bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of rescue stenting following failed mechanical thrombectomy for anterior circulation large vessel occlusion: propensity score analysis
Authors: Peng Feng , Wan Junfang , Liu Wenhua , Huang Wenguo , Wang Li , Qiu Tao , Yang Shiquan , Shi Qiang , Zhang Shuai , Zeng Guoyong , Wang Yan , Ai Zhibin , Liu Yong , Hu Wei , Wen Changming , Shi Zhonghua , Pu Jie , Qiu Zhongmin , Wu Deping , Gong Zili , Shuai Jie , Yang Qingwu , Zi Wenjie , Li Fengli
Published: September 2019

Purpose

To evaluate the effectiveness and safety of rescue stenting (RS) after failed mechanical thrombectomy (MT) for patients with large artery occlusion in the anterior circulation.

Methods

Consecutive patients who experienced failed reperfusion and subsequently did or did not undergo RS at 16 comprehensive stroke centers were enrolled from January 2015 to June 2018. Propensity score matching was used to achieve baseline balance between the patient groups. Symptomatic intracranial hemorrhage (sICH) at 48 hours and the modified Rankin Scale scores and mortality at 3 months in the two groups were compared.

Results

A total of 90 patients with RS and 117 patients without RS after failed MT were enrolled. Propensity score matching analysis selected 132 matched patients. The good outcome rate was significantly higher in matched patients with RS than in those without RS (36.4% vs 19.7%, p=0.033), whereas the sICH (13.6% vs 21.2%, p=0.251) and mortality (31.9% vs 43.9%, p=0.151) were not significantly different between the groups.

Conclusions

RS seems to be an effective safe choice for patients with large vessel occlusion of the anterior circulation who underwent failed MT.
Nutritional evaluation of seal by-products as an alternative protein source for use in monogastric animals
Authors: Anderson Derek M. , Priest Gina , Collins Stephanie A. , MacIsaac Janice L.
Published: September 2019

Seal by-products (grey seal with the bone in, grey seal with the bone removed, and harp seal) were subjected to five different processing methods: high (100 °C) and low (45 °C) temperature oven-drying, freeze-drying (FD), silage by acid or natural fermentation. Growth performance of diets containing these seal by-products was evaluated in rats as a monogastric model species. With the exception of naturally fermented grey seal without bone, weight gains for rats fed the boneless grey seal products were highest of the seal products (24.65–30.04 g rat−1) and statistically similar to those of rats fed casein (32.15 g rat−1). An in vivo crude protein (CP) digestibility study was conducted using 12 adult white rats in metabolic cages that allowed separate collection of urine and feces. The 16% CP diets contained chromic oxide as an inert fecal marker at 0.5%. Total fecal and urine production, as well as feed and water intake, were recorded daily within the three experimental periods. Digestibility of CP was significantly higher for the naturally fermented grey seal without bone silage (94.0%) than casein (89.0%), whereas the other seal products were statistically similar (91.7%–92.7%). The CP content of FD grey seal was as high as 91.7% (FD). Seal by-products have the potential to be used as alternative high-protein feedstuffs in monogastric diets.
Fourteen steps to relevance: taking probiotics from the bench to the consumer
Authors: Reid Gregor
Published: September 2019

Much is made of the need to translate scientific research into improved care of people or other life forms. Grant applications invariably start with the extent of a problem and end by claiming that their work will or could result in making an impact. In truth, very few projects ever lead to translation at the level of the host, nor was that really their intent. For those who are focused on applied science, there are many ways to reach the desired goal, sometimes through serendipity or by logical stepwise progress. The following paper will provide personal insight into the stages, pitfalls, and ultimate assessment of relevance in the context of using probiotic lactobacilli for human health and other applications.
Axial-anomaly in noncommutative QED and Pauli–Villars regularization
Authors: AlMasri Mohammad Walid
Published: September 2019

We calculate the [Formula: see text](1) axial-anomaly in two and four dimensions using a modified path integral method coupled to a Pauli–Villars regulator field in the noncommutative QED. Pauli–Villars regularization method provides us with unambiguous way to connect the modified path integral formalism with perturbative axial Ward identities at each step of calculations.
Neural Conversation Generation with Auxiliary Emotional Supervised Models
Authors: Zhou Guangyou , Fang Yizhen , Peng Yehong , Lu Jiaheng
Published: September 2019

An important aspect of developing dialogue agents involves endowing a conversation system with emotion perception and interaction. Most existing emotion dialogue models lack the adaptability and extensibility of different scenes because of their limitation to require a specified emotion category or their reliance on a fixed emotional dictionary. To overcome these limitations, we propose a neural conversation generation with auxiliary emotional supervised model (nCG-ESM) comprising a sequence-to-sequence (Seq2Seq) generation model and an emotional classifier used as an auxiliary model. The emotional classifier was trained to predict the emotion distributions of the dialogues, which were then used as emotion supervised signals to guide the generation model to generate diverse emotional responses. The proposed nCG-ESM is flexible enough to generate responses with emotional diversity, including specified or unspecified emotions, which can be adapted and extended to different scenarios. We conducted extensive experiments on the popular dataset of Weibo post--response pairs. Experimental results showed that the proposed model was capable of producing more diverse, appropriate, and emotionally rich responses, yielding substantial gains in diversity scores and human evaluations.
EL: Local Image Descriptor Based on Extreme Responses to Partial Derivatives of 2D Gaussian Function
Authors: Maver Jasna , Skočaj Danijel
Published: September 2019

