bluuebunny/crossref_metadata_2025 huggingface dataset:
Computing of Low Shear Stress-Driven Endothelial Gene Network Involved in Early Stages of Atherosclerotic Process
Authors: Vozzi Federico , Campolo Jonica , Cozzi Lorena , Politano Gianfranco , Di Carlo Stefano , Rial Michela , Domenici Claudio , Parodi Oberdan
Published: September 2018

Background. In the pathogenesis of atherosclerosis, a central role is represented by endothelial inflammation with influx of chemokine-mediated leukocytes in the vascular wall. Aim of this study was to analyze the effect of different shear stresses on endothelial gene expression and compute gene network involved in atherosclerotic disease, in particular to homeostasis, inflammatory cell migration, and apoptotic processes.Methods. HUVECs were subjected to shear stress of 1, 5, and 10 dyne/cm2in a Flow Bioreactor for 24 hours to compare gene expression modulation. Total RNA was analyzed by Affymetrix technology and the expression of two specific genes (CXCR4 and ICAM-1) was validated by RT-PCR. To highlight possible regulations between genes and as further validation, a bioinformatics analysis was performed.Results. At low shear stress (1 dyne/cm2) we observed the following: (a) strong upregulation of CXCR4; (b) mild upregulation of Caspase-8; (c) mild downregulation of ICAM-1; (d) marked downexpression of TNFAIP3. Bioinformatics analysis showed the presence of network composed by 59 new interactors (14 transcription factors and 45 microRNAs) appearing strongly related to shear stress.Conclusions. The significant modulation of these genes at low shear stress and their close relationships through transcription factors and microRNAs suggest that all may promote an initial inflamed endothelial cell phenotype, favoring the atherosclerotic disease.
Unsupervised Scoliosis Diagnosis via a Joint Recognition Method with Multifeature Descriptors and Centroids Extraction
Authors: Zhang Liyuan , Zhao Jiashi , Yang Huamin , Jiang Zhengang , Li Qingliang
Published: September 2018

To solve the problem of scoliosis recognition without a labeled dataset, an unsupervised method is proposed by combining the cascade gentle AdaBoost (CGAdaBoost) classifier and distance regularized level set evolution (DRLSE). The main idea of the proposed method is to establish the relationship between individual vertebrae and the whole spine with vertebral centroids. Scoliosis recognition can be transferred into automatic vertebral detection and segmentation processes, which can avoid the manual data-labeling processing. In the CGAdaBoost classifier, diversified vertebrae images and multifeature descriptors are considered to generate more discriminative features, thus improving the vertebral detection accuracy. After that, the detected bounding box represents an appropriate initial contour of DRLSE to make the vertebral segmentation more accurate. It is helpful for the elimination of initialization sensitivity and quick convergence of vertebra boundaries. Meanwhile, vertebral centroids are extracted to connect the whole spine, thereby describing the spinal curvature. Different parts of the spine are determined as abnormal or normal in accordance with medical prior knowledge. The experimental results demonstrate that the proposed method cannot only effectively identify scoliosis with unlabeled spine CT images but also have superiority against other state-of-the-art methods.
Estimating Everyday Neuropsychological Functioning in Multiple Sclerosis: Reliability and Validity of the Greek Multiple Sclerosis Neuropsychological Questionnaire
Authors: Konstantinopoulou Eleni , Ioannidis Panagiotis , Bakirtzis Christos , Giantzi Virginia , Afrantou Theodora , Parissis Dimitrios , Messinis Lambros , Nasios Grigorios , Grigoriadis Nikolaos
Published: September 2018

The Multiple Sclerosis Neuropsychological Questionnaire is a brief screening questionnaire for the assessment of everyday neuropsychological competence of patients with Multiple Sclerosis. The aim of the present study was to examine psychometric properties of the Greek version of the instrument. One hundred and three MS patients and 60 informants participated in the present study and completed the questionnaire. From the initial patient sample, 51 participants completed broadly used neuropsychological tests and measures estimating cognitive failures and depression. Moreover, after a six-month interval the MSNQ was administered to 58 patients from the initial sample in order to explore test-retest reliability. Cronbach's α was 0.92 and 0.93 for patient and informant forms, respectively. The patient form was correlated significantly with measures of cognitive failures and depression. Low correlations were found between the informant form and performance on cognitive tests. In regard to the patient form, significant correlation was observed between repeated administrations and, psychometrically, the three-factor structure was preferable than the one-factor structure. The present study confirms the already established pattern of correlations among the two MSNQ forms, neuropsychological test performance and depression measurements. Additional research is needed in order to define a cut-off score for the MSNQ-I providing further information about the diagnostic interpretability of the instrument.
A New Method Based on Field Strength for Road Infrastructure Risk Assessment
Authors: Li Yi , Chen Yuren
Published: September 2018

