bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of Prenatal Care and Associated Factors among Pregnant Women at Public Health Facilities of Wogera District, Northwest Ethiopia
Authors: Kassaw Asrat , Debie Ayal , Geberu Demiss Mulatu
Published: January 2020

Background. Prenatal care refers to services a pregnant woman receives during pregnancy to ensure a healthy outcome for herself and her newborn. However, only limited studies have so far been done to assess the quality of prenatal care in the study area. Thus, this study is aimed at assessing the quality of prenatal care and associated factors at public health facilities in Wogera district, northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted in Wogera district from March to April 2019. A total of 465 pregnant women were interviewed using a semi-structured interviewer-administered questionnaire; consecutive sampling was used to select the participants. The binary logistic regression analysis model was fitted to identify the potential predictor variables. Variables with <0.2 p values were fitted into the multivariable logistic regression analysis model; <0.05 p values and an adjusted odds ratio (AOR) with a 95% confidence interval (CI) were used to declare factors associated with the quality of prenatal care. Results. The overall quality of prenatal care was 32.7% (95% CI: 28.1, 37.2). Four or more prenatal care visits (AOR=2.3; 95% CI: 1.2, 4.7), high maternal education (AOR=2.9; 95% CI: 1.03, 7.93), over USD 175.5 monthly household income (AOR=2.8; 95% CI: 1.1, 7.8), and the availability of maternity waiting areas (AOR=2.4; 95% CI: 1.2, 5.0) were positively associated with the quality of the care. Conclusion. The overall quality of prenatal care in this study was low. Therefore, promoting focused prenatal care and increasing infrastructure, encouraging maternal education, and compensating for the healthcare costs for women with low household income might enhance the quality of the care.
Immune Checkpoint Blockade in Combination with Stereotactic Body Radiotherapy in Patients with Metastatic Pancreatic Ductal Adenocarcinoma
Authors: Xie Changqing , Duffy Austin G. , Brar Gagandeep , Fioravanti Suzanne , Mabry-Hrones Donna , Walker Melissa , Bonilla Cecilia Monge , Wood Bradford J. , Citrin Deborah E. , Gil Ramirez Elizabeth M. , Escorcia Freddy E. , Redd Bernadette , Hernandez Jonathan M. , Davis Jeremy L. , Gasmi Billel , Kleiner David , Steinberg Seth M. , Jones Jennifer C. , Greten Tim F.
Published: January 2020

Purpose:

The effectiveness of immune checkpoint inhibitors (ICI) is limited in pancreatic ductal adenocarcinoma (PDAC). We conducted a phase I study to evaluate the safety of ICI with stereotactic body radiation therapy (SBRT) in patients with metastatic PDAC.

Patients and Methods:

Patients enrolled must have received at least one line of prior systemic chemotherapy for metastatic disease. Cohorts A1 and A2 received durvalumab every 2 weeks plus either 8 Gy in one fraction of SBRT on day 1 or 25 Gy in five fractions on day −3 to +1. Cohorts B1 and B2 received durvalumab plus tremelimumab every 4 weeks and either 8 Gy in one fraction of SBRT on day 1 or 25 Gy in five fractions on day −3 to +1. ICIs were continued until unacceptable toxicity or disease progression. The primary objective was the safety and feasibility of treatment. Objective response was assessed in lesions not subjected to SBRT.

Results:

Fifty-nine patients were enrolled and 39 were evaluable for efficacy. No dose-limiting toxicities were seen. The most common adverse event was lymphopenia. Two patients achieved a partial response (one confirmed and the other unconfirmed). The overall response rate was 5.1%. Median PFS and OS was 1.7 months [95% confidence intervals (CI), 0.8–2.0 months] and 3.3 months (95% CI, 1.2–6.6 months) in cohort A1; 2.5 months (95% CI, 0.1–3.7 months) and 9.0 months (95% CI, 0.5–18.4 months) in A2; 0.9 months (95% CI, 0.7–2.1 months) and 2.1 months (95% CI, 1.1–4.3 months) in B1; and 2.3 months (95% CI, 1.9–3.4 months) and 4.2 months (95% CI, 2.9–9.3 months) in B2.

Conclusions:

The combination of ICI and SBRT has an acceptable safety profile and demonstrates a modest treatment benefit in patients with metastatic PDAC.
Insulin-like Growth Factor-1, Insulin-like Growth Factor Binding Protein-3 and the Incidence of Malignant Neoplasms in a Nested Case–Control Study
Authors: Adachi Yasushi , Nojima Masanori , Mori Mitsuru , Himori Ryogo , Kubo Toshiyuki , Yamano Hiro-o. , Lin Yingsong , Wakai Kenji , Tamakoshi Akiko
Published: January 2020