We propose a two‐part local image descriptor EL (Edges and Lines), based on the strongest image responses to the first‐ and second‐order partial derivatives of the two‐dimensional Gaussian function. Using the steering theorems, the proposed method finds the filter orientations giving the strongest image responses. The orientations are quantized, and the magnitudes of the image responses are histogrammed. Iterative adaptive thresholding of histogram values is then applied to normalize the histogram, thereby making the descriptor robust to nonlinear illumination changes. The two‐part descriptor is empirically evaluated on the HPatches benchmark for three different tasks, namely, patch verification, image matching, and patch retrieval. The proposed EL descriptor outperforms the traditional descriptors such as SIFT and RootSIFT on all three evaluation tasks and the deep‐learning‐based descriptors DeepCompare, DeepDesc, and TFeat on the tasks of image matching and patch retrieval.
Lipschitz Continuity for the Solutions of Triharmonic Equation
Authors: Yu Zhou , Bing Xiao
Published: September 2019

Let be the unit disk in the complex plane and denote . Write for the class of all sense‐preserving homeomorphism of onto the boundary of a C2 convex Jordan domain Ω. In this paper, five equivalent conditions for the solutions of triharmonic equations with Dirichlet boundary value conditions and to be Lipschitz continuous are presented.
Infantile Myofibroma Presenting as a Large Ulcerative Nodule in a Newborn
Authors: Shahzad Farooq , Chappell Ava G. , Purnell Chad A. , Aldulescu Monica , Chamlin Sarah
Published: September 2019

The differential diagnosis of a congenital cutaneous vascular-appearing mass in a newborn is broad and includes both benign and malignant tumors. We report the case of a newborn who presented with an erythematous exophytic skin nodule on the right upper leg. Excision was performed due to ulceration, concern for bleeding, and for diagnosis. Pathology revealed the mass to be an infantile myofibroma. This case highlights the importance of considering a broad differential diagnosis in a newborn with a cutaneous mass. While history, physical exam, and imaging can help diagnose some cases, a biopsy or excision is often needed to distinguish benign lesions from more concerning lesions.
Third Molar Displacement into Submandibular Space
Authors: Oliveira Mirlany Mendes Maciel , da Franca Acioly Rodrigo , de Souza Dennis Dinelly , da Silva Bruno Araújo , Carvalho Daniel Do Carmo
Published: September 2019

There are various accidents and complications that may occur during extraction of dental elements. The displacement of dental elements to other facial spaces is one kind of the possible complications, and there may be significant physical and psychological results for the patient. The treatment for this kind of occurrence may vary from a conservative technique to surgical procedure, what will depend on clinical characteristics, symptoms, the location of the dental element, and its relation to adjacent structures. The objective of this article is to report a clinical case of the displacement of a lower third molar tooth into the submandibular space during its extraction, followed by surgical removal through extraoral approach, with proservation for the next two years when patient evolved to paresthesia of the inferior alveolar nerve.
Intranasal Ectopic Tooth in Adult and Pediatric Patients: A Report of Two Cases
Authors: Bergamaschi Isabela Polesi , Olsson Bernardo , Sebastiani Aline Monise , Trento Guilherme dos Santos , Rebellato Nelson Luis Barbosa , Klüppel Leandro Eduardo , da Costa Delson Joao , Scariot Rafaela
Published: September 2019

The aim of this study was to report two rare cases of ectopic tooth into the nasal cavity. The first case reports a 32-year-old female patient with the main complaint of having a tooth inside her nose. According to her, this condition causes pain and sporadic nosebleed. The patient had a facial trauma when she was 6 years old. The second case refers to an 8-year-old girl with left incomplete unilateral cleft lip and palate. The main complaint was left-sided nasal obstruction by a white hard mass. The treatment for both cases was surgical removal of the ectopic erupted tooth under general anesthesia. In conclusion, we can state that the surgical removal of intranasal tooth is a safe procedure and improves patient’s quality of life.
Aurora A–Selective Inhibitor LY3295668 Leads to Dominant Mitotic Arrest, Apoptosis in Cancer Cells, and Shows Potent Preclinical Antitumor Efficacy
Authors: Du Jian , Yan Lei , Torres Raquel , Gong Xueqian , Bian Huimin , Marugán Carlos , Boehnke Karsten , Baquero Carmen , Hui Yu-Hua , Chapman Sonya C. , Yang Yanzhu , Zeng Yi , Bogner Sarah M. , Foreman Robert T. , Capen Andrew , Donoho Gregory P. , Van Horn Robert D. , Barnard Darlene S. , Dempsey Jack A. , Beckmann Richard P. , Marshall Mark S. , Chio Li-Chun , Qian Yuewei , Webster Yue W. , Aggarwal Amit , Chu Shaoyou , Bhattachar Shobha , Stancato Louis F. , Dowless Michele S. , Iversen Phillip W. , Manro Jason R. , Walgren Jennie L. , Halstead Bartley W. , Dieter Matthew Z. , Martinez Ricardo , Bhagwat Shripad V. , Kreklau Emiko L. , Lallena Maria Jose , Ye Xiang S. , Patel Bharvin K.R. , Reinhard Christoph , Plowman Gregory D. , Barda David A. , Henry James R. , Buchanan Sean G. , Campbell Robert M.
Published: September 2019