Because road infrastructures have significant impact on driving safety, their risk levels need to be evaluated dynamically according to drivers’ perception. To achieve this, this paper proposes two field strength models to quantify the impact of road infrastructures on drivers. First, road infrastructures are classified into two types (continuous and discrete). Then, two field strength models for these types are proposed. Continuous field strength model describes the impact of long-belt-shape infrastructure by differential and integral methods. Discrete field strength model describes the static and dynamic characteristics of infrastructures. This model includes four parameters: mass of vehicles, mass of infrastructures, warning level, and kinetic energy of road infrastructures. The field strength is a relative concept, which changes with vehicle state. At the end of this paper, risk assessment principles are listed to clarify the nature of road infrastructure risk evaluation. A workflow of risk assessment and a case study are presented to illustrate the application of this novel method. The result of this study shows that ① the field strength is positively related to its risk level; ② the distribution of road infrastructure risks explains driver behaviour correctly; ③ drivers tend to keep driving in low-risk area. These findings help to explain the impact mechanism of road infrastructures on drivers, which can be applied in AI-based driving assistance system in the future.
Double Magnetic Loop and Methods for Calculating Its Inductance
Authors: Mocholí Belenguer Ferran , Mocholí Salcedo Antonio , Milián Sánchez Victor , Arroyo Núñez José Humberto
Published: September 2018

Due to their simplicity and operating mode, magnetic loops are one of the most used traffic sensors in Intelligent Transportation Systems (ITS). However, at this moment, their potential is not being fully exploited, as neither the speed nor the length of the vehicles can be surely ascertained with the use of a single magnetic loop. In this way, the vast majority of them are only being used to count vehicles on urban and interurban roads. For this reason, in order to contribute to the development of new traffic sensors and make roads safer, this paper introduces a theoretical study to explain the design and peculiarities of the innovative double loops, how to calculate their magnetic field and three different methods to calculate their inductance. Finally, the different inductance values obtained by these three methods will be analyzed and compared with experimental measurements carried out by our research group in order to know which method is more accurate and if all of them are equally reliable.
Experimental Study and Mixed‐Dimensional FE Analysis of T‐Rib GFRP Plate‐Concrete Composite Bridge Decks
Authors: Tian Jun , Wu Xiaowei , Zheng Yu , Du Yinfei , Quan Xiankai
Published: September 2018

In order to extend the understanding of structural performance of a T‐rib glass fibre‐reinforced polymer (GFRP) plate‐concrete composite bridge deck, four GFRP plate‐concrete composite bridge decks were tested, which consist of cast‐in‐place concrete sitting on a GFRP plate with T‐ribs. Subsequently, a mixed‐dimensional finite element (FE) analysis model was proposed to simulate the behavior of the test models. The test and simulation results showed that the composite specimens had an excellent interface bonding performance between GFRP plate and concrete throughout flexural response until specimens failure occurred. The failure mode of those composite specimens was shear failure in concrete structures. It was found that the interface roughness of the GFRP plate could not affect the ultimate bearing capacity and stiffness of composite specimens significantly. However, the height of concrete structures had a strong effect on those structural behaviors. In addition, the longitudinal compressive reinforcing CFRP rebars had a little influence on ultimate bearing capacity of composite specimens, while it had a significant influence on ductility of composite specimens. The mixed‐dimensional FE analysis model can accurately simulate the local complex stress state of GFRP plates, ultimate loads, stiffness, and midspan deflections and simultaneously can significantly reduce computational time. Therefore, mixed‐dimensional FE analysis can provide a suitable solution to simulate the structural performance of T‐rib GFRP plate‐concrete composite bridge decks.
The Fire Service for the Removal of a Metallic Penile Constricting Device: A Ready Help When All Else Fail
Authors: Omisanjo Olufunmilade A. , Ojewuyi Olufemi , Abolarinwa Abimbola , Akinola Oluwaseun , Omorinde Mofeyisayo , Oshodi Olabode , Ikuerowo Stephen , Adedokun Ayoade , Oke David
Published: September 2018

The placement of a constricting device around the penis is a urologic emergency. Though injuries from constricting penile devices are generally rare, they may be associated with serious complications. There is no standard modality for the removal of penile constricting devices and the management of the patient can therefore prove to be a formidable challenge to the urologist. Timely intervention is always important in preventing complications especially penile gangrene. Depending on the type of device used along with the duration and severity of penile constriction caused, significant resourcefulness may be required in the treatment of the patient. Achieving a timely and successful outcome may require a multidisciplinary approach involving equipment only available with the fire service or other agencies. We report the case of a 30-year-old man with a background psychiatric illness who had his penile constricting device removed under conscious sedation in the emergency room with the aid of a power driven arc saw from the fire service with a successful outcome.
Monitoring Anti-NS1 Antibodies in West Nile Virus-Infected and Vaccinated Horses
Authors: Rebollo Belén , Sarraseca Javier , Lecollinet Sylvie , Abouchoaib Nabil , Alonso Javier , García-Bocanegra Ignacio , Sanz Antonio J. , Venteo Ángel , Jiménez-Clavero Miguel A.
Published: September 2018