Insulin-like growth factor (IGF)-1 is a potent mitogen, but IGF binding protein (IGFBP)-3 inhibits IGF1. To elucidate the relationship between both IGF1 and IGFBP and the risk of tumorigenesis, the association between IGF1 and IGFBP3 serum levels and of malignant tumor incidence was investigated in a prospective case–control study nested in the Japan Collaborative Cohort Study. A baseline survey was started in 1988–1990, 110,585 subjects were enrolled, and 35% of participants donated blood samples. Those who had been diagnosed with malignant tumors by 1997 were considered cases. The analysis involved 1,349 cases and 4,012 controls. Conditional logistic regression was used to estimate ORs for cancer incidence associated with IGF-related molecules. After controlling for alcohol intake, body mass index (BMI), and smoking, participants with high total-IGFBP3 and free-IGFBP3, which is estimated by the molar difference of (IGFBP3 − IGF1), had a risk of future neoplasms (Ptrend = 0.014 and 0.009, respectively), but those with IGF1 did not. People in the second to fifth quintiles had a lower risk than those in the first quintile (ORs 0.676–0.736 and 0.657–0.870, respectively). Limiting subjects to those followed for 3 years weakened the negative associations of total- and free-IGFBP3, whereas a positive relationship of free-IGF1, which was estimated by the molar ratio of IGF1/IGFBP3, was seen (Ptrend = 0.004, 0.002, and 0.013, respectively). After controlling for alcohol intake, smoking, BMI, and diabetes mellitus, the results were confirmed. These findings suggest that serum IGF1 and IGFBP3 are related to future risk of malignant neoplasms.
In vitro Evaluation of Linezolid and Doripenem Clearance with Different Hemofilters
Authors: Hiraiwa Toshihisa , Moriyama Kazuhiro , Matsumoto Kana , Shimomura Yasuyo , Kato Yu , Yamashita Chizuru , Hara Yoshitaka , Kawaji Takahiro , Kurimoto Yasuyoshi , Nakamura Tomoyuki , Kuriyama Naohide , Shibata Junpei , Komura Hidefumi , Morita Kunihiko , Nishida Osamu
Published: January 2020

Introduction: Renal replacement therapy (RRT) is widely used in the treatment of septic acute kidney injury. However, little is known about how the adsorption properties of hemofilters used in RRT affect antibiotic concentration. Because a cytokine-adsorption membrane is frequently used in RRT, it is important to determine the antibiotic adsorption capacity of this membrane. Objective: The present study aimed to investigate the antibiotic adsorption capacity of different hemofilter membranes by in vitro experiments using 2 antibacterial agents (linezolid and doripenem). Methods: We performed experimental hemofiltration in vitro using polyacrylonitrile (AN69ST), polymethylmethacrylate (PMMA), and polysulfone (PS) hemofilters for 1,440 min. The test solution was a 1,000-mL substitution fluid containing 30 µg/mL linezolid and 120 µg/mL doripenem. We measured drug concentrations at the inlet, outlet, and filtrate ports of the hemofilters for 1,440 min and calculated the sieving coefficient (SC) and adsorption rate (Ra) of the drugs onto the hemofilters. Results: The amount of linezolid adsorbed onto AN69ST, PMMA, and PS membranes was decreased relative to that in the control group at 15 min (p < 0.05). However, no SC for linezolid was obtained thereafter. The Ra of linezolid onto AN69ST, PMMA, and PS membranes was higher than that in the control group (p < 0.05). In contrast, no significant differences were observed in the concentrations and Ra values of doripenem adsorbed onto AN69ST, PMMA, and PS membranes compared with those in the control group. Conclusions: Doripenem was not adsorbed onto PMMA, PS, and AN69ST membranes. Linezolid was adsorbed onto PMMA, PS, and AN69ST membranes, but only temporarily, and this did not affect drug bioavailability.
The Impact of Stump Closure Techniques on Pancreatic Fistula Stratified by the Thickness of the Pancreas in Distal Pancreatectomy
Authors: Watanabe Nobuyuki , Yamamoto Yusuke , Sugiura Teiichi , Okamura Yukiyasu , Ito Takaaki , Ashida Ryo , Uesaka Katsuhiko
Published: January 2020

Background: The purpose of this retrospective study was to evaluate the impact of stump closure techniques on pancreatic fistula (PF) focusing on pancreatic thickness after distal pancreatectomy (DP). Methods: A total of 213 patients who underwent DP between 2007 and 2017 were retrospectively reviewed. The risk factors of PF were investigated. Results: In all patients, age ≥65 years (odds ratio [OR]: 3.60, p = 0.012), operation time ≥300 min (OR: 3.05, p = 0.013) and thickness of transected pancreas (OR: 1.37, p < 0.001) were identified as independent risk factors for clinically relevant PF. A receiver operating curve analysis revealed the optimum cut-off values of thickness to be 14 mm with stapler closure and 17 mm with the clamp-crushing method. There were no significant differences regarding PF between the stapler closure and clamp-crushing methods in the thin (<14 mm) and very thick pancreas (≥17 mm) groups (p = 0.822, p = 0.072). In contrast, stapler closure was the only independent risk factor for developing PF in the moderately thick (≥14, <17 mm) pancreas group (OR: 6.75 and p = 0.004, respectively). Conclusion: The clamp-crushing method was superior to stapler closure for pancreatic transection, especially in patients with moderately thick pancreas.
Recurrent Stroke in a Young Patient with Embolic Stroke of Undetermined Source and Patent Foramen Ovale: Quo Vadis?
Authors: Feil Katharina , Heinrich Johanna , von Falkenhausen Aenne S. , Becker Regina , Küpper Clemens , Müller Katharina , Thunstedt Dennis C. , Sinner Moritz F. , Kääb Stefan , Kellert Lars
Published: January 2020