Although Aurora A, B, and C kinases share high sequence similarity, especially within the kinase domain, they function distinctly in cell-cycle progression. Aurora A depletion primarily leads to mitotic spindle formation defects and consequently prometaphase arrest, whereas Aurora B/C inactivation primarily induces polyploidy from cytokinesis failure. Aurora B/C inactivation phenotypes are also epistatic to those of Aurora A, such that the concomitant inactivation of Aurora A and B, or all Aurora isoforms by nonisoform–selective Aurora inhibitors, demonstrates the Aurora B/C-dominant cytokinesis failure and polyploidy phenotypes. Several Aurora inhibitors are in clinical trials for T/B-cell lymphoma, multiple myeloma, leukemia, lung, and breast cancers. Here, we describe an Aurora A–selective inhibitor, LY3295668, which potently inhibits Aurora autophosphorylation and its kinase activity in vitro and in vivo, persistently arrests cancer cells in mitosis, and induces more profound apoptosis than Aurora B or Aurora A/B dual inhibitors without Aurora B inhibition–associated cytokinesis failure and aneuploidy. LY3295668 inhibits the growth of a broad panel of cancer cell lines, including small-cell lung and breast cancer cells. It demonstrates significant efficacy in small-cell lung cancer xenograft and patient-derived tumor preclinical models as a single agent and in combination with standard-of-care agents. LY3295668, as a highly Aurora A–selective inhibitor, may represent a preferred approach to the current pan-Aurora inhibitors as a cancer therapeutic agent.
A Novel Salicylanilide Derivative Induces Autophagy Cell Death in Castration-Resistant Prostate Cancer via ER Stress-Activated PERK Signaling Pathway
Authors: Hsieh Chia-Ling , Huang Hsu-Shan , Chen Kuan-Chou , Saka Teigi , Chiang Chih-Ying , Chung Leland W.K. , Sung Shian-Ying
Published: September 2019

Metastatic castration-resistant prostate cancer (CRPC) is currently incurable. Cancer growth and progression is intimately affected by its interaction with host microenvironment. Cotargeting of the stroma and prostate cancer is therefore an emerging therapeutic strategy for metastatic CRPC. Cancer-induced osteoclastogenesis is known to contribute to CRPC bone metastasis. This study is to extend pharmacologic value of our synthesized LCC03, a derivative of 5-(2′,4′-difluorophenyl)-salicylanilide that has previously testified for its osteoclastogenesis activity, by exploring its additional cytotoxic properties and underlying mechanism in CRPC cells. LCC03 was chemically synthesized and examined for cell growth inhibition in a serial of CRPC cell lines. We demonstrated that LCC03 dose-dependently suppressed proliferation and retarded cell-cycle progression in CRPC cells. The classical autophagy features, including autophagosome formation and LC3-II conversion, were dramatically shown in LCC03-treated CRPC cells, and it was associated with the suppressed AKT/mTOR signaling pathways, a major negative regulator of autophagy. Moreover, an expanded morphology of the endoplasmic reticulum (ER), increased expression of the ER stress markers GRP78 and PERK, and eIF2α phosphorylation were observed. Blockage of autophagy and PERK pathways using small molecule inhibitors or shRNA knockdown reversed LCC03-induced autophagy and cell death, thus indicating that the PERK–eIF2α pathway contributed to the LCC03-induced autophagy. Furthermore, treatment of tumor-bearing mice with intraperitoneal administered LCC03 suppressed the growth of CRPC xenografts in mouse bone without systemic toxicity. The dual action of 5-(2′,4′-difluorophenyl)-salicylanilide on targeting both the osteoclasts and the tumor cells strongly indicates that LCC03 is a promising anticancer candidate for preventing and treating metastatic CRPC.
The Efficacy of Ferumoxytol for Iron Deficiency Anemia: A Meta-Analysis of Randomized Controlled Trials
Authors: Shao Yanping , Luo Wenda , Xu Haiyan , Zhang Li , Guo Qunyi
Published: September 2019

Introduction: This systematic review and meta-analysis aims to explore the influence of ferumoxytol versus placebo on iron deficiency anemia. Methods: We search for randomized controlled trials (RCTs) assessing the effect of ferumoxytol on iron deficiency anemia on PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. This meta-analysis is performed using the random-effects model. Results: Four RCTs are included in the meta-analysis. Compared with the control group for iron deficiency anemia, intravenous ferumoxytol can significantly improve the proportion of patients with a ≥20 g/L hemoglobin (Hb) increase (RR = 18.43; 95% CI = 7.29–46.57; p < 0.00001), the proportion of patients with an Hb level ≥120 g/L (RR = 18.55; 95% CI = 8.66–39.72; p < 0.00001), transferrin saturation (mean difference = 11.08; 95% CI = 9.86–12.31; p < 0.00001) and FACIT-fatigue score (mean difference = 4.60; 95% CI = 3.21–6.00; p < 0.00001), but has no remarkable influence on adverse events (RR = 1.33; 95% CI = 0.84–2.10; p = 0.22), serious adverse events (RR = 1.22; 95% CI = 0.74–2.02; p = 0.44), and death (RR = 0.32; 95% CI = 0.05–1.95; p = 0.22). Conclusions: Intravenous ferumoxytol can provide the important benefits for iron deficiency anemia.
Antibiotic Allergy in Children: More than Just a Label
Authors: Abrams Elissa , Netchiporouk Elena , Miedzybrodzki Barbara , Ben-Shoshan Moshe
Published: September 2019