West Nile virus (WNV) is a zoonotic arboviral pathogen affecting humans, birds, and horses. Vaccines are available for veterinary use, which efficiently prevent the infection in horses. Most common diagnostic tools rely on the identification of the agent (RT-PCR, virus isolation), or on the detection of antibodies (IgM and IgG) recognizing structural proteins of the virus or neutralizing virus infection in cell cultures (virus-neutralization tests). The recent emergence of WNV in different parts of the world has resulted in an increase in the vaccination of horses in many countries. Methods for differentiation between infected and vaccinated animals (“DIVA” assays) would be useful for surveillance and control purposes but are still not available. A usual approach in this regard is the use of antibodies to nonstructural proteins as markers of nonvaccinated, infected animals, and the nonstructural NS1 protein of WNV has been proposed as a candidate for such a marker. The aim of this study was to test the hypothesis that NS1 can be a useful antigen in DIVA assays for differentiating WNV vaccinated and infected horses in field conditions. For that, we examined serum samples from either vaccinated and infected horses both from experimental infections/vaccinations (under controlled conditions) and from the field, exposed to natural infection or vaccinated in response to a risk of infection. The overall conclusion of the study is that NS1 antigen can effectively differentiate WNV infected from vaccinated horses in experimental (controlled) conditions, but this differentiation might be difficult depending on the conditions prevailing in the field.
Revision Surgery in Total Joint Replacement Is Cost-Intensive
Authors: Weber Markus , Renkawitz Tobias , Voellner Florian , Craiovan Benjamin , Greimel Felix , Worlicek Michael , Grifka Joachim , Benditz Achim
Published: September 2018

Revisions after total joint replacement increase constantly. In the current study, we analyzed clinical outcome, complication rates, and cost-effectiveness of revision arthroplasty. In a retrospective analysis of 162 revision hip and knee arthroplasties from our institutional joint registry responder rate, patient-reported outcome measures (EQ-5D, WOMAC), complication rates, and patient-individual charges in relation to reimbursement were compared with a matched control group of primary total joint replacements. Positive responder rate one year postoperatively was lower for revision arthroplasties with 72.9% than for primary arthroplasties with 90.1% (OR=0.30, 95%CI=0.18–0.59, p=0.001). Correspondingly, improvement in patient-reported outcome measures one year after surgery was lower in revision than in primary joint arthroplasty with EQ-5D 0.19±0.25 to 0.30±0.24 (p<0.001) and WOMAC 24.3±30.3 to 41.2±21.3 (p<0.001). Infection rate was higher in revision (6.8%) compared to primary replacements (0%, p=0.001). Mean charges in revision arthroplasty were 76.0% higher than in matched primary joint replacements (7110.8±2249.4$ to 4041.1±975.7$, p<0.001), whereas reimbursement was only 23.6% higher (9243.3±2258.4$ in revision and 7477.9±703.1$ in primary arthroplasty, p<0.001). Revision arthroplasty is associated with lower outcome and higher infection rate compared to primary replacements. The high financial expense of revision arthroplasty is only partly covered by a higher reimbursement.
Chemoprevention of Head and Neck Cancers: Does It Have Only One Face?
Authors: Siemianowicz Krzysztof , Likus Wirginia , Dorecka Mariola , Wilk Renata , Dziubdziela Włodzimierz , Markowski Jarosław
Published: September 2018

Head and neck squamous cell cancer (HNSCC) represents a significant burden worldwide. Chemoprevention of HNSCC is a means of cancer control with a use of drugs or natural agents in order to hinder or delay the cancer development. The purpose of this article is to review mechanism of action of different chemopreventive agents’ groups and results of most important researches concerning them. The safety issues of HNSCC chemoprevention are also discussed. In case of HNSCC there is currently no agent, which would give positive result in the third phase of clinical trials. Promising results of preclinical trials are not always confirmed by further tests. Main problems are low effectiveness, high toxicity, and lack of highly specificity biomarkers for monitoring the research. New trials concerning many agents, as well as novel technologies for provision of pharmaceutical forms of them, including drug nanocarriers, are currently underway, which gives hope for finding the perfect chemopreventive agent formula.
Improving Bus Operations through Integrated Dynamic Holding Control and Schedule Optimization
Authors: Liu Shuozhi , Luo Xia , Jin Peter J.
Published: September 2018

Bus bunching can lead to unreliable bus services if not controlled properly. Passengers will suffer from the uncertainty of travel time and the excessive waiting time. Existing dynamic holding strategies to address bus bunching have two major limitations. First, existing models often rely on large slack time to ensure the validity of the underlying model. Such large slack time can significantly reduce the bus operation efficiency by increasing the overall route travel times. Second, the existing holding strategies rarely consider the impact on the schedule planning. Undesirable results such as bus overloading issues arise when the bus fleet size is limited. This paper explores analytically the relationship between the slack time and the effect of holding control. The optimal slack time determined based on the derived relationship is found to be ten times smaller than in previous models based on numerical simulation results. An optimization model is developed with passenger-orient objective function in terms of travel cost and constraints such as fleet size limit, layover time at terminals, and other schedule planning factors. The optimal choice of control stops, control parameters, and slack time can be achieved by solving the optimization. The proposed model is validated with a case study established based on field data collected from Chengdu, China. The numerical simulation uses the field passenger demand, bus average travel time, travel time variance of road segments, and signal timings. Results show that the proposed model significantly reduce passengers average travel time compared with existing methods.
Precise Spatiotemporal Interruption of Regulatory T-cell–Mediated CD8+ T-cell Suppression Leads to Tumor Immunity
Authors: Zhou Xiaoyu , Zhao Shushu , He Yue , Geng Shuang , Shi Yan , Wang Bin
Published: September 2018