So far, there has been no generally accepted diagnostic and therapeutic algorithm for patients with embolic stroke of undetermined source (ESUS). As recent clinical trials on secondary stroke prevention in ESUS did not support the use of oral anticoagulation and the concept of ESUS comprises heterogeneous subgroups of patients, including a wide age range, concomitant patent foramen ovale (PFO), variable cardiovascular risk factors as well as a variable probability for atrial fibrillation (AF), an individualized clinical approach is needed. In this context, we here present a case of recurrent stroke in a young patient with ESUS and PFO. During treatment according to our Catch-up-ESUS registry study, prolonged cardiac monitoring diagnosed AF, and PFO closure was omitted.
A Case of Repeating Transient Increase in Intraocular Pressure by Instability of an Intraocular Lens Implanted in the Capsular Bag
Authors: Takada Yukihisa  , Sumioka Takayoshi , Ishikawa Nobuyuki , Yasuda Shingo , Komori Ryoko , Saika Shizuya
Published: January 2020

We observed repeated episodes of rapid increases in intraocular pressure (IOP) considered to be caused by an in-the-bag intraocular lens (IOL) instability in a patient with an implanted IOL. As acute glaucoma attack-like increase in IOP was noted in the left eye on November 8, she was admitted to Wakayama Medical University Hospital. The findings at the first examination included an IOP of 62 mm Hg, instability of a PMMA one-piece IOL, shallow anterior chamber, narrow angle, moderate mydriasis, and loss of pupillary light reaction in the left avitreous eye. On November 15, a 6-mm Hg increase in IOP was observed during 60-min dark room prone provocative testing. After the first examination, the patient perceived pain and reduced visual acuity of the left eye and emergently consulted our hospital twice. Despite miosis, normalization of the anterior chamber depth and IOP with widening of the angle were achieved by resting in the supine position. These episodes were thought to be caused by instability and anterior shift of the IOL. On January 17, 2018, suture fixation of the in-the-bag IOL was performed. The IOL was fixed by transscleral suturing of the bilateral supporting parts to the sclera. Recurrence of sudden ophthalmalgia, instability of the in-the-bag IOL, and an increase in IOP have not been observed for 1 year after surgical treatment. Instability of an in-the-bag IOL caused repeated acute angle-closure glaucoma-like attacks. The situation was well treated by suturing and fixing the haptics of IOL to the sclera.
Rise in Low-Density Lipoprotein Cholesterol during Hospitalization is Related with Poor Outcome at Discharge in Patients with Acute Ischemic Stroke
Authors: Yuan Huai Wu , Yang Yi Na , Chen Han Feng , Ji Ren Jie , Lin Ya Jie , Guo Ren Yong , Peng Guo Ping , Liang Hui , Luo Benyan
Published: January 2020

Background: The statistical association between a short-term rise in low-density lipoprotein cholesterol (LDL-C) levels and the short-term outcome of acute ischemic stroke remains unknown. We aimed to evaluate the association in acute ischemic stroke patients during hospitalization. Methods: Patients with acute ischemic stroke who received statin at discharge were enrolled in this multicenter registry study. LDL-C values were measured on the first day after admission and on the day before discharge to determine the rise in LDL-C levels. Poor outcome was defined as a modified Ranking Scale score ≥2 at discharge. The National Institutes of Health Stroke Scale increase from admission to discharge by 2 points was defined as clinical deterioration. Logistic regression analyses were used to analyze the relationship between LDL-C rise during hospitalization and poor outcome at discharge. Variables that were significantly different between the LDL-C rise and LDL-C fall groups were considered in adjustment for confounding variables in model 1. Age, sex, and those variables in model 1 were considered in adjustment for confounding variables in model 2. Results: Among the 676 patients, 110 (16.3%) showed a rise in LDL-C levels during hospitalization. Multivariate analyses showed that LDL-C at admission <1.6 mmol/L was significantly correlated with LDL-C rise during hospitalization (p < 0.001). There were significantly more patients with a poor outcome in the “LDL-C rise” group than in the “LDL-fall” group (p = 0.002). Multiple models consistently showed that LDL-C rise increased the risk of a poor outcome at discharge in model 1 (OR [95% CI] 1.351 [1.059–1.723], p = 0.016) and model 2 (OR [95% CI] 1.370 [1.071–1.751], p = 0.012). LDL-C rise also increased the risk of clinical deterioration, although its p value only was 0.043 in model 1 and 0.048 in model 2. Conclusions: Rise in LDL-C during hospitalization from acute ischemic stroke is an independent predictor of poor outcome at discharge. In particular, patients with lower LDL-C values at admission are a higher at risk, and LDL-C in these patients should thus be monitored while in hospital.
Prevalence, Mortality, and Cause of Death in Charcot-Marie-Tooth Disease in Korea: A Nationwide, Population-Based Study
Authors: Park Hyung Jun , Choi Young-Chul , Oh Ji Won , Yi Sang-Wook
Published: January 2020

