54%) involved digits. Conclusions: Pediatric traumatic amputations of the upper extremity are a significant contribution to health care spending. Interventions and educational campaigns can be targeted based on national trends to prevent these costly injuries.
A new method to boost performance of heat recovery steam generators by integrating pinch and exergy analyses
Authors: Moosazadeh Moosavi Seyed Abootorab , Mafi Mostafa , Kaabi Nejadian Abdolrazzagh , Salehi GholamReza , Torabi Azad Masoud
Published: May 2018

Combined cycle power plants are gaining more attention throughout the world and their usage is increasing. This is because their efficiency is higher than simple Rankine or Brayton cycles. However, their efficiency could still increase. In this article, the driving force plot and exergy analysis are used to study the behavior of heat exchangers of a heat recovery steam generator in base case and off-design conditions. Based on the obtained results, a new method is proposed to improve performance of a heat recovery steam generator during the summers in which higher ambient temperature results in lower efficiency of plant. In this new method, hot flue gas at the heat recovery steam generator inlet is split which results in higher steam production in heat recovery steam generator. The results showed that the new proposed method is very beneficial and increases net output power of the plant. When split ratio increases from 2.5% to 15%, the power produced in steam turbine increases from 0.15 to 0.9 MW. It also increases exergy destruction of the heat recovery steam generator. This is due to higher mass flow rate of the produced steam and higher temperature difference between hot and cold streams. It is shown that this new method can reduce the negative effects of consuming more fuel in duct burner during the summers.
Hygrothermal performance of Brazilian gypsum walls
Authors: Santos Almai , Ramos Nuno MM , Maia Joana , Delgado JMPQ
Published: May 2018

The aim of this article is to evaluate the hygrothermal behaviour of gypsum walls in the climatic diversity of Brazil, based on the action and interaction between external climatic variables and the facade element. First, a laboratory characterization of material properties for the gypsum was carried out to determine their hygrothermal behaviour, particularly water vapour permeability, capillary absorption, retention curve and thermal conductivity. Second, the wall system performance was also evaluated in terms of its watertightness. It was concluded that the addition of a silicone water-repellent, typically used by the local industry, could lead to a classification of preventive against water. It was also concluded that a content of water-repellent above 0.5% would not result in additional benefits regarding watertightness. The second part of this work was focused on the evaluation of the hygrothermal behaviour of the standard and the water-resistant gypsum walls by means of hygrothermal numerical simulation. This analysis was intended to assess the influence of various factors such as the wall components (namely, wall coatings), the climatic conditions by geographical location and also the interior conditions, the orientation of the facades and the driving rain. The results demonstrated that the Brazilian climatic diversity can lead to very different exposure conditions. The locations in Interior Northeast Brazil, which are especially dry, corresponded to the ones with lower moisture content results. The results showed that gypsum masonry application on facades, with unfavourable climatic contexts, high precipitation and low solar exposure, would result in low durability. Only future works, including in situ studies may support the justification for applying the studied solutions in facades in favourable climatic conditions.
Proton-pump inhibitors among adults: a nationwide drug-utilization study
Authors: Hálfdánarson Óskar Ö. , Pottegård Anton , Björnsson Einar S. , Lund Sigrún H. , Ogmundsdottir Margret H. , Steingrímsson Eiríkur , Ogmundsdottir Helga M. , Zoega Helga
Published: May 2018

Background:

The use of proton-pump inhibitors (PPIs) has grown worldwide, and there are concerns about increased unsubstantiated long-term use. The aim of the study was to describe the real-world use of PPIs over the past decade in an entire national population.

Methods:

This was a nationwide population-based drug-utilization study. Patterns of outpatient PPI use among adults in Iceland between 2003 and 2015 were investigated, including annual incidence and prevalence, duration of use, and dose of tablet used (lower versus higher), as well as the proportion of PPI use attributable to gastroprotection.

Results:

We observed 1,372,790 prescription fills over the entire study period, of which 95% were for higher-dose PPIs. Annual incidence remained stable across time (3.3–4.1 per 100 persons per year), while the annual prevalence increased from 8.5 per 100 persons to 15.5 per 100 persons. Prevalence increased with patient age and was higher among women than men. Duration of treatment increased with patients’ age (36% of users over 80 years remained on treatment after 1 year compared with 13% of users aged 19–39 years), and was longer among those initiating on a higher dose compared with a lower dose. The proportion of PPI users concurrently using nonsteroidal anti-inflammatory drugs decreased over the study period, while the proportion concurrently using acetylsalicylic acid, oral anticoagulants, or platelet inhibitors increased.