Within the broad category of adverse drug reactions in children, there has been a recent focus specifically on the evaluation of children with antibiotic allergy, in particular, beta-lactam allergy. The potential consequences of being labeled beta-lactam allergy are increasingly recognized. Appropriate evaluation of children with suspected reactions to antibiotics is essential as it is increasingly being recognized that the label of “penicillin allergy” is associated with adverse health and economic outcomes. This review will focus on the 3 main classes of antibiotics reported to cause allergic reactions in children: beta lactams (penicillin derivatives and cephalosporins), macrolides, and sulfonamides. This article is a narrative review of the prevalence, diagnosis, and management of different types of antibiotic allergies in children. Our review reveals that antibiotic allergy is often overreported and not appropriately diagnosed in the pediatric age groups. There is a recent shift in the diagnostic paradigm from the use of skin tests and if negative challenges to the use of challenge only in the pediatric age group. Larger studies to establish the usefulness and safety of this new approach as well as updated guidelines are needed.
Extensive Emperipolesis of Neoplastic Lymphocytes by Mesothelial Cells in Pleural Effusion Cytology in a Case of a Mediastinal T-Cell Lymphoblastic Lymphoma: A Rare but Diagnostically Useful Phenomenon
Authors: Haefliger Simon , Rebetez Julien , Buser Paul J. , Dirnhofer Stefan , Bubendorf Lukas
Published: September 2019

Emperipolesis is a biological process defined by the presence of an intact cell within the cytoplasm of another cell. In pleural fluid cytology, the phenomenon is very rare but has already been described in B-cell lymphoma. Here, we report the first case of a T-cell lymphoma diagnosed on a pleural fluid exhibiting extensive emperipolesis of tumor cells by mesothelial cells. Additionally, in order to evaluate the prevalence of emperipolesis in lymphocyte rich pleural effusion cytology, we reviewed cases from our archive, including cases with lymphoma and cases with reactive T-lymphocyte rich effusion.
The Use of a Combination of Vaccinium Macracarpon, Lycium barbarum L. and Probiotics (Bifiprost®) for the Prevention of Chronic Bacterial Prostatitis: A Double-Blind Randomized Study
Authors: Chiancone Francesco , Carrino Maurizio , Meccariello Clemente , Pucci Luigi , Fedelini Maurizio , Fedelini Paolo
Published: September 2019

Introduction: To evaluate the efficacy of Bifiprost® + Serenoa Repens 320 mg versus Serenoa Repens 320 mg alone for the prevention of chronic bacterial prostatitis (CBP) due to enterobacteriaceae. Methods: Between September 2016 and September 2018, 120 patients with CBP at the National Institutes of Health (NIH type II) with recurrent infections due to enterobacteriaceae (Escherichia Coli and Enterococcus faecalis) were enrolled and randomized into 2 groups each to receive Bifiprost® + Serenoa Repens 320 mg (Group A) or Serenoa Repens 320 mg alone (Group B) daily for 24 weeks (after receiving a proper antibiotic treatment with subsequent culture negativization). The primary endpoint was the reduction in the episodes of prostatitis. The secondary endpoint evaluated was the score of the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI). Evaluation was performed at baseline and at 12, 24, and 36 weeks. Results: The patients of the Group A experienced a significantly larger reduction in the prostatitis episodes than the Group B at 24 and 36 weeks, but they did not experience a significantly larger reduction at 12 weeks. After 12 weeks of treatment, the mean NIH-CPSI score was reduced in both groups compared with baselines, but no significant differences were seen between the Group A and Group B. On the contrary, we observed a significant difference in the mean NIH-CPSI score between the 2 groups at 24 and 36 weeks. Conclusion: The association of Bifiprost® and Serenoa Repens 320 mg improves the prevention of the episodes of CBP due to enterobacteriaceae and ameliorates prostatitis-related symptoms after 6 months of therapy. The long-term impact on the entero-urinary route was also seen 3 months after the end of the treatment.
Unexpected Response to Nivolumab in a “Fast Progressor” Head and Neck Cancer Patient
Authors: Napolitano Martina , Trudu Lucia , Bertolini Federica
Published: September 2019