Tumors can develop despite the presence of competent host immunity via a complex system of immune evasion. One of the most studied factors originating from the host is immune suppression by regulatory T cells (Treg). Ample laboratory and clinical evidence suggests that Treg ablation leads to robust antitumor immune activation. However, how Tregs specifically achieve their suppression in the context of tumor progression is not entirely clear, particularly with regard to the timing and location where Treg inhibition takes place. In this work, we report that Tregs migrate to tumor-draining lymph nodes (TDLN) and block expression of sphingosine-1-phosphate receptor 1 (S1P1) on CD8+ T cells. This event trapped the CD8+ T cells in the TDLN and served as a facilitating factor for tumor growth. Intriguingly, minimalistic depletion of Tregs in TDLN in a short window following tumor inoculation was sufficient to restore CD8+ T-cell activities, which resulted in significant tumor reduction. Similar treatments outside this time frame had no such effect. Our work therefore reveals a subtle feature in tumor biology whereby Tregs appear to be driven by newly established tumors for a programmed encounter with newly activated CD8+ T cells in TDLN. Our results suggest the possibility that clinical interception of this step can be tested as a new strategy of cancer therapy, with expected high efficacy and low systemic side effects.

Significance:

These findings reveal a strong tumor suppressive effect invoked by minimal blockade of tumor draining lymph node regulatory T cells during early versus late tumorigenesis.
Cyclooxygenase-2 Influences Response to Cotargeting of MEK and CDK4/6 in a Subpopulation of Pancreatic Cancers
Authors: Maust Joel D. , Frankowski-McGregor Christy L. , Bankhead Armand , Simeone Diane M. , Sebolt-Leopold Judith S.
Published: September 2018

The ineffectiveness of chemotherapy in patients with pancreatic cancer highlights a critical unmet need in pancreatic cancer therapy. Two commonly mutated genes in pancreatic cancer, KRAS and CDKN2A, have an incidence exceeding 90%, supporting investigation of dual targeting of MEK and CDK4/6 as a potential therapeutic strategy for this patient population. An in vitro proliferation synergy screen was conducted to evaluate response of a panel of high passage and patient-derived pancreatic cancer models to the combination of trametinib and palbociclib to inhibit MEK and CDK4/6, respectively. Two adenosquamous carcinoma models, L3.6pl and UM59, stood out for their high synergy response. In vivo studies confirmed that this combination treatment approach was highly effective in subcutaneously implanted L3.6pl and UM59 tumor-bearing animals. Both models were refractory to single-agent treatment. Reverse-phase protein array analysis of L3.6pl tumors excised from treated animals revealed strong downregulation of COX-2 expression in response to combination treatment. Expression of COX-2 under a CMV-driven promoter and shRNA knockdown of COX-2 both led to resistance to combination treatment. Our findings suggest that COX-2 may be involved in the improved therapeutic outcome seen in some pancreatic tumors that fail to respond to MEK or CDK4/6 inhibitors alone but respond favorably to their combination.
Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions
Authors: Skovgaard Christiansen Ida , Kuijvenhoven Jolanda Corina , Bodtger Uffe , Naur Therese Maria Henriette , Ahmad Khaliq , Singh Sidhu Jatinder , Nessar Rafi , Salih Goran Nadir , Høegholm Asbjørn , Annema Jouke Tabe , Clementsen Paul Frost
Published: September 2018

Background: Diagnosing centrally located lung tumors without endobronchial abnormalities and not located near the major airways is a diagnostic challenge. Tumors near or adjacent to the esophagus can be aspirated and detected with esophageal ultrasound (EUS) using gastrointestinal endoscopes. Objective: To assess the feasibility and diagnostic yield of endoscopic ultrasound with bronchoscope-guided fine needle aspiration (EUS-B-FNA) in paraesophageally located lung tumors and its added value to bronchoscopy and endobronchial ultrasound (EBUS). Methods: Retrospective, multicenter international study (from January 1, 2015 until January 1, 2018) of patients with suspected lung cancer, undergoing bronchoscopy, EBUS, and endoscopic ultrasound bronchoscopy (EUS-B) in one session by a single operator (pulmonologist), in whom the primary lung tumor was detected and aspirated by EUS-B. In the absence of malignancy following endoscopy, transthoracic ultrasound needle aspiration, clinical and radiological follow-up of at least 6 months was performed. The yield and sensitivity of EUS-B-FNA and its added value to bronchoscopy and EBUS was assessed. Results: 58 patients were identified with the following diagnosis: non-small-cell lung cancer (n = 43), small-cell lung cancer (n = 6), mesothelioma (n = 2), metastasis (n = 1), nonmalignant (n = 6). The yield and sensitivity of EUS-B-FNA for detecting lung cancer was 90%. In 26 patients (45%), the intrapulmonary tumor was exclusively detected by EUS-B. Adding EUS-B to conventional bronchoscopy and EBUS increased the diagnostic yield for diagnosing lung cancer in para­esophageally located lung tumors from 51 to 91%. No EUS-B-related complications were observed. Conclusion: EUS-B-FNA is a feasible and safe technique for diagnosing centrally located intrapulmonary tumors that are located near or adjacent to the esophagus. EUS-B should be considered in the same endoscopy session following nondiagnostic bronchoscopy and EBUS.
Development of a Simple Risk Score Model to Predict Renal Artery Stenosis
Authors: Khatami Mohammad Reza , Jalali Arash , Zare Elmira , Sadeghian Saeid
Published: September 2018