Conclusions:

In this nationwide study, a considerable increase in overall outpatient use of PPIs over a 13-year period was observed, particularly among older adults. Patients were increasingly treated for longer durations than recommended by clinical guidelines and mainly with higher doses.
Comparison of trends in cardiovascular risk factors between two regions with and without a community and primary care prevention programme
Authors: Eliasson Mats , Eriksson Marie , Lundqvist Robert , Wennberg Patrik , Söderberg Stefan
Published: May 2018

Background

The effect of primary prevention of cardiovascular disease is debated. The Västerbotten Intervention Programme (VIP) is an individual and community-based public health programme that comprises the whole county of Västerbotten (VB). In the neighbouring county of Norrbotten (NB), no programmes have been implemented.

Method

Between 1994 and 2014, five surveys were performed in the two counties on persons aged 40 to 75 years within the Northern Sweden MONICA Study. The number of subjects participating was 6600 (75.4%). We compared time trends in risk factors between the two counties using regression models including age, county and year of survey. To test whether time trends differed between counties, the interaction between county and year was included in the models.

Results

Systolic blood pressure declined in both counties, and the decline was faster in Västerbotten than in Norrbotten ( p = 0.043 for interaction county*year). Diastolic blood pressure declined in VB but increased in NB ( p < 0.001). Cholesterol levels declined at a similar rate in both counties whereas body mass index increased in both counties. Fasting glucose decreased in VB ( p = 0.003) and increased in NB. The prevalence of regular smokers decreased faster in VB than in NB ( p = 0.01). Trend in waist and hip circumference, known diabetes, having an academic degree, being physically inactive or 10 year cardiovascular mortality according to SCORE did not differ.

Conclusion

Blood pressure, glucose and smoking improved at a faster rate in the county with a community and primary care-based intervention than in the county without such an intervention.
Clinical pathways — a Middle–Eastern perspective
Authors: Al Nobani Karen
Published: May 2018

Clinical pathways were first developed at Sheikh Khalifa Medical Centre (SKMC), Abu Dhabi, in 2001 – one year after the facility first opened. Long lengths of stay and unjustified variances in clinical practice were the main reasons for the development. Laparoscopic cholcyctectomy was the first to be implemented six months after development began. Convincing the workgroup members to buy into clinical pathways was difficult in the initial stages of development, but after highlighting the benefits of clinical pathways, they became more receptive to change. Other problems that were faced during the development was the limited use of clinical pathways in the region, the rapidly changing workforce, the cultural/religious need of the patient and varied knowledge base among nursing staff. There were also many advantages to developing pathways in the Middle East; diverse workforce and an ever-changing work environment helped to make clinical pathways at SKMC effective in delivering high standards of care. There are currently nine clinical pathways: surgical, medical and paediatric, and two in development – paediatric acute gastroenteritis and coronary artery bypass grafting. Lengths of stay have been reduced since implementing clinical pathways, some more significant than others. In future months, clinical pathways will be in electronic format and will be known as power plans.
Social Media Acceptance and Usage by Business Communication Faculty
Authors: Sapkota Kayla N. , Vander Putten Jim
Published: May 2018

Social media are an ubiquitous, technological phenomenon, permeating both personal and professional lives. Increasingly, business professionals use social media at work, yet it is often omitted from the business curriculum. This qualitative study investigated business communication faculty members’ perceptions and usage of social media in classroom and business contexts. Data were collected via interviews and course syllabi review. Interviews were transcribed and coded using an adapted technology acceptance model. Overall, participants accepted social media’s importance as a business tool but did not reach a consensus about its inclusion in the curriculum. Guidelines for addressing social media in the business communication classroom are presented.
The temple and the state in medieval South India
Authors: Veluthat Kesavan
Published: May 2018

This article brings out certain aspects of the ways in which the temple and the state were related in the early medieval period. Arriving in South India almost simultaneously, both derived support from each other. While the state patronised the temple, the latter lent considerable legitimacy to the former. The temple gradually started appropriating the role of the state in numerous ways, assuming administrative, judicial and fiscal functions. In many cases it was now in a position even to challenge the local political authorities.
Dynastic rule and religious ritual: A study of the S´ulkīs in early medieval Odisha
Authors: Sahu Bhairabi Prasad
Published: May 2018

The quest of ruling houses to acquire moral authority over their subjects by associating themselves with particular cults and rituals seems to have been a common enough phenomenon in India. This article studies the ways in which the Śulkī rulers in a part of Odisha (ninth-tenth centuries) promoted the cult of the female deity Stambheśvarī, originally represented by a simple post or pillar, by incorporating her in the Brahmanical pantheon. The article traces the stages in which this transformation occurred.
Akbar’s enterprise of religious conciliation: The early phase, 1561–1578: Spontaneous or motivated
Authors: Moosvi Shireen
Published: May 2018