Background: Charcot-Marie-Tooth disease (CMT) is a group of clinically and genetically heterogeneous disorders that primarily affect the peripheral nervous system. Epidemiological studies of CMT have not yet been performed in Korea. Objectives: This study was performed to estimate the prevalence of CMT in Korea and the socioeconomic status, mortality, and causes of death of Korean patients with CMT. Methods: Data on patients with CMT were obtained from the rare intractable disease registry and the National Health Insurance Service for the years 2005–2018. Results: During the study period, 2,885 CMT patients were enrolled. The prevalence per 100,000 persons in 2018 was 5.2 (6.1 for men and 4.4 for women), peaking at ages 15–39 years, with almost twice as many men (n = 714) as women (n = 402) in this age group. Of the CMT patients, 226 (7.8%) were receiving medical aid, a public assistance program targeting poor individuals, at the time of diagnosis and 253 (8.8%) at last follow-up or death. From 2005 to 2017, 170 patients died, including 118 men and 52 women. The standardized mortality ratio (SMR) was 1.57 (95% CI 1.34–1.83) for all patients and did not differ in men and women. Age-specific SMR was highest in patients aged under 9 years, gradually declining thereafter. Neurologic disease as a cause of death was significantly more frequent in CMT patients than in the general population. Conclusions: This was the first nationwide epidemiologic study of CMT patients in Korea. This study confirmed the characteristics associated with the prevalence of and mortality from CMT by age and is the first to report the socioeconomic status and causes of death of CMT patients.
Vertex markers: Modification of grid methods as markers to reproduce large size augmented reality objects to afford hands
Authors: Kusuma Wahyu Teja , Supianto Ahmad Afif , Tolle Herman
Published: January 2020

The weakness of the research on developing Marker Based Augmented Reality applications found is using small digital content. Weakness is caused by the area of view of Augmented Reality cameras is limited by the placement of markers that are affordable to the user's hand. This study reproducing large digital objects by cutting large digital objects into many pieces. But to keep continuity accuracy between digital object pieces, this study aims to modify the grid method to become a vertex marker. Vertex marker is produced by removing the edge and using the vertex to place the marker. Vertex markers inherit the advantages of the Grid method. Therefore, vertex markers can be used to reproduce large digital objects accurately and can be reached by hand when displayed. The aim of this study is to measure the accuracy of the grid method that has been modified into a marker. The fundamental contributions and advantages of the vertex marker are innovations in the field of Marker Based Augmented Reality research.
Hybrid protocol for wireless EH network over weibull fading channel: performance analysis
Authors: Tin Phu Tran , Nguyen Tan N. , Thanh Trang Tran
Published: January 2020

In this paper, the hybrid TSR-PSR protocol for wireless energy harvesting (EH) relaying network over the Weibull fading channel is investigated. The system network is working in half-duplex (HD) mode. For evaluating the system performance, the closed-form and integral-form expressions of the outage probability (OP) are investigated and derived. After that, numerical results convinced that our derived analytical results are the same with the simulation results by using Monte Carlo simulation. This paper provides a novel recommendation for the wireless EH relaying network.
Characterization and modeling the effect of temperature on power HBTs InGaP/GaAs
Authors: Nadjet Mokeddem , Kheireddine Ghaffour
Published: January 2020

The variation and stability of HBT’s parameters at different temperatures are important for utilizing these devices in high-power integrated circuits. The temperature dependence of the DC current gain of bipolar transistors, as a key device parameter, has been extensively investigated. A major issue of the power HBT’s is that the current gain is decreased with junction temperature due to self-heating effect. Hence, how to stabilize the DC current gain and RF performances is important issue to develop the power HBTs. This work describes the DC and high-frequency temperature dependence of InGaP/GaAs HBT’s. The substrate temperature (T) was varied from 25 to 150°C. The static and dynamic performances of the HBT are degraded at high temperature, due to the reduced of carrier mobility with increasing temperature. The current gain (β) decreases at high temperatures; from 140 to 127 at 25 to 150°C, while the decreases in the peak Ft and Fmax are observed from about 110 GHz to 68 GHz and from 165 GHz to 53 GHz respectively in the temperature range of 25 to 150°C.
The transient stability analysis of wind turbines interconected to grid under fault
Authors: Gourma Anass , Berdai Abdelmajid , Reddak Moussa
Published: January 2020

Wind farm has been growing in recent years due to its very competitive electricity production cost. Wind generators have gone from a few kilowatts to megawatts. However, the participation of the wind turbine in the stability of the electricity grid is a critical point to check, knowing that the electricity grid is meshed, any change in active and reactive flux at the network level affects its stability. With a rate of 50% wind turbine penetration into the electricity grid, the stability of the rotor angle is a dynamic phenomenon which is only visible by the variation of the active energy. The purpose of this journal is to verify the impact of wind turbine integration on an electrical grid, by exploiting the relationship between the reactive energy produced by the Doubly Fed Induction Generator equipping most wind energy systems, and the stability of the rotor angle of the synchronous generators equipping the conventional power plants in the electrical system.
Optimal parameters of inverter-based microgrid to improve transient response
Authors: Pizarro Pérez Sergio Andrés , Candelo-Becerra John E. , Hoyos Velasco Fredy E.
Published: January 2020

The inertia issues in a microgrid can be improved by modifying the inverter control strategies to represent a virtual inertia simulation. This method employs the droop control strategy commonly used to share the power of a load among different power sources in the microgrid. This paper utilizes a modified droop control that represents this virtual inertia and applies an optimization algorithm to determine the optimal parameters and improve transient response. The results show better control when different variations are presented in the loads, leading the microgrid to have a better control of the operation. The optimization method applied in this research allows improvement to the transient response, thus avoiding unnecessary blackouts in the microgrid.
Direct-on-line-start permanent-magnet-assisted synchronous reluctance motors with ferrite magnets for driving constant loads
Authors: Viego Percy R. , Sousa Vladimir , Gómez Julio R. , Quispe Enrique C.
Published: January 2020