Prior to the advent of immune checkpoint inhibitors targeting PD-1/PD-L1 axis no drug demonstrated to improve survival or quality of life in the second-line treatment of recurrent or metastatic head and neck squamous cell carcinoma (R/M-HNSCC). Nivolumab appear to have a clear clinical benefit for R/M-HNSCC, based on improved survival, good toxicity profile, reduction in symptoms and improvement in overall quality of life. This benefit seems to be greater for PD-L1 positive patients and independent of previous treatment, even being observed among heavily pre-treated patients. However, even in responding tumors acquired resistance to nivolumab usually occurred, limiting the drug’s activity. We report a case of unexpected prolonged stable disease in second-line treatment with nivolumab after a rapid progression disease under first-line chemotherapy in biomarker-positive R/M-HNSCC.
Loss of PTPN23 Promotes Proliferation and Epithelial-to-Mesenchymal Transition in Human Intestinal Cancer Cells
Authors: van der Lely Lisa , Häfliger Janine , Montalban-Arques Ana , Bäbler Katharina , Schwarzfischer Marlene , Sabev Max , Gottier Claudia , Lang Silvia , Scharl Michael , Spalinger Marianne R.
Published: September 2019

Background/Objectives: Protein tyrosine phosphatase nonreceptor type 23 (PTPN23) has recently been associated with several human epithelial cancers via regulation of growth factor signaling. Colorectal carcinoma (CRC) is a leading cause for cancer-related death worldwide and is associated with aberrant epidermal (EGF) and vascular endothelial growth factor signaling. Here, we investigated whether PTPN23 might play a role in CRC. Methods: Expression of PTPN23 was analyzed in CRC tissue by immunohistochemistry. PTPN23 was silenced in HT-29 cells to address the role of PTPN23 in EGF signaling, gene expression, and cell migration. Results: PTPN23 silencing in HT-29 and Caco-2 intestinal epithelial cancer cells significantly enhanced activation of pro-oncogenic signaling molecules and genes promoting epithelial-to-mesenchymal transition (EMT) upon EGF treatment, while genes encoding tight junction proteins were significantly reduced. Conclusions: Our data clearly indicate that loss of PTPN23 is associated with increased activation of pro-oncogenic signaling pathways and an enhanced ability of human intestinal cancer cells to undergo EMT. Taken together, these findings show that PTPN23 acts as a tumor suppressor gene in CRC.
Perioperative Management of Pancreaticoduodenectomy: Avoiding Admission to the Intensive Care Unit
Authors: Faraj Walid , Mukherji Deborah , Zaghal Ahmad M. , Nassar Hussein , Mokadem Farah H. , Jabbour Samar , Ayoub Chakib , Rizk Marwan S. , Kanso Mariam , Jaafar Rola F. , Heaton Nigel , Khalife Mohamad
Published: September 2019

Introduction: With the advancement in surgical expertise at high-volume centers and advances in perioperative management, pancreaticoduodenectomy is becoming safer and remains the gold standard for treating periampullary pathologies. We describe our experience in optimizing perioperative management in order to avoid admission to the intensive care unit and improve outcomes. Method: Retrospective data were collected on 370 surgical patients who underwent a pancreaticoduodenectomy between the years 1994 and 2016. Results: Of the 370 patients, 200 operated between 2009 and 2016 did not require intensive care admission, blood transfusion, or central line insertion. The results were compared between different time intervals: before the year 1998, between the years 1998 and 2008, and between the years 2009 and 2016. The median blood loss dropped from 800 to 400 to 300 mL, respectively. The median operative time also dropped from 360 to 335 to 215 min, respectively. In addition, the median length of hospital stay decreased from 25 to 16 to 7 days, respectively. Conclusion: With the centralization of pancreaticoduodenectomy in high-volume centers and with specialized surgeons performing the surgery, there is a significant decrease in the onset of postoperative complications with a lesser need for blood transfusions and, subsequently, better recovery of patients without the need for intensive care unit admission.
Point of Care Clinical Risk Score to Improve the Negative Diagnostic Utility of an Agatston Score of Zero
Authors: Alshahrani Ali M. , Mahmood Hamza , Wells George A. , Hossain Alomgir , Rybicki Frank J. , Achenbach Stephan , Al-Mallah Mouaz H. , Andreini Daniele , Bax Jeroen J. , Berman Daniel S. , Budoff Matthew J. , Cademartiri Filippo , Callister Tracy Q. , Chang Hyuk-Jae , Chinnaiyan Kavitha , Cury Ricardo C. , DeLago Augustin , Feuchtner Gudrun , Hadamitzky Martin , Hausleiter Joerg , Kaufmann Philipp A. , Kim Yong-Jin , Leipsic Jonathon A. , Maffei Erica , Marques Hugo , Pontone Gianluca , Raff Gilbert , Rubinshtein Ronen , Shaw Leslee J. , Villines Todd C. , Lin Fay Y. , Min James K. , Chow Benjamin J.
Published: September 2019

Background:

Coronary artery calcification is a marker of underlying atherosclerotic vascular disease. The absence of coronary artery calcification is associated with a low prevalence of obstructive coronary artery disease (CAD), but it cannot be ruled out completely. We sought to develop a clinical tool that can be added to Agatston score of zero to rule out obstructive CAD with high accuracy.

Methods:

We developed a clinical score retrospectively from a cohort of 4903 consecutive patients with an Agatston score of zero. Patients with prior diagnosis of CAD, coronary percutaneous coronary intervention, or surgical revascularization were excluded. Obstructive CAD was defined as any epicardial vessel diameter narrowing of ≥50%. The score was validated using an external cohort of 4290 patients with an Agatston score of zero from a multinational registry.