It is argued in the article that the development of Akbar’s religious views before his espousal of Shul-i Kul, after 1578, cannot be entirely linked to changing political exigencies. Akbar’s own personal character and inclinations must also be factored in. It is particularly argued that the thesis of a turn to Muslim orthodoxy in the late 1560s and the 1570s must be reconsidered.
The issue of religion in 1857: Three documents
Authors: Jafri S.Z.H.
Published: May 2018

The rebels of 1857 had many causes to incite them to rise against the British. Religion has often been held to be a major source of disquiet for them owing to the perceived threat posed by Christian conversions. In this article, three documents are studied which present three different aspects of rebel consciousness. The first represents its secular character, for there is little reference to faith or religion in it. The second is a tract addressed obviously to Muslims to rise against the English on religious grounds. But annexed to it is a manifesto appealing to all Hindus and Muslims to join the rebellion: the emphasis on communal unity is manifest. Finally, we have the memoirs of an embittered theologian writing an account of the rebellion in its immediate aftermath: regrets and suspicion are manifest here.
Book Review: Anirudh Deshpande, Hope and Despair: Mutiny, Rebellion and Death in India, 1946
Authors: Ray Shatam
Published: May 2018

Anirudh Deshpande, Hope and Despair: Mutiny, Rebellion and Death in India, 1946 (Delhi: Primus Books), 2016, xxii+122 pp., ₹950 (hb).
Book Review: Channa Wickremesekera, The Tamil Separatist War in Sri Lanka, South Asia Edition
Authors: Ananth V. Krishna
Published: May 2018

Channa Wickremesekera, The Tamil Separatist War in Sri Lanka, South Asia Edition (London and New York: Routledge), 2016, ₹895.
Book Review: Deepak Kumar, The Trishanku Nation: Memory, Self, and Society in Contemporary India
Authors: Rezavi S.A. Nadeem
Published: May 2018

Deepak Kumar, The Trishanku Nation: Memory, Self, and Society in Contemporary India (New Delhi: Oxford University Press), 2016, xi, 211 pp., ₹495.
Book Review: Tahir Mahmood, Religion, Law and Society across the Globe: Musings of a Seeker after Truth
Authors: Nasir Mohd.
Published: May 2018

Tahir Mahmood, Religion, Law and Society across the Globe: Musings of a Seeker after Truth (New Delhi: Universal Law Publishing Co), 2013, ₹895.
A sturdy regional currency: The continuous use of Maḥmūdīs in Gujarat under the Mughals
Authors: Haider Najaf
Published: May 2018

The Mughal Empire established a single trimetallic currency with the silver rupee as its basic coin. Yet, strangely, its most commercialised penance Gujarat continued to use alongside the imperial rupee a local silver coin called ma°mødð. The paper examines how this came about and how Gujarat in effect got divided into two zones, in one of which the rupee was the main circulating medium, in the other, the ma°mødð.
The princely states and the national movement: The case of Kashmir (1931–39)
Authors: Lone Suhail-ul-Rehman
Published: May 2018

The British created an invisible wall between ‘British India’ and the ‘Princely India’ by governing the latter indirectly through hereditary princes, who were supposedly fully autonomous, but for British ‘paramountcy’. The Indian National Congress had from the beginning adopted a policy of non-interference in the states’ affairs, which Mahatma Gandhi too upheld. However, nationalism began to cast its influence in the states despite this policy of non-interference. In Kashmir the opposition to the Maharaja took, first, the form of a Muslim agitation against the ruler’s oppressive measures. But in time as the movement against the Dogra Raj obtained increasing support from the nationalist leaders, notably Jawaharlal Nehru, the Muslim Conference (later named National Conference) leadership headed by Sheikh Abdullah gravitated towards the All-India States Peoples Conference and its spiritual parent, the Congress. The Congress too abandoned its policy of non-interference fully by 1939. This shift ultimately caused a rift in the valley, with Ch. Ghulam Abbas forming the Muslim Conference in opposition to Sheikh Abdullah’s National Conference in 1941.
Book Review: K. Paddayya, Revitalizing Indian Archaeology: Further Theoretical Essays
Authors: Shrimali Krishna Mohan
Published: May 2018

K. Paddayya, Revitalizing Indian Archaeology: Further Theoretical Essays (2 vols) (New Delhi: Aryan Books International), 2016, xxxi + 803 pp., ₹1,950 (for the set).
Book Review: Iqtidar Alam Khan, The Mughal Nobility: Two Political Biographies and T.C.A. Raghavan, Attendant Lords: Bairam Khan and Abdur Rahim, Courtiers and Poets in Mughal India
Authors: Moosvi Shireen
Published: May 2018

Iqtidar Alam Khan, The Mughal Nobility: Two Political Biographies (Ranikhet: Permanent Black/Ashoka University), 2016, 178 + 188 pp., ₹995.