Background/Aims: Renal artery stenosis (RAS) is a known cause of secondary hypertension and renal failure. Although renal artery angiography is the gold standard for diagnosing RAS, a simple method to estimate if patients will develop RAS is required. The aim of this retrospective study was to develop a simple risk score to predict significant RAS. Methods: Four thousand one hundred seventy-seven patients who underwent renal angiography between 2002 and 2016 at Tehran Heart Center were included. Significant RAS was defined as narrowing of the renal artery by at least 70%. Multiple predictors of the RAS were determined using multivariable logistic regression with a backward elimination method. The scoring system obtained from the final model was presented as nomogram. The possible nonlinear effect of continuous variables was evaluated using restricted cubic splines. Overfitting of the final model was assessed applying the tenfold cross-validation method. Model performance was checked using calibration plot as well as Hosmer-Lemeshow goodness of fit test, and area under the receiver operating characteristics (ROC) curve. Results: The prevalence of RAS was 14.1%. Female sex (OR [95% CI]: 1.53 [1.26–1.85]), hypertension (OR [95% CI]: 1.38 [1.08–1.77]), estimated glomerular filtration rate (OR [95% CI]: 0.98 [0.97–0.98]), body mass index (OR [95% CI]: 0.97 [0.95–0.99]), and age (OR [95% CI]: 1.01 [1.00–1.02]) were determined as the multiple predictors of RAS. The area under the ROC curve of the final predictive model was 0.702 (95% CI: 0.679–0.725). Conclusion: This model assesses the risk of RAS using available information. This model can be used for both clinical and research purposes.
Three Severe Cases of Viral Infections with Post-Kidney Transplantation Successfully Confirmed by Polymerase Chain Reaction and Flow Cytometry
Authors: Nakanishi Keita , Kaito Hiroshi , Ogi Miki , Takai Denshi , Fujimura Junya , Horinouchi Tomoko , Yamamura Tomohiko , Minamikawa Shogo , Ninchoji Takeshi , Nozu Kandai , Imadome Ken-Ichi , Iijima Kazumoto
Published: September 2018

Viral infections in patients with post-kidney transplantation are often difficult to diagnose as well as treat. We herein report three cases with severe viral infections after kidney transplantation. All their causative pathogens could be detected promptly by polymerase chain reaction and flow cytometry during the early stages of infection. These examinations would also be of great use to monitor therapeutic responses and disease activity. It is indeed true that no specific treatment is available for most of the viral infections, but we should be aware that some infections, such as Epstein-Barr virus infection, can be treatable with prompt and specific treatment, such as rituximab.
Surgical Outcomes of Liver Resection Combined with Inferior Vena Cava Resection and Reconstruction with Artificial Vascular Graft
Authors: Tomimaru Yoshito , Eguchi Hidetoshi , Wada Hiroshi , Doki Yuichiro , Mori Masaki , Nagano Hiroaki
Published: September 2018

Background/Aim: Inferior vena cava (IVC) resection and reconstruction with concomitant liver resection sometimes represent the only chance for patients with liver tumors involving the IVC to get cured. However, surgical outcomes of liver resection with IVC resection and reconstruction using an artificial vascular graft have not been well investigated. Methods: Out of a total of 1,179 cases, only 12 involving liver resection between 1998 and 2016 at our institution included IVC resection and reconstruction using an artificial vascular graft. An expanded polytetrafluoroethylene graft was used for the IVC reconstruction in all 12 cases. We investigated the surgical outcomes of these combined surgeries. Results: The median operative time was 650 min and the median blood loss was 2,600 mL. Postoperative complications (≥ grade III in the Clavien-Dindo classification) developed in 2 patients – 1 case of bleeding and one of bile leakage. There were no cases of operative mortality. No complications associated with the vascular graft were observed throughout the postoperative follow-up period, and the grafts remained patent in all cases. Conclusions: These results indicate favorable surgical outcomes of liver resection combined with IVC resection and reconstruction.
Free Pentosidine Assessment Based on Fluorescence Measurements in Spent Dialysate
Authors: Kalle Sigrid , Tanner Risto , Luman Merike , Fridolin Ivo
Published: September 2018

The aim of this study was to primarily explore the relationship between free pentosidine and the fluorescence properties of spent dialysate, and also to develop a model to assess the levels of free pentosidine in spent dialysate based on the fluorescence measurements. First, 40 patients (20 females and 20 males) were examined during 40 dialysis sessions. High-pressure liquid chromatography (HPLC) was used to measure the free pentosidine concentrations from the spent dialysate. The full fluorescence spectra of the spent dialysates were recorded and single- and multi-wavelength (MW) models were developed. The average free pentosidine concentrations in the spent dialysate measured by HPLC at the start and end of the dialysis session were (mean ± SD) 4.25 ± 3.11 and 0.94 ± 0.69 μg/L respectively. The removal ratios (RRs) between RR_lab and RR_MW were statistically similar (p > 0.2). The concentration of free pentosidine and the RR can therefore be estimated from the spent dialysate when utilising fluorescence measurements.
Towards a Regional Registry of Extended Typed Blood Donors: Molecular Typing for Blood Group, Platelet and Granulocyte Antigens
Authors: Portegys Jan , Rink Gabi , Bloos Pia , Scharberg Erwin A. , Klüter Harald , Bugert Peter
Published: September 2018