For driving constant loads in industry, the use of direct-on-line-start permanent-magnet-assisted synchronous reluctance motors with ferrite magnets (DOL-Start-PMa-SynRM) is proposed. The bibliographic search demonstrated that this new motor has greater efficiency than one similar induction motor (IM). It was evidenced that the main element that is required for direct starting is to insert a squirrel cage into the rotor of a PMa-SynRM, which does not produce negative operational effects in a steady state. An economic evaluation was carried out in a sugar mill company, applying the differential net present value (NPV) method, and a sensitivity analysis, considering the four factors that present the most variation. It was demonstrated, by means of a Pareto diagram standardized for the NPV that the most significant factors are fuel factor, lifespan and the multiplication of both. With response surfaces that are obtained with a multilevel factorial experiment, it was determined that, by varying the factors in the ranges considered, the NPV always remains positive and higher than 2200 USD. This is mainly due to the notable difference between the efficiency of the DOL-Start-PMa-SynRM and that of the IM. Consequently, is proved that an investment in the DOL-Start-PMa-SynRM may be feasible.
Unified adaptive framework for contrast enhancement of blood vessels
Authors: S. Pearl Mary , V. Thanikaiselvan
Published: January 2020

Information about blood vessel structures influences a lot of diseases in the medical realm. Therefore, for proper localization of blood vessels, its contrast should be enhanced properly. Since the blood vessels from all the medical angio-images have almost similar properties, a unified approach for the contrast enhancement of blood vessel structures is very useful. This paper aims to enhance the contrast of the blood vessels as well as the overall contrast of all the medical angio-images. In the proposed method, initially, the vessel probability map is extracted using hessian eigenanalysis. From the map, vessel edges and textures are derived and summed at every pixel location to frame a unique fractional differential function. The resulting fractional value from the function gives out the most optimal fractional order that can be adjusted to improve the contrast of blood vessels by convolving the image using Grunwald-Letnikov (G-L) fractional differential kernel. The vessel enhanced image is Gaussian fitted and contrast stretched to get overall contrast enhancement. This method of enhancement, when applied to medical angio-images such as the retinal fundus, Computerised Tomography (CT), Coronary Angiography (CA) and Digital Subtraction Angiography (DSA), has shown improved performance validated by the performance metrics.
Observer based dynamic control model for bilaterally controlled MU-lapa robot: Surgical tool force limiting
Authors: Pillai Branesh M. , Wilasrusmee Chumpon , Suthakorn Jackrit
Published: January 2020

During laparoscopic surgeries, primary surgical tool insertion is the demanding and strenuous task. As the surgeon is unaware of the type of the tissue and associated parameters to conduct the insertion, therefore, to ease the procedure, the movement of the surgical tool needs to be controlled. It’s the operational capabilities that are to be manipulated to perform a smooth surgery even from a distant location. In this study, a robot system is being introduced for laparoscopic primary surgical tool insertion. It will incorporate a novel observer based dynamic control along with robot assisted bilateral control. Moreover, a virtual spring damper force lock system is introduced through which the slave system will notify the master regarding the target achieved and excessive force. The validation of the proposed control system is experimented with bilaterally controlled MU-LapaRobot. The experiment is comprising 3 cases of bilateral control criteria which are non-contact motion, contact motion, and limit force locking. The results defined the same value for contact and non-contact motion by 0.3N. The results depicted a force error of 3.6% and a position error of 5.8% which validated the proposed algorithm.
The American Heart Association 2030 Impact Goal: A Presidential Advisory From the American Heart Association
Authors: Angell Sonia Y. , McConnell Michael V. , Anderson Cheryl A.M. , Bibbins-Domingo Kirsten , Boyle Douglas S. , Capewell Simon , Ezzati Majid , de Ferranti Sarah , Gaskin Darrell J. , Goetzel Ron Z. , Huffman Mark D. , Jones Marsha , Khan Yosef M. , Kim Sonia , Kumanyika Shiriki K. , McCray Alexa T. , Merritt Robert K. , Milstein Bobby , Mozaffarian Dariush , Norris Tyler , Roth Gregory A. , Sacco Ralph L. , Saucedo Jorge F. , Shay Christina M. , Siedzik David , Saha Somava , Warner John J.
Published: January 2020

Each decade, the American Heart Association (AHA) develops an Impact Goal to guide its overall strategic direction and investments in its research, quality improvement, advocacy, and public health programs. Guided by the AHA’s new Mission Statement, to be a relentless force for a world of longer, healthier lives, the 2030 Impact Goal is anchored in an understanding that to achieve cardiovascular health for all, the AHA must include a broader vision of health and well-being and emphasize health equity. In the next decade, by 2030, the AHA will strive to equitably increase healthy life expectancy beyond current projections, with global and local collaborators, from 66 years of age to at least 68 years of age across the United States and from 64 years of age to at least 67 years of age worldwide. The AHA commits to developing additional targets for equity and well-being to accompany this overarching Impact Goal. To attain the 2030 Impact Goal, we recommend a thoughtful evaluation of interventions available to the public, patients, providers, healthcare delivery systems, communities, policy makers, and legislators. This presidential advisory summarizes the task force’s main considerations in determining the 2030 Impact Goal and the metrics to monitor progress. It describes the aspiration that these goals will be achieved by working with a diverse community of volunteers, patients, scientists, healthcare professionals, and partner organizations needed to ensure success.
Altering Sphingolipid Metabolism Attenuates Cell Death and Inflammatory Response After Myocardial Infarction
Authors: Hadas Yoav , Vincek Adam S. , Youssef Elias , Żak Magdalena M. , Chepurko Elena , Sultana Nishat , Sharkar Mohammad Tofael Kabir , Guo Ningning , Komargodski Rinat , Kurian Ann Anu , Kaur Keerat , Magadum Ajit , Fargnoli Anthony , Katz Michael G. , Hossain Nadia , Kenigsberg Ephraim , Dubois Nicole C. , Schadt Eric , Hajjar Roger , Eliyahu Efrat , Zangi Lior
Published: January 2020