T.C.A. Raghavan, Attendant Lords: Bairam Khan and Abdur Rahim, Courtiers and Poets in Mughal India (Noida: Harper Collins Publishers), 2017, 338 pp., ₹699.
Book Review: J.V. Naik, The Collected Works of J.V. Naik: Reform and Renaissance in Nineteenth Century Maharashtra
Authors: Habib Irfan
Published: May 2018

J.V. Naik, The Collected Works of J.V. Naik: Reform and Renaissance in Nineteenth Century Maharashtra, edited with an Introduction by Murali Ranganathan (Mumbai: Asiatic Society of Mumbai), 2016, 380 pp., ₹750 (Hb).
Book Review: Bikash Nath, Tea Plantation Workers of Assam and the Indian National Movement, 1921–1947
Authors: Alam Ishrat
Published: May 2018

Bikash Nath, Tea Plantation Workers of Assam and the Indian National Movement, 1921–1947 (New Delhi: Primus Books), 2016, xx + 360 pp., ₹1950 (Hb).
Book Review: Sudhir Chandra, Gandhi—An Impossible Possibility
Authors: Habib Irfan
Published: May 2018

Sudhir Chandra, Gandhi—An Impossible Possibility, translated by Chinta Padmanabhan (London: Routledge, Abingdon, South Asian edition), 2017, xv + 152 pp., ₹595.
History and historiography in constituting a region: The case of Kerala
Authors: Veluthat Kesavan
Published: May 2018

The formation of regions is as complex a process as the formation of countries or nations. Geography has much to do with it in some cases, languages in others. But political events, commercial networks and tribal or caste dominance can also play their part. History, actual or imagined, may be invoked to create regional consciousness. This article examines how owing to complex factors Kerala came to be identified as a definite region by the sixteenth century, so identified not only by its mainstream tradition but also by people external to it.
Floods and people, colonial north Bengal, 1871–1922
Authors: Ghosh Tirthankar
Published: May 2018

North Bengal is an area of heavy rainfall through which rivers flowing down from the Himalayas have been frequently overflowing and changing their beds in the soft alluvial soil. Floods have, therefore, been a recurring phenomenon, caused by snow-melting and heavy rainfall. The present article is an intensive study of the floods that ravaged north Bengal in a period of over 50 years (1871–1922) during which the ground surface changed with the building of embanked railway lines, other embankments and dams thereby blocking the natural drainage lines of the past. The article also chronicles how the local populations suffered from the constant recurrence and increasing virulence of floods. It thus aims to bring together the information we have on the environmental and the human history of the region for a period of about 50 years of colonial rule.
Gandhi, Ambedkar and British policy on the communal award
Authors: Biswas Sujay
Published: May 2018

It has now become a fashion among many historians, notably from the West, to denounce Gandhi’s fast and the Poona Pact of 1932 as a great betrayal of the ‘Untouchables’. This view essentially overlooks the constant effort of British imperialism to divide the Indian people into a number of special-interest groups at loggerheads with each other and so weaken the National Movement. This paper weighs the critics’ assertions in the light of the British Government’s own statements and those of the leaders of the Depressed Castes. It is also forgotten that the Poona Pact greatly increased Depressed Castes’ representation; and that no separate electorates have been ever established in Western democracies to avoid majoritarian rule.
Book review: Syed Ejaz Hussain, Shiraz-i Hind: A History of Jaunpur Sultanate
Authors: Moosvi Shireen
Published: May 2018

Syed Ejaz Hussain, Shiraz-i Hind: A History of Jaunpur Sultanate (New Delhi: Manohar Publishers and Distributors), 2017, 266 pp., ₹2,995 (Hb).
Book review: T.C.A. Raghavan, The People Next Door: The Curious History of India’s Relations with Pakistan
Authors: Habib Irfan
Published: May 2018

T.C.A. Raghavan, The People Next Door: The Curious History of India’s Relations with Pakistan (Noida: Harper Collins Publishers), 2017, 348 pp., ₹699.
Fibroblast growth factor 23–secreting pancreaticobiliary malignancy
Authors: Barta Valerie , Lalkiya Neel , Phan Huy , Miller Ilene , Sachdeva Mala
Published: May 2018