Background: The provision of compatible blood products to patients is the most essential task of transfusion medicine. Besides ABO and Rh, a number of additional blood group antigens often have to be considered for the blood supply of immunized or chronically transfused patients. It also applies for platelet antigens (HPA) and neutrophil antigens (HNA) for patients receiving platelet or granulocyte concentrates. Here, we describe the molecular screening for a number of blood group, HPA, and HNA alleles. Based on the screening results we are building up a regional blood donor registry to provide extended matched blood products on demand. Methods: We developed and validated TaqMan™ PCR and PCR-SSP methods for genetic markers defining 37 clinically relevant blood group antigens (beyond ABO and Rh), 10 HPA, and 11 HNA. Furthermore, we describe a feasible method for fast molecular screening of the HNA-2null phenotype. All data were statistically evaluated regarding genotype distribution. Allele frequencies were compared to ExAC data from non-Finnish Europeans. Results: Up to now more than 2,000 non-selected regular blood donors in south-west Germany have been screened for blood group, HPA, and HNA alleles. The screening results were confirmed by serology and PCR-SSP methods for selected numbers of samples. The allele frequencies were similar to non-finnish Europeans in the ExAC database except for the alleles encoding the S, HPA-3b and HNA-4b antigens, with significantly lower prevalence in our cohort, as well as the LU14 and the HNA-3b antigens, with a higher frequency compared to the ExAC data. We identified 71 donors with rare blood groups such as Lu(a+b-), Kp(a+b-), Fy(a-b-) and Vel-, and 169 donors with less prevalent HPA or HNA types. Conclusion: Molecular screening for blood group alleles by using TaqMan™ PCR is an effective and reliable high-throughput method for establishing a rare donor registry.
Cardiac Troponins for the Diagnosis of Acute Myocardial Infarction in Chronic Kidney Disease
Authors: Kraus Daniel , von Jeinsen Beatrice , Tzikas Stergios , Palapies Lars , Zeller Tanja , Bickel Christoph , Fette Georg , Lackner Karl J. , Drechsler Christiane , Neumann Johannes T. , Baldus Stephan , Blankenberg Stefan , Münzel Thomas , Wanner Christoph , Zeiher Andreas M. , Keller Till
Published: September 2018

Background

Patients with chronic kidney disease (
CKD
) are at high risk of myocardial infarction. Cardiac troponins are the biomarkers of choice for the diagnosis of acute myocardial infarction (
AMI
) without
ST
‐segment elevation (
NSTE
). In patients with
CKD
, troponin levels are often chronically elevated, which reduces their diagnostic utility when
NSTE
‐
AMI
is suspected. The aim of this study was to derive a diagnostic algorithm for serial troponin measurements in patients with
CKD
and suspected
NSTE
‐
AMI
.

Methods and Results

Two cohorts, 1494 patients from a prospective cohort study with high‐sensitivity troponin I (hs‐
cTnI
) measurements and 7059 cases from a clinical registry with high‐sensitivity troponin T (hs‐
cTnT
) measurements, were analyzed. The prospective cohort comprised 280
CKD
patients (estimated glomerular filtration rate <60 mL/min/1.73 m
2
). The registry data set contained 1581
CKD
patients. In both cohorts,
CKD
patients were more likely to have adjudicated
NSTE
‐
AMI
than non‐
CKD
patients. The specificities of hs‐
cTnI
and hs‐
cTnT
to detect
NSTE
‐
AMI
were reduced with
CKD
(0.82 versus 0.91 for hs‐
cTnI
and 0.26 versus 0.73 for hs‐
cTnT
) but could be restored by applying optimized cutoffs to either the first or a second measurement after 3 hours. The best diagnostic performance was achieved with an algorithm that incorporates serial measurements and rules in or out
AMI
in 69% (hs‐
cTnI
) and 55% (hs‐
cTnT
) of CKD patients.

Conclusions

The diagnostic performance of high‐sensitivity cardiac troponins in patients with
CKD
with suspected
NSTE
‐
AMI
is improved by use of an algorithm based on admission troponin and dynamic changes in troponin concentration.
Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest
Authors: Behnes Michael , Mashayekhi Kambis , Weiß Christel , Nienaber Christoph , Lang Siegfried , Reiser Linda , Bollow Armin , Taton Gabriel , Reichelt Thomas , Ellguth Dominik , Engelke Niko , Schupp Tobias , Ansari Uzair , El‐Battrawy Ibrahim , Rusnak Jonas , Akin Muharrem , Borggrefe Martin , Akin Ibrahim
Published: September 2018

Background

The study sought to assess the prognostic impact of acute myocardial infarction (
AMI
) with and without
ST
‐segment–elevation myocardial infarction (
STEMI
and
NSTEMI
) in patients with ventricular tachyarrhythmias and sudden cardiac arrest (
SCA
) on admission.