Results:

The score consisted of 7 variables: age, sex, typical chest pain, dyslipidemia, hypertension, family history, and diabetes mellitus. The model was robust with an area under the curve of 0.70 (95% CI, 0.65–0.76) in the derivation cohort and 0.69 (95% CI, 0.65–0.72) in the validation cohort. Patients were divided into 3 risk groups based on the score: low (≤6), intermediate (7–13), and high (≥14). Patients who score ≤6 have a negative likelihood ratio of 0.42 for obstructive CAD, whereas those who score ≥14 have a positive likelihood ratio of >5.5 for obstructive CAD. The outcome was ruled out in >98% of patients with a score ≤6 in the validation cohort.

Conclusions:

We developed a score that may be used to identify the likelihood of obstructive CAD in patients with an Agatston score of zero, which may be used to direct the need for additional testing. However, the results of this retrospective analysis are hypothesis generating and before clinical implementation should be validated in a trial with a prospectively collected data.
Amendments and updates to F.C. Fraser’s key to Indian Lestes spp. (Odonata: Lestidae) to resolve confusion of L. patricia Fraser, 1924 and L. nigriceps Fraser, 1924, with notes on L. nodalis Selys 1891 and L. garoensis Lahiri, 1987
Authors: KOSTERIN OLEG E.
Published: September 2019

Last year I reported the rediscovery in Cambodia of Lestes nigriceps Fraser, 1924, described from Pusa, India (Fraser 1924a) but never reported since that time from India (Kosterin 2018). In my paper I presumed non-conspecificity of the male and females of the type series and made critical comments on Fraser’s appendage drawing (Fraser 1924a: plate IX: 6) and verbal descriptions (Fraser 1924a; 1933) of this species but did not consider his key for Lestes Leach, 1815 in the 1st volume of “Fauna of British India including Ceylon and Burma. Odonata” (Fraser 1933). Later I found a considerable corruption in this key, which could lead to misidentifications. (It is noteworthy to stress that Fraser explicitly provided keys for males only).
Garra roseae, a new species from the Makran region in southern Iran (Teleostei: Cyprinidae)
Authors: MOUSAVI-SABET HAMED , SAEMI-KOMSARI MARYAM , DOADRIO IGNACIO , FREYHOF JÖRG
Published: September 2019

Garra roseae, new species, is described from the stream Tang-e-Sarhe in the Iranian Makran region. It is distinguished from its congeners in the Middle East by lacking barbels, having a small mental disc, 42–58 total scales along the lateral line, 24–30 scales along the predorsal midline, and 20–24 circumpeduncular scales. It is further characterised by having five diagnostic nucleotide substitutions and a minimum K2P distance of 5.39% to G. rossica and 5.49% to G. nudiventris in the mtDNA COI barcode region. Garra phryne from eastern Iran is considered to be a synonym of G. nudiventris.
Development of a Misaligned Tropical Cyclone
Authors: Schecter David A. , Menelaou Konstantinos
Published: September 2019

A cloud-resolving model is used to examine the virtually shear-free evolution of incipient tropical cyclones initialized with different degrees of misalignment between the lower- and middle-tropospheric centers of rotation. Increasing the initial displacement of rotational centers (the tilt) from a negligible value to several hundred kilometers extends the time scale of hurricane formation from 1 to 10 days. Hindered amplification of the maximum tangential velocity υm at the surface of a strongly perturbed system is related to an extended duration of misalignment resulting from incomplete early decay and subsequent transient growth of the tilt magnitude. The prolonged misalignment coincides with a prolonged period of asymmetric convection peaked far from the surface center of the vortex. A Sawyer–Eliassen model is used to analyze the disparity between azimuthal velocity tendencies of selected pre–tropical storm vortices with low and high degrees of misalignment. Although no single factor completely explains the difference of intensification rates, greater misalignment is linked to weaker positive azimuthal velocity forcing near υm by the component of the mean secondary circulation attributed to heating by microphysical cloud processes. Of note regarding the dynamics, enhanced tilt only modestly affects the growth rate of kinetic energy outside the core of the surface vortex while severely hindering intensification of υm within the core for at least several days. The processes controlling the evolution of the misalignment associated with inefficient development are examined in detail for a selected simulation. It is found that adiabatic mechanisms are capable of driving the transient amplification of tilt, whereas diabatic processes are essential to ultimate alignment of the tropical cyclone.
Topographic Forcing from East Asia and North America in the Northern Winter Stratosphere and Their Mutual Interference
Authors: Ren Rongcai , Xia Xin , Rao Jian
Published: September 2019