Malignancy-related tumor-induced osteomalacia is a rare but important entity. We report the first case of oncogenic renal phosphate wasting in the setting of a pancreaticobiliary malignancy. Our patient presented with refractory hypophosphatemia. Workup revealed high fibroblast growth factor 23 levels as well as a new pancreaticobiliary mass. All other causes of hypophosphatemia were ruled out. With tumor-induced osteomalacia, an accurate diagnosis and location of the offending tumor is essential for appropriate management and treatment.
Combining tacit knowledge elicitation with the SilverKnETs tool and random forests – The example of residential housing choices in Leipzig
Authors: Scheuer Sebastian , Haase Dagmar , Haase Annegret , Kabisch Nadja , Wolff Manuel , Schwarz Nina , Großmann Katrin
Published: May 2018

Residential choice behaviour is a complex process underpinned by both housing market restrictions and individual preferences, which are partly conscious and partly tacit knowledge. Due to several limitations, common survey methods cannot sufficiently tap into such tacit knowledge. Thus, this paper introduces an advanced knowledge elicitation process called SilverKnETs and combines it with data mining using random forests to elicit and operationalize this type of knowledge. For the application case of the city of Leipzig, Germany, our findings indicate that rent, location and type of housing form the three predictors strongly influencing the decision making in residential choices. Other explanatory variables appear to have a much lower influence. Random forests have proven to be a promising tool for the prediction of residential choices, although the design and scope of the study govern the explanatory power of these models.
The rs4712527 Polymorphism in the CDKAL1 Gene: A Protective Factor for Proliferative Diabetic Retinopathy Progress in Type 2 Diabetes
Authors: Yang Pablo , Luna José D. , Alcoba Emilio , Sein Aylén , Gramajo Ana L. , Juárez Claudio P. , Beltramo Dante M. , Soria Néstor W.
Published: May 2018

Purpose:

Diabetic retinopathy (DR) is one of the chronic retinal disorders linked to diabetes and remains the leading cause of blindness in working-age people. Many studies have demonstrated the existence of associations between type 2 diabetes mellitus (T2DM) and variants in the cyclin-dependent kinase 5 regulatory subunit–associated protein 1-like 1 ( CDKAL1) gene. Here, we performed a case-control study in the CDKAL1 gene (rs4712527 polymorphism) to investigate the potential association between this single-nucleotide polymorphism (SNP) and DR risk.

Methods:

Two hundred thirty-one patients with T2DM (126 patients with proliferative diabetic retinopathy [PDR] and 105 patients without diabetic retinopathy [WDR]), who assisted at the Centro Privado de Ojos Romagosa, Fundación VER, were studied. An independent cohort of 98 patients (56 with PDR and 42 with WDR) from the Hospital Nacional de Clínicas was taken for replication. A complete ophthalmological examination included an external examination of the eye and adnexa, pupil responsiveness, and slit-lamp biomicroscopic examination. Genotyping of rs4712527 was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The odds ratio (OR) and 95% CI were calculated by unconditional logistic regression adjusted for diabetes duration, body mass index, insulin therapy, HbA1c, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and systolic and diastolic blood pressure.

Results:

Analysis from the rs4712527 SNP in the Centro Privado de Ojos Romagosa, Fundación VER, cohort was found to be associated with decreased risk of PDR both before and after adjustment, under the codominant (adjusted OR = 0.16 [95% CI, 0.06-0.44]; P = 4e-04), dominant (adjusted OR = 0.17 [95% CI, 0.07-0.43]; P = 1e-04), overdominant (adjusted OR = 0.20 [95% CI, 0.08-0.52]; P = 5e-04), and log-additive (adjusted OR = 0.28 [95% CI, 0.13-0.59]; P = 4e-04) models. In the combined analysis including both cohorts, the rs4712527 was nominally involved as a protective factor in the development of DR.