Background:

Sphingolipids have recently emerged as a biomarker of recurrence and mortality after myocardial infarction (MI). The increased ceramide levels in mammalian heart tissues during acute MI, as demonstrated by several groups, is associated with higher cell death rates in the left ventricle and deteriorated cardiac function. Ceramidase, the only enzyme known to hydrolyze proapoptotic ceramide, generates sphingosine, which is then phosphorylated by sphingosine kinase to produce the prosurvival molecule sphingosine-1-phosphate. We hypothesized that Acid Ceramidase (AC) overexpression would counteract the negative effects of elevated ceramide and promote cell survival, thereby providing cardioprotection after MI.

Methods:

We performed transcriptomic, sphingolipid, and protein analyses to evaluate sphingolipid metabolism and signaling post-MI. We investigated the effect of altering ceramide metabolism through a loss (chemical inhibitors) or gain (modified mRNA [modRNA]) of AC function post hypoxia or MI.

Results:

We found that several genes involved in de novo ceramide synthesis were upregulated and that ceramide (C16, C20, C20:1, and C24) levels had significantly increased 24 hours after MI. AC inhibition after hypoxia or MI resulted in reduced AC activity and increased cell death. By contrast, enhancing AC activity via AC modRNA treatment increased cell survival after hypoxia or MI. AC modRNA-treated mice had significantly better heart function, longer survival, and smaller scar size than control mice 28 days post-MI. We attributed the improvement in heart function post-MI after AC modRNA delivery to decreased ceramide levels, lower cell death rates, and changes in the composition of the immune cell population in the left ventricle manifested by lowered abundance of proinflammatory detrimental neutrophils.

Conclusions:

Our findings suggest that transiently altering sphingolipid metabolism through AC overexpression is sufficient and necessary to induce cardioprotection post-MI, thereby highlighting the therapeutic potential of AC modRNA in ischemic heart disease.
From Perviousness to Plaque Imaging in Acute Basilar Occlusions
Authors: Berndt Maria T. , Pree David , Kaesmacher Johannes , Maegerlein Christian , Friedrich Benjamin , Zimmer Claus , Wunderlich Silke , Mück Fabian G. , Wirth Stefan , Boeckh-Behrens Tobias
Published: January 2020

Background and Purpose—

Recent studies show that mechanical thrombectomy of acute basilar artery occlusions (BAO) results in high rates of successful recanalization and good outcomes, but predictors are not completely established yet. Varying occlusion types may benefit differently, and especially, an underlying basilar stenosis (BS) seems to have an impact. Aim of this study was to investigate angiographic and clinical differences in BAO subtypes and to test the potential of perviousness measures for a preinterventional identification of clinically relevant different occlusion types.

Methods—

All consecutive patients with acute BAO, endovascular treated at a single comprehensive stroke center, were included. Different occlusion patterns, especially underlying BS, were identified and analyzed in respect of angiographic and clinical (National Institutes of Health Stroke Scale/modified Rankin Scale) outcome parameters (N=115). Thrombus perviousness measures (change in thrombus attenuation Δt and corrected void fraction ε) were assessed in admission computed tomography imaging and correlated to different etiological subgroups.

Results—

Despite comparable rates of successful recanalization (87% for BAO with BS versus 95% without BS), the BS group showed worse clinical outcome with higher National Institutes of Health Stroke Scale/modified Rankin Scale values (
P
=0.002/0.003). The group of BS turned out to have lower thrombus density values in unenhanced scans (mean, 42.0 Hounsfield units) and higher perviousness measures Δt (mean, 34.6 Hounsfield units) and ε (mean, 0.23) than thrombi without an underlying BS (mean, 53.6 Hounsfield units/13.1 Hounsfield units/0.08,
P
=0.01/ 0.004/ 0.001).

Conclusions—

In agreement with previous studies, outcome of mechanical thrombectomy of BAO seems to depend on pathogenesis with less clinical benefit for underlying BS, raising the question of early identification of this subgroup. Perviousness showed a high potential to differentiate acute BAO with and without BS, possibly usable as an admission imaging marker for BS.
The Role of the Absolutive Object in Morphological Accessibility
Authors: Tollan Rebecca
Published: January 2020

This squib discusses environments in which a subject bears ergative case in the absence of an absolutive object, contrasting syntactically ergative languages (e.g., Q’anjob’al) with languages in which the ergative argument cannot be targeted for φ-agreement (e.g., Hindi-Urdu). In these environments, the parallels between Ā-movement and verb agreement with respect to the morphological accessibility hierarchy (Bobaljik 2008, Deal 2016) break down: in the absence of an absolutive object, syntactically ergative languages allow for extraction of the ergative argument, but in absolutive-only φ-agreement languages, agreement never targets the ergative argument.
The Impurity of Stone Vessels in 11QTa and CD in Light of the Chalk Vessel Finds at Kh. Qumran
Authors: Adler Yonatan
Published: January 2020