This study uses the stratosphere-resolved Whole Atmosphere Community Climate Model to demonstrate the “independent” and “dependent” topographic forcing from the topography of East Asia (EA) and North America (NA), and their “joint” forcing in the northern winter stratosphere. The mutual interference between the EA and NA forcing is also demonstrated. Specifically, without EA, an independent NA can also, like EA, induce a severe polar warming and weakening of the stratospheric polar vortex. While EA favors a displacement of the polar vortex toward Eurasia, NA favors a displacement toward the North America–Atlantic region. However, the independent-EA-forced weakening effect on the polar vortex can be largely decreased and changes to a location displacement when NA exists, and the interference the other way around is even more critical, being able to completely offset the independent-NA-forced effect, because EA can substantively obstruct NA’s effect on the tropospheric wave pattern over the Eurasia–Pacific region. The much stronger (weaker) interference of EA (NA) is associated with its stronger (weaker) downstream weakening effect on the zonal flow that impinges on NA (EA). The mutual interference always tends to further destruct the upward wave fluxes over the eastern North Pacific and enhance the downward wave fluxes over North America. The overall changes in upward wave fluxes, as well as that in the Rossby stationary wavenumber responsible for the stratospheric changes, are related to changes in the zonal-mean flow pattern. The joint effects of EA and NA, rather than being a linear superimposition of their independent effects, are largely dominated by the effects of EA.
The Connection between the Southern Annular Mode and a Feature-Based Perspective on Southern Hemisphere Midlatitude Winter Variability
Authors: Spensberger Clemens , Reeder Michael J. , Spengler Thomas , Patterson Matthew
Published: September 2019

This article provides a reconciling perspective on the two main, but contradictory, interpretations of the southern annular mode (SAM). SAM was originally thought to characterize meridional shifts in the storm track across the entire hemisphere. This perspective was later questioned, and SAM was interpreted as a statistical artifact depending on the choice of base region for the principal component analysis. Neither perspective, however, fully describes SAM. We show that SAM cannot be interpreted in terms of midlatitude variability, as SAM merely modulates the most poleward part of the cyclone tracks and only marginally influences the distribution of other weather-related features of the storm track (e.g., position of jet axes and Rossby wave breaking). Instead, SAM emerges as the leading pattern of geopotential variability due to strong correlations of sea level pressure around the Antarctic continent. As SAM correlates strongly both with the pan-Antarctic mean temperature and the meridional heat flux through 65°S, we hypothesize that SAM can be interpreted as a measure of the degree of the (de)coupling between Antarctica and the southern midlatitudes. As an alternative way of characterizing southern midlatitude variability, we seek domains in which the leading EOF patterns of both the geopotential and storm-track features yield a dynamically consistent picture. This approach is successful for the South Pacific. Here the leading variability patterns are closely related to the Pacific–South America pattern and point toward an NAO-like variability.
Toward a Consistent Definition between Satellite and Model Clear-Sky Radiative Fluxes
Authors: Loeb Norman G. , Rose Fred G. , Kato Seiji , Rutan David A. , Su Wenying , Wang Hailan , Doelling David R. , Smith William L. , Gettelman Andrew
Published: September 2019

A new method of determining clear-sky radiative fluxes from satellite observations for climate model evaluation is presented. The method consists of applying adjustment factors to existing satellite clear-sky broadband radiative fluxes that make the observed and simulated clear-sky flux definitions more consistent. The adjustment factors are determined from the difference between observation-based radiative transfer model calculations of monthly mean clear-sky fluxes obtained by ignoring clouds in the atmospheric column and by weighting hourly mean clear-sky fluxes with imager-based clear-area fractions. The global mean longwave (LW) adjustment factor is −2.2 W m−2at the top of the atmosphere and 2.7 W m−2at the surface. The LW adjustment factors are pronounced at high latitudes during winter and in regions with high upper-tropospheric humidity and cirrus cloud cover, such as over the west tropical Pacific, and the South Pacific and intertropical convergence zones. In the shortwave (SW), global mean adjustment is 0.5 W m−2at TOA and −1.9 W m−2at the surface. It is most pronounced over sea ice off of Antarctica and over heavy aerosol regions, such as eastern China. However, interannual variations in the regional SW and LW adjustment factors are small compared to those in cloud radiative effect. After applying the LW adjustment factors, differences in zonal mean cloud radiative effect between observations and climate models decrease markedly between 60°S and 60°N and poleward of 65°N. The largest regional improvements occur over the west tropical Pacific and Indian Oceans. In contrast, the impact of the SW adjustment factors is much smaller.
Can Mountain Waves Contribute to Damaging Winds Far Away from the Lee Slope?
Authors: Kelley Jeffrey D. , Schultz David M. , Schumacher Russ S. , Durran Dale R.
Published: September 2019

On 25 December 2016, a 984-hPa cyclone departed Colorado and moved onto the northern plains, drawing a nearby Arctic front into the circulation and wrapping it cyclonically around the equatorward side of the cyclone. A 130-km-wide and 850-km-long swath of surface winds exceeding 25 m s−1 originated underneath the comma head of the lee cyclone and followed the track of the Arctic front from Colorado to Minnesota. These strong winds formed in association with a downslope windstorm and mountain wave over Colorado and Wyoming, producing an elevated jet of strong winds. Central to the distribution of winds in this case is the Arctic air mass, which both shielded the elevated winds from surface friction behind the front and facilitated the mixing of the elevated jet down to the surface just behind the Arctic front, due to steep lapse rates associated with cold-air advection. The intense circulation south of the cyclone center transported the Arctic front and the elevated jet away from the mountains and out across Great Plains. This case is compared to an otherwise similar cyclone that occurred on 28–29 February 2012 in which a downslope windstorm occurred, but no surface mesoscale wind maximum formed due to the absence of a well-defined Arctic front and postfrontal stable layer. Despite the superficial similarities of this surface wind maximum to a sting jet (e.g., origin in the midtroposphere within the comma head of the cyclone, descent evaporating the comma head, acceleration to the top of the boundary layer, and an existence separate from the cold conveyor belt), this swath of winds was not caused by a sting jet.
Revisit Rates for Pediatric Tonsillectomy: An Analysis of Admit and Discharge Times
Authors: Gilani Sapideh , Bhattacharyya Neil
Published: September 2019

Objective:

To determine the association between intraday timing of outpatient pediatric tonsillectomy and revisit outcomes and complications.