Conclusions:

Our findings suggest that the rs4712527 in the CDKAL1 gene might be involved in the protection to develop PDR in T2DM.
Bayesian Inference and Testing Any Hypothesis You Can Specify
Authors: Etz Alexander , Haaf Julia M. , Rouder Jeffrey N. , Vandekerckhove Joachim
Published: May 2018

Hypothesis testing is a special form of model selection. Once a pair of competing models is fully defined, their definition immediately leads to a measure of how strongly each model supports the data. The ratio of their support is often called the likelihood ratio or the Bayes factor. Critical in the model-selection endeavor is the specification of the models. In the case of hypothesis testing, it is of the greatest importance that the researcher specify exactly what is meant by a “null” hypothesis as well as the alternative to which it is contrasted, and that these are suitable instantiations of theoretical positions. Here, we provide an overview of different instantiations of null and alternative hypotheses that can be useful in practice, but in all cases the inferential procedure is based on the same underlying method of likelihood comparison. An associated app can be found at https://osf.io/mvp53/ . This article is the work of the authors and is reformatted from the original, which was published under a CC-By Attribution 4.0 International license and is available at https://psyarxiv.com/wmf3r/ .
Chemical controls on ikaite formation
Authors: Tollefsen Elin , Stockmann Gabrielle , Skelton Alasdair , Mörth Carl-Magnus , Dupraz Christophe , Sturkell Erik
Published: May 2018

The hydrated carbonate mineral ikaite (CaCO3·6H2O) is thermodynamically unstable at all known conditions on Earth. Regardless, ikaite has been found in marine sediments, as tufa columns and in sea ice. The reason for these occurrences remains unknown. However, cold temperatures (<6°C), high pH and the presence of Mg2+ and SO42– in these settings have been suggested as factors that promote ikaite formation. Here we show that Mg concentration and pH are primary controls of ikaite precipitation at 5°C. In our experiments a sodium carbonate solution was mixed with seawater at a temperature of 5°C and at a constant rate. To test the effect of Mg2+ and SO42– we used synthetic seawater which allowed us to remove these elements from the seawater. The pH was controlled by different ratios of Na2CO3 and NaHCO3 in the carbonate solution. We found that ikaite precipitated when both seawater and synthetic seawater from which SO4 had been removed were used in the experiments. However, ikaite did not precipitate in experiments conducted with synthetic seawater from which Mg had been removed. In these experiments, calcite precipitated instead of ikaite. By varying the Mg concentration of the synthetic seawater and the pH of the sodium carbonate solution, we constructed a kinetic stability diagram for ikaite and calcite as a function of Mg concentration and pH. One possible explanation of our finding is that Mg2+ inhibits calcite nucleation and thereby allows metastable ikaite to form instead.
Transfusion dependence, use of hospice services, and quality of end-of-life care in leukemia
Authors: LeBlanc Thomas W. , Egan Pamela C. , Olszewski Adam J.
Published: May 2018

Key Points

Transfusion-dependent Medicare patients with leukemia had a 51% shorter duration of hospice stay, indicating a barrier to timely referral. Use of hospice in leukemia has increased and is associated with improved quality measures, regardless of transfusion dependence.
RnaSeqSampleSize: real data based sample size estimation for RNA sequencing
Authors: Zhao Shilin , Li Chung-I , Guo Yan , Sheng Quanhu , Shyr Yu
Published: May 2018

Background

One of the most important and often neglected components of a successful RNA sequencing (RNA-Seq) experiment is sample size estimation. A few negative binomial model-based methods have been developed to estimate sample size based on the parameters of a single gene. However, thousands of genes are quantified and tested for differential expression simultaneously in RNA-Seq experiments. Thus, additional issues should be carefully addressed, including the false discovery rate for multiple statistic tests, widely distributed read counts and dispersions for different genes.

Results

To solve these issues, we developed a sample size and power estimation method named RnaSeqSampleSize, based on the distributions of gene average read counts and dispersions estimated from real RNA-seq data. Datasets from previous, similar experiments such as the Cancer Genome Atlas (TCGA) can be used as a point of reference. Read counts and their dispersions were estimated from the reference’s distribution; using that information, we estimated and summarized the power and sample size. RnaSeqSampleSize is implemented in R language and can be installed from Bioconductor website. A user friendly web graphic interface is provided at https://cqs.app.vumc.org/shiny/RnaSeqSampleSize/.

Conclusions

RnaSeqSampleSize provides a convenient and powerful way for power and sample size estimation for an RNAseq experiment. It is also equipped with several unique features, including estimation for interested genes or pathway, power curve visualization, and parameter optimization.
Safety and efficacy of obinutuzumab in Chinese patients with B‐cell lymphomas: a secondary analysis of the GERSHWIN trial
Authors: Qin Yan , Song Yuqin , Shen Zhixiang , Du Xin , Ji Wei , Hsu Wanling , Zhu Jun , Shi Yuankai
Published: May 2018

Background

Patients with relapsed/refractory B‐cell lymphomas have limited treatment options. GERSHWIN is an open‐label, single‐arm, phase Ib study of obinutuzumab monotherapy in Chinese patients with histologically documented CD20+ relapsed/refractory chronic lymphocytic leukemia (CLL), diffuse large B‐cell lymphoma (DLBCL), or follicular lymphoma (FL). The primary outcome measure of pharmacokinetics has been previously reported. We now present data on the secondary endpoint measures (e.g., safety, and efficacy and pharmacodynamics).