Methods and Results

A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (
VT
), fibrillation (
VF
), and sudden cardiac arrest (
SCA
) on admission from 2002 to 2016.
AMI
versus non‐
AMI
and
STEMI
versus
NSTEMI
were compared applying multivariable Cox regression models and propensity‐score matching for evaluation of the primary prognostic end point defined as long‐term all‐cause mortality at 2.5 years. Secondary end points were 30 days all‐cause mortality, cardiac death at 24 hours, in hospital death, and recurrent percutaneous coronary intervention (re‐
PCI
) at 2.5 years. In 2813 unmatched high‐risk patients with ventricular tachyarrhythmias and
SCA
,
AMI
was present in 29% (10%
STEMI
, 19%
NSTEMI
) with higher rates of
VF
(54% versus 31%) and
SCA
(35% versus 26%), whereas
VT
rates were higher in non‐
AMI
(56% versus 30%) (
P
 < 0.05).
AMI
‐related
VT
≥48 hours was associated with higher mortality (log rank
P
 = 0.001). Multivariable Cox regression models revealed non‐
AMI
(hazard ratio = 1.458;
P
 = 0.001) and
NSTEMI
(hazard ratio = 1.460;
P
 = 0.036) associated with increasing long‐term all‐cause mortality at 2.5 years, which was also proven after propensity‐score matching (non‐
AMI
versus
AMI
: 55% versus 43%, log rank
P
 = 0.001, hazard ratio = 1.349;
NSTEMI
versus
STEMI
: 45% versus 34%, log rank
P
 = 0.047, hazard ratio = 1.372). Secondary end points including 30 days and in‐hospital mortality, as well as re‐
PCI
were higher in non‐
AMI
patients.

Conclusions

In high‐risk patients presenting with ventricular tachyarrhythmias and
SCA
, non‐
AMI
revealed higher mortality than
AMI
, respectively
NSTEMI
than
STEMI
, alongside
AMI
‐related VT ≥48 hours.
Designing with Publics that Are Already Busy: A Case from Denmark
Authors: Birkbak Andreas , Petersen Morten Krogh , Jørgensen Tobias Bornakke
Published: September 2018

Design research has recently turned the attention to how designers contribute to the organization of publics when designing objects. This also raises the question of what kind of “good” public is being pursued. In this article, we argue for the importance of taking pre-existing normative projects into account to avoid approaching publics as yet another instantiation of “users” of design objects. We develop the argument by discussing our recent attempt at designing an online data visualization tool for public use. Instead of inviting potential future users of our tool to a design workshop, we decided to adopt an ethnographic interest in the existing “goods” that guided the publics for which we wanted to design. Based on explorations of three sites, we found our publics to be already busy with concerns that were both highly relevant to the data practices we were trying to facilitate, while at the same time overflowing and provoking our framing of the publics we were attempting to engage. Drawing from work in Science and Technology Studies on multiple ways of “doing good” in practice, we propose a reconsideration in design of the publics that we hope to “spark into being,” by pursuing the question of how to design with rather than for publics that are already busy.
Participatory Design Practices in Mental Health in the UK: Rebutting the Optimism
Authors: Pierri Paola
Published: September 2018

In what has been defined as an “era of participation,” design practices have become very central to the process of making publics and in bringing to life the dream of developing new ways of political engagement. By reflecting on my professional practice, I highlight the overly optimistic attitude that—most of the time—over-simplifies the role of design, especially when applied in public and community organizations. I illustrate participation as a paradox in itself, by problematizing the role and meaning of participatory encounters, and revealing some complex dynamics of exclusion and self-exclusion that are at play in the public realm.
Constructing Common Knowledge: Design Practice for Social Change in Craft Livelihoods in India
Authors: Mamidipudi Annapurna
Published: September 2018

From a policy point of view, the nine million craftspeople in India are underdeveloped economically and in need of expert design interventions to adapt to the market. Within nationalistic projects those same craftspeople are transformed into a heritage that needs to be preserved, rather than having a trajectory into a promising future. Is there an escape from these discourses of poverty or museumization when thinking about craftspeople? In response, this article investigates how design can be key to achieve social change that craftspeople desire. I propose that designers intending to mitigate vulnerability in livelihoods of craftspeople have to design not towards a pre-determined set of desirable economic outcomes, but include social and cultural outcomes. Using empirical examination of designer narratives as base, this article extends constructivist STS concepts of “cultures of technology” to “cultures of design” to elaborate three lenses to analyze design practice: Intervention, which focuses on the economic impact of development; Interaction that focuses on symmetric social relations between actors, within socio-technical ensembles that respond to nascent aspirations and needs of craftspeople; and Mediation, which includes constructing cultural worlds where craftspeople's expertise is common knowledge—as active producers of culture, rather than passive consumers of design.
Just Craft: Capabilities and Empowerment in Participatory Craft Projects
Authors: von Busch Otto , Pazarbasi Cigdem Kaya
Published: September 2018

In this article, we regard craft as a form of making “publics” from the perspective of the capabilities approach. With this approach, we argue capabilities developed in craft empowerment projects can be mapped and better understood. If projects empower higher internal as well as external capabilities, artisan practices can be used strategically to mobilize further social agency, autonomy, and political praxis.
What is the Scandal of Philosophy?
Authors: de Sá Pereira Roberto Horácio
Published: September 2018

The central question of this paper is: what has Kant’s Refutation of Idealism argument proven, if anything? What is the real scandal of philosophy and universal human reason? I argue that Kant’s Refutation argument can only be considered as sound if we assume that his target is what I call ‘metaphysical external-world skepticism’ (rather than traditional ‘epistemological external-world skepticism’). What is in question is not the ‘existence’ of outside things, but their very ‘nature’, that is, the claim that the thing outside us, which appears to us as persistent body in space, exists in itself as a substantia noumenon. Assuming the indirect-realist view that we only immediately know ideas and that their putative objects are known by inference, the metaphysical external-world skeptic doubts that the nature of things outside oneself is mind-independent.
Evaluation of Subtropical North Atlantic Ocean Circulation in CMIP5 Models against the Observational Array at 26.5°N and Its Changes under Continued Warming
Authors: Beadling R. L. , Russell J. L. , Stouffer R. J. , Goodman P. J.
Published: September 2018