Scholars have argued that 11QTa and CD view stone vessels as susceptible to impurity. Chalk vessel finds at Kh. Qumran have presented a challenge to this idea, and solutions to date have been unsatisfying. The recent publication of final reports on these finds invites us to reconsider both the archaeological and textual evidence relating to the ritual status of stone vessels at Qumran. The typological profile of the Kh. Qumran assemblage parallels that found at Jewish sites elsewhere. It will be argued that both 11QTa and CD viewed stone vessels as unsusceptible to most kinds of ritual impurity—apart from corpse impurity. The pentateuchal basis for this understanding will be elucidated, and it will be argued that the position of 11QTa and CD on the matter was common among contemporary Jews. The foregoing will allow an investigation into the origins of the chalk vessel industry in the late 1st century BCE.
Carotenoid supplementation affects the post-hibernation performance of southern corroboree frogs
Authors: McInerney Emma P. , Silla Aimee J. , Byrne Phillip G.
Published: January 2020

Many animals hibernate to survive winter conditions, however, arousal from hibernation generates reactive oxygen species (ROS) that can cause oxidative stress. Dietary antioxidants, like carotenoids, may reduce oxidative stress during arousal from hibernation, and assist with post-hibernation recovery and performance. We tested the effect of carotenoid supplementation on exercise performance (escape-response and activity) in southern corroboree frogs (Pseudophryne corroboree) following initial arousal from hibernation (24–48 h post-arousal) and post-recovery (six weeks post-hibernation). Carotenoids did not affect performance following initial arousal. However, carotenoids improved escape-response six weeks post-hibernation, with carotenoid-supplemented frogs hopping faster and further in their first hop than unsupplemented frogs. Carotenoids also affected post-recovery activity, with carotenoid-supplemented frogs being less mobile than unsupplemented frogs. Carotenoids may affect post-hibernation performance by reducing oxidative stress or by increasing diet quality. Our study provides novel evidence for an effect of carotenoids on performance post-hibernation and highlights the importance of nutrition to hibernating organisms.
Rights of Nature and Their Implementation
Authors: Krämer Ludwig
Published: January 2020

This paper passes in review the different pieces of legislation and court judgments which were issued until now as regards rights of nature, and critically comments on their impact. In a first section, the legislation, including the constitutional texts of some countries, will be presented. In a second section, the implementation of the different measures will be discussed, also with a view, whether the EU could learn from the trend to give natural assets rights of their own. Short concluding remarks will end the contribution.
The Personal Is Political: Revisiting “English” and “Homeland” by Reading Shirley Geok-lin Lim’s Hong Kong Poetry
Authors: Chang Joan Chiung-huei
Published: January 2020

In the 1970s, when Carol Hanisch proposes that “the personal is political,” she emphasizes how all personal issues—including challenges, choices, and behaviors—carry their political imports. Therefore, while we examine individual experiences, we can expect to understand the historical and political contexts of the public, and seek for solutions to problems if there is any. In the studies of Oversea Chinese, we observe how Shirley Geok-lin Lim, a Chinese Malaysian who has become naturalized in the United States, represents an untypical diasporic prototype as she is often traveling from one place to another and in an “in-between” position, different from traditional paradigms of settlement or diaspora. This essay focuses the analysis on the usage of English and the concept about homeland to read poetry written by Shirley Lim in Hong Kong, so as to investigate how her personal experience could bespeak the political and cultural identifications for people in Hong Kong.
Two new genera of long clawed Isohypsibioidea Guil, Jørgensen & Kristensen, 2019
Authors: KACZMAREK ŁUKASZ , BARTYLAK TOMASZ , ROSZKOWSKA MILENA
Published: January 2020

Two new eutardigrade genera Vladimirobius gen. nov. and Weglarskobius gen. nov. are erected for the species Grevenius irregibilis (Biserov, 1992) and Isohypsibius altai Kaczmarek & Michalczyk, 2006a, respectively. They are characterized by strongly modified claws, bucco-pharyngeal apparatus of the Isohypsibius variant, pharyngeal apophyses, and placoids present. The primary branches of internal claws of Vladimirobius gen. nov. are wide in lateral view and have very prominent gibbosity-like projections, whereas primary branches of external claws are thin and extremely long. In Weglarskobius gen. nov. claws IV are similar in shape and size, but the primary branches are extremely long, and thin. Moreover, claws on legs I–III vary greatly in size and shape in Weglarskobius gen. nov. Such supposed autapomorphies fully justify erection of the two new genera, even if the genetic data are presently unavailable.
Taxonomic revision of the Protopolybia picteti-emortualis species-group (Richards, 1978), with descriptions of two new species (Hymenoptera: Vespidae, Polistinae)
Authors: DOS SANTOS JUNIOR JOSÉ N. A. , SILVEIRA ORLANDO T. , CARPENTER JAMES M.
Published: January 2020

A taxonomic revision of the Protopolybia picteti-emortualis species-group now demonstrates that this group is possibly the largest in Protopolybia, comprising 15 species: P. eldinaris sp. nov.; P. djaneteae sp. nov.; P. cameranii (Zavattari 1906) = P. bella (Von Ihering 1903) syn. nov.; P. fulvotincta stat. rev.; P. biguttata, P. nitida, P. alvarengai, P. iheringi, P. perfulvula, P. steinbachi, P. wheeleri, P. rotundata, P. picteti, P. emortualis and P. duckei. Male and female genitalia are illustrated for P. biguttata Bequaert, P. bella, P. nitida, P. fulvotincta and P. picteti. New collection records and a new identification key are presented for this species-group.
The Unintended Consequences of Risk Assessment Regimes: How Risk Adversity at European Universities Is Affecting African Studies
Authors: Piccolino Giulia , Franklin Sabine
Published: January 2020