Methods

Patients received 1000 mg obinutuzumab intravenously on days 1, 8, and 15 of cycle 1 (CLL patients; first dose split over 2 days), and on day 1 of cycles 2–8. Each cycle lasted for 21 days; the treatment period was 24 weeks. All subjects receiving at least one dose of obinutuzumab were included in the analysis of safety, efficacy, as well as pharmacodynamics.

Results

A total of 48 patients (> 18 years of age) were enrolled (CLL: 12; DLBCL: 23; FL: 13). The subjects received a median of two lines of anticancer treatment prior to the enrollment. Thirty‐five patients (72.9%) had at least one adverse event (AE). The most frequent AE was infusion‐related reactions (15 patients; 31.3%), followed by pyrexia (11 patients; 22.9%). Treatment‐related AEs were reported in 28 patients (58.3%), and included one death (interstitial lung disease). End‐of‐treatment (EoT) response rate was 33.3%. Best overall response rate was 47.9%. Most CLL patients achieved a partial response at EoT (58.3%). CD19+ depletion occurred in 75.0% of the patients with CLL, and all patients with FL and DLBCL.

Conclusions

The safety and efficacy of obinutuzumab monotherapy in Chinese patients with B‐cell lymphomas were similar to that observed in previous studies in non‐Chinese patients; no new safety signals were observed.

Clinical trial registration ID NCT01680991
The OU-ISIR Large Population Gait Database with real-life carried object and its performance evaluation
Authors: Uddin Md. Zasim , Ngo Thanh Trung , Makihara Yasushi , Takemura Noriko , Li Xiang , Muramatsu Daigo , Yagi Yasushi
Published: May 2018

In this paper, we describe the world’s largest gait database with real-life carried objects (COs), which has been made publicly available for research purposes, and its application to the performance evaluation of vision-based gait recognition. Whereas existing databases for gait recognition include at most 4007 subjects, we constructed an extremely large-scale gait database that includes 62,528 subjects, with an equal distribution of males and females, and ages ranging from 2 to 95 years old. Moreover, whereas existing gait databases consider a few predefined CO positions on a subject’s body, we constructed a database that contained unconstrained variations of COs being carried in unconstrained positions. Additionally, gait samples were manually classified into seven carrying status (CS) labels. The extremely large-scale gait database enabled us to evaluate recognition performance under cooperative and uncooperative settings, the impact of the training data size, the recognition difficulty level of the CS labels, and the possibility of the classification of CS labels. Particularly, the latter two performance evaluations have not been investigated in previous gait recognition studies.
Assessing the Association Between Blood Loss and Postoperative Hemoglobin After Cesarean Delivery: A Prospective Study of 4 Blood Loss Measurement Modalities
Authors: Fedoruk Kelly , Seligman Katherine M. , Carvalho Brendan , Butwick Alexander J.
Published: May 2018

BACKGROUND:

Visual estimation and gravimetric methods are commonly used to quantify the volume of blood loss during cesarean delivery (CD). However, the correlation between blood loss and post-CD hemoglobin (Hb) is poorly studied, and it is unclear whether the correlation varies according to how blood loss is measured.

METHODS:

After obtaining Institutional Review Board approval, we performed a prospective study of 61 women undergoing CD to assess the relations between post-CD Hb and blood loss measured using 4 modalities: gravimetric blood loss measurement (gBL), visual blood loss estimation by a blinded obstetrician (oBL) and anesthesiologist (aBL), and the Triton System (tBL). Hb was measured preoperatively and within 10 minutes after CD. gBL was quantified as blood volume in a suction canister in addition to the weight of blood-soaked sponges. tBL was measured with the Triton System by photographing blood-soaked sponges and suction canister contents. To assess the relation between blood loss and post-CD Hb, we performed correlation analyses and compared the magnitude of the correlations across the 4 measurement modalities using Williamttest. A Bonferroni correction was set to identify a statistically significant correlation (P< .0125) and statistically significant differences between correlation coefficients (P< .008).

RESULTS:

The mean (standard deviation) preoperative Hb was 12 (1.1) g/dL and post-CD Hb was 11.3 (1.0) g/dL. Median (interquartile range) values for gBL, oBL, aBL, and tBL were 672 mL (266–970), 700 mL (600–800), 750 mL (600–1000), and 496 mL (374–729), respectively. A statistically significant but weak correlation was observed between tBL and post-CD Hb (r= −0.33;P= .01). No statistically significant correlations were observed among aBL (r= −0.25;P= .06), oBL (r= −0.2;P= .13), and gBL (r= −0.3;P= .03) with post-CD Hb. We did not detect any significant differences between any 2 correlation coefficients across the 4 modalities.