Observationally based metrics derived from the Rapid Climate Change (RAPID) array are used to assess the large-scale ocean circulation in the subtropical North Atlantic simulated in a suite of fully coupled climate models that contributed to phase 5 of the Coupled Model Intercomparison Project (CMIP5). The modeled circulation at 26.5°N is decomposed into four components similar to those RAPID observes to estimate the Atlantic meridional overturning circulation (AMOC): the northward-flowing western boundary current (WBC), the southward transport in the upper midocean, the near-surface Ekman transport, and the southward deep ocean transport. The decadal-mean AMOC and the transports associated with its flow are captured well by CMIP5 models at the start of the twenty-first century. By the end of the century, under representative concentration pathway 8.5 (RCP8.5), averaged across models, the northward transport of waters in the upper WBC is projected to weaken by 7.6 Sv (1 Sv ≡ 106 m3 s−1; −21%). This reduced northward flow is a combined result of a reduction in the subtropical gyre return flow in the upper ocean (−2.9 Sv; −12%) and a weakened net southward transport in the deep ocean (−4.4 Sv; −28%) corresponding to the weakened AMOC. No consistent long-term changes of the Ekman transport are found across models. The reduced southward transport in the upper ocean is associated with a reduction in wind stress curl (WSC) across the North Atlantic subtropical gyre, largely through Sverdrup balance. This reduced WSC and the resulting decrease in the horizontal gyre transport is a robust feature found across the CMIP5 models under increased CO2 forcing.
Prediction of the Madden–Julian Oscillation: A Review
Authors: Kim Hyemi , Vitart Frédéric , Waliser Duane E.
Published: September 2018

There has been an accelerating interest in forecasting the weather and climate within the subseasonal time range. The Madden–Julian oscillation (MJO), an organized envelope of tropical convection, is recognized as one of the leading sources of subseasonal predictability. This review synthesizes the latest progress regarding the MJO predictability and prediction. During the past decade, the MJO prediction skill in dynamical prediction systems has exceeded the skill of empirical predictions. Such improvement has been mainly attributed to more observations and computer resources, advances in theoretical understanding, and improved numerical models aided in part by multinational efforts through field campaigns and multimodel experiments. The state-of-the-art dynamical forecasts have shown MJO prediction skill up to 5 weeks. Prediction skill can be extended by improving the ensemble generation approach tailored for MJO prediction and by averaging multiensembles or multimodels. MJO prediction skill can be influenced by the tropical mean state and low-frequency climate mode variations, as well as by the extratropical circulation. MJO prediction skill is proven to be sensitive to model physics, ocean–atmosphere coupling, and quality of initial conditions, while the impact of the model resolution seems to be marginal. Remaining challenges and recommendations on new research avenues to fully realize the predictability of the MJO are discussed.
Impact of AMSU-A Radiances in a Column Ensemble Kalman Filter
Authors: Mitchell Herschel L. , Houtekamer P. L. , Heilliette Sylvain
Published: September 2018

A column EnKF, based on the Canadian global EnKF and using the RTTOV radiative transfer (RT) model, is employed to investigate issues relating to the EnKF assimilation of Advanced Microwave Sounding Unit-A (AMSU-A) radiance measurements. Experiments are performed with large and small ensembles, with and without localization. Three different descriptions of background temperature error are considered: 1) using analytical vertical modes and hypothetical spectra, 2) using the vertical modes and spectrum of a covariance matrix obtained from the global EnKF after 2 weeks of cycling, and 3) using the vertical modes and spectrum of the static background error covariance matrix employed to initiate a global data assimilation cycle. It is found that the EnKF performs well in some of the experiments with background error description 1, and yields modest error reductions with background error description 3. However, the EnKF is virtually unable to reduce the background error (even when using a large ensemble) with background error description 2. To analyze these results, the different background error descriptions are viewed through the prism of the RT model by comparing the trace of the matrix , where is the RT model and is the background error covariance matrix. Indeed, this comparison is found to explain the difference in the results obtained, which relates to the degree to which deep modes are, or are not, present in the different background error covariances. The results suggest that, after 2 weeks of cycling, the global EnKF has virtually eliminated all background error structures that can be “seen” by the AMSU-A radiances.
Playing in the Darkness: Use of the Object and Use of the Subject
Authors: Cooper Steven H.
Published: September 2018

Play in the context of the patient’s sense of absence, loss, and compromised capacities for symbolization can be a link between unsymbolized experience and greater capacities for representation. Winnicott’s concepts of play evolved as one of the ways that analysts translate unconscious and unrepresented experience. For many patients who have experienced absence, the analyst and the analytic setting are subjected to the patient’s unconscious efforts to destroy and negate meaning and relatedness. For the analyst to be “used” as an object to be destroyed and to survive destruction, he must become a subject in the mind of the patient and in his own mind as analyst within the intersubjective field. The analyst’s work with his own resistance is vital to becoming a changing subject and an object available for play in the psychoanalytic process.