Many European universities have introduced procedures for assessing risks to social researchers. These procedures are inspired by occupational and safety health standards, whose logic is driven by the suppression of uncertainty. The rise of risk assessment also fits into a broader global trend of increasingly representing marginalised areas of the world as risky and insecure. While there is a lack of evidence about the actual impact of these procedures on mitigating risks, they are posing an increasing burden on researchers in terms of time, effort, and financial resources, affecting particularly research in and about Africa. Risk assessment can also influence the choice of research methods and reinforce neocolonial patterns of knowledge production by encouraging the transfer of risk to local partners, whose views are rarely integrated in the risk assessment process. This analysis discusses the unintended impact of risk assessment and gives some suggestions for improving processes of preventing risk to social researchers.
Length of Stay for Patients With Limited English Proficiency in Pediatric Urgent Care
Authors: Patel Aimy T. , Lee Brian R. , Donegan Ravneet , Humiston Sharon G.
Published: January 2020

This retrospective chart review compared the length of stay (LOS) of families with limited English proficiency (LEP) versus English-speaking families seen in 3 pediatric urgent care centers (PUCCs). Visits were included for patients aged 2 months to 17 years seen between January 1, 2016, and December 31, 2016, with 1 of 5 primary diagnoses. For each LEP encounter, we randomly selected 3 English-speaking encounters within the same PUCC and diagnosis class. We compared overall LOS between LEP and English-speaking encounters. Of our entire sample, 184 (1.03%) were LEP encounters, of which 145 (78.8%) preferred Spanish. Comparing the LEP visits to 552 matched English-speaking visits, we found a significant difference in average LOS (LEP 85.5 minutes; English-speaking 76.4 minutes) and in prescriptions provided ( P = .005) but not in triaged acuity nor number of medications administered, laboratory or radiological studies, or suction treatments. This study serves as a starting point to better care for patients/families with LEP in PUCCs.
Redesigning Today’s Driving Automation Toward Adaptive Backup Control With Context-Based and Invisible Interfaces
Authors: Cabrall Christopher D. D. , Stapel Jork C. J. , Happee Riender , de Winter Joost C. F.
Published: January 2020

Objective

We investigated a driver monitoring system (DMS) designed to adaptively back up distracted drivers with automated driving.

Background

Humans are likely inadequate for supervising today’s on-road driving automation. Conversely, backup concepts can use eye-tracker DMS to retain the human as the primary driver and use computerized control only if needed. A distraction DMS where perceived false alarms are minimized and the status of the backup is unannounced might reduce problems of distrust and overreliance, respectively. Experimental research is needed to assess the viability of such designs.

Methods

In a driving simulator, 91 participants either supervised driving automation ( auto-hand-on-wheel vs. auto-hands-off-wheel), drove with different forms of DMS-induced backup control ( eyes-only-backup vs. eyes-plus-context-backup; visible-backup vs. invisible-backup), or drove without any automation. All participants performed a visual N-back task throughout.

Results

Supervised driving automation increased visual distraction and hazard non-responses compared to backup and conventional driving. Auto-hand-on-wheel improved response generation compared to auto-hands-off-wheel. Across entire driving trials, the backup improved lateral performance compared to conventional driving. Without negatively impacting safety, the eyes-plus-context-backup DMS reduced unnecessary automated control compared to the eyes-only-backup DMS conditions. Eyes-only-backup produced low satisfaction ratings, whereas eyes-plus-context-backup satisfaction was on par with automated driving. There were no appreciable negative consequences attributable to the invisible-backup driving automation.

Conclusions

We have demonstrated preliminary feasibility of DMS designs that incorporate driving context information for distraction assessment and suppress their status indication.

Application

An appropriately designed DMS can enable benefits for automated driving as a backup.
Military cosmopolitanism and romantic indigeneity: Crafting claims to statehood in Kiran Desai’s The Inheritance of Loss and Easterine Kire’s Bitter Wormwood
Authors: Sircar Sushmita
Published: January 2020

The world wars definitively changed the relations with the state of the peoples of India’s northeastern frontier. The wars were both fought on their terrain (with the invasion of the Japanese army) and led to the recruitment of people from the region to serve in the British Army. The contemporary Anglophone Indian novel documents the lingering effects of this militarization in the many insurgencies that have fragmented the region in the postcolonial era. Kiran Desai’s The Inheritance of Loss (2006) depicts the Gorkhaland uprising of the 1980s in the Kalimpong district of West Bengal, which demanded a separate state, while Easterine Kire’s Bitter Wormwood (2011) describes the Naga peoples’ traditional way of life against the backdrop of attempts to declare independence from the Indian state. In this article I argue that these novels capture how these secessionist movements use the experience of the world wars to craft a political identity based on military brotherhood to claim independence from the Indian state. These movements thus undertake a complex reworking of the valences of the figure of the “soldier”, central to so many accounts of national integrity. At the same time, reproducing the nationalist logic of the Indian state, these novels more readily recognize an “indigenous” identity based on a claim to the land as the political basis of nationhood. Hence, these novels about secessionist struggles reveal how certain narratives of nation formation become the only legitimate means for making claims for political rights and independent statehood over the course of the twentieth century.