CONCLUSIONS:

Given that we observed only weak correlations between each modality with post-CD Hb and no significant differences in the magnitude of the correlations across the 4 modalities, there may be limited clinical utility in estimating post-CD Hb from blood loss values measured with any of the 4 modalities.
Readiness for Discharge After Foot and Ankle Surgery Using Peripheral Nerve Blocks: A Randomized Controlled Trial Comparing Spinal and General Anesthesia as Supplements to Nerve Blocks
Authors: YaDeau Jacques T. , Fields Kara G. , Kahn Richard L. , LaSala Vincent R. , Ellis Scott J. , Levine David S. , Paroli Leonardo , Luu Thuyvan H. , Roberts Matthew M.
Published: May 2018

BACKGROUND:

Neuraxial anesthesia is often viewed as superior to general anesthesia but may delay discharge. Comparisons do not typically use multimodal analgesics and nerve blockade. Combining nerve blockade with general anesthesia may reduce pain, opioid consumption, and nausea. We hypothesized that general anesthesia (with nerve blocks) would lead to earlier readiness for discharge, compared to spinal anesthesia (with nerve blocks).

METHODS:

All patients underwent ambulatory foot and ankle surgery, with a predicted case duration of 1–3 hours. All patients received popliteal and adductor canal nerve blocks using bupivacaine and dexamethasone. No intraoperative opioids were administered. All patients received ondansetron, dexamethasone, ketamine, and ketorolac. Patients, data collectors, and the data analyst were not informed of group assignment. Patients were randomized to spinal or general anesthesia with concealed allocation. Spinal anesthesia was performed with mepivacaine and accompanied with propofol sedation. After general anesthesia was induced with propofol, a laryngeal mask airway was inserted, followed by sevoflurane and propofol. Time until ready for discharge, the primary outcome, was compared between groups after adjusting for age and surgery time using multivariable unconditional quantile regression. Secondary outcomes compared at multiple timepoints were adjusted for multiple comparisons using the Holm–Bonferroni step-down procedure.

RESULTS:

General anesthesia patients were ready for discharge at a median of 39 minutes earlier (95% confidence interval, 2–75; P = .038) versus spinal anesthesia patients. Patients in both groups met readiness criteria for discharge substantially before actual discharge. Pain scores at rest were higher among general anesthesia patients 1 hour after leaving the operating room (adjusted difference in means, 2.1 [95% confidence interval, 1.0–3.2]; P < .001). Other secondary outcomes (including opioid use, opioid side effects, nausea, headache, sore throat, and back pain) were not different.

CONCLUSIONS:

General anesthesia was associated with earlier readiness for discharge, but the difference may not be clinically significant and did not lead to earlier actual discharge. Most secondary outcomes were not different between groups. The choice of spinal or general anesthesia as an adjunct to peripheral nerve blockade can reflect patient, clinician, and institutional preferences.
What Does a Red Meat Allergy Have to Do With Anesthesia? Perioperative Management of Alpha-Gal Syndrome
Authors: Dunkman W. Jonathan , Rycek Wendy , Manning Michael W.
Published: May 2018

Over the past decade, there has been a growing awareness of a new allergic syndrome known as alpha-gal allergy or alpha-gal syndrome, commonly recognized as a red meat allergy. We performed a review of the literature to identify articles that provide both background on this syndrome in general and any reports of reactions to medications or medical devices related to alpha-gal syndrome. Alpha-gal syndrome results from IgE to the oligosaccharide galactose-α-1,3-galactose, expressed in the meat and tissues of noncatarrhine mammals. It is triggered by the bite of the lone star tick and has been implicated in immediate-onset hypersensitivity to the monoclonal antibody cetuximab and delayed-onset hypersensitivity reactions after the consumption of red meat. There is growing recognition of allergic reactions in these patients to other drugs and medical devices that contain alpha-gal. Many of these reactions result from inactive substances that are part of the manufacturing or preparation process such as gelatin or stearic acid. This allergy may be documented in a variety of ways or informally reported by the patient, requiring vigilance on the part of the anesthesiologist to detect this syndrome, given its serious implications. This allergy presents a number of unique challenges to the anesthesiologist, including proper identification of a patient with alpha-gal syndrome and selection of anesthetic and adjunctive medications that will not trigger this allergy.