Study Design:

Cross-sectional analysis of New York databases.

Setting:

Ambulatory surgery, emergency department and inpatient hospital settings.

Subjects and Methods:

The State Ambulatory Surgery, State Emergency Department and State Inpatient Databases for 2010-2011 were analyzed for revisits. Outcomes assessed were revisits for any reason, bleeding, acute pain or fever, nausea, vomiting and dehydration. The relationships between the hour of admission for surgery, the hour of discharge and the revisit outcomes were analyzed.

Results:

The study included 33,611 children (mean age, 6.62 years; 45.7% female) and 62.0% were admitted in the early morning. Discharges were most common in the early afternoon (28.3%). Revisit rates were significantly higher for the early evening discharges (6.0%) versus late morning discharges (3.1%) ( P < .001). Revisits for bleeding were 1.8% for discharge in the early evening versus 0.6% in the late morning ( P < .001). Revisits for fever, nausea, vomiting or dehydration were 1.8% for discharge in the early evening versus 0.9% in the late morning ( P = .002). Late afternoon admission was significantly associated with higher revisit rates (10.9%, P < .001). Bleeding revisits were highest for late afternoon admit hour (1.5%, P = .001). Revisits for acute pain were also highest for late afternoon admit hour (2.3%, P = .005).

Conclusion:

Revisit are significantly higher when the patient is discharged late. Late afternoon surgery is also significantly associated with higher revisit rates. Surgeons may wish to consider these findings when a late tonsillectomy or late discharge is anticipated post-tonsillectomy.
Assessment of Tracheostomy and Laryngectomy Knowledge among Non-Otolaryngology Physicians
Authors: Hsieh Tsung-yen , Timbang Leah , Kuhn Maggie , Brodie Hilary , Squires Lane
Published: September 2019

Objective:

Identify knowledge deficits about alternate airways (AAs) (tracheostomy and laryngectomy) among physicians across multiple specialties a tertiary institution and to assess the impact of an educational lecture on improving deficits.

Methods:

Study Design: Cross-sectional assessment. Setting: Academic medical center. Subjects and Methods: An anonymous 10-item, multiple choice assessment was given to physicians at a tertiary care center in the departments of Otolaryngology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, and Pediatrics. An educational lecture on AAs was presented. Scores between a pre-lecture and a 3-month post-lecture assessment were compared. Data was analyzed using ANOVA and chi-squared analysis.

Results:

Otolaryngology physicians scored an average of 97.8%, while non-otolaryngology physicians scored 58.3% ( P < .05). Non-otolaryngology surgical physicians scored 68.4% while non-surgical physicians were lower at 55.1% ( P < .0001). Comparing pre-lecture to post-lecture scores, all non-otolaryngology physicians improved their scores significantly from 58.3% to 86.5% ( P < .005). Non-surgical physicians had significant improvement after the instructional lecture, closing the score gap with surgical physicians for the post-lecture assessment.

Discussion:

The care of patients with AAs requires an understanding of their basic principles. Our findings identify significant knowledge deficits among non-otolaryngologists. Through an instructional lecture, we demonstrated improvement in knowledge among non-otolaryngology physicians and durability of the knowledge after 3 months.

Conclusions:

Through an instructional lecture, we found tracheostomy and laryngectomy knowledge deficits can be identified and improved upon. Periodic reinforcement of basic principles for non-otolaryngology physicians may be a promising strategy to ensure the proper care of patients with AAs.
Noxious Housing: The Influence of Single Room Occupancy (SRO) Facilities on Neighborhood Crime
Authors: Krupa Julie M. , Boggess Lyndsay N. , Chamberlain Alyssa W. , Grubesic Tony H.
Published: September 2019

Certain establishments (e.g., alcohol outlets or pawnshops) attract or generate crime because they operate with little oversight and are often located in poor or disordered neighborhoods. Single room occupancy (SRO) facilities share some of these characteristics. SROs tend to be rundown motels or apartment buildings that offer affordable housing for low-income clientele. It is likely that SROs also generate and attract criminal activity that affects the neighborhood. Using police incident report data for St. Petersburg, FL, this study examines the impact of SROs on violent, property, and nuisance crimes at the neighborhood level. Negative binomial regression models suggest that the presence of an SRO in the focal or nearby neighborhood increases local crime, with the impact varying by crime type.
Multiple Discrimination against Female Immigrants Wearing Headscarves
Authors: Weichselbaumer Doris
Published: September 2019

Western countries have experienced a large influx of Muslim immigrants, and concomitantly the Muslim headscarf has become the subject of major controversy. Drawing on theories of stigma, social identity, and multiple discrimination/intersectionality, this study examines the effect of wearing this headscarf in the German labor market. The author applies the method of correspondence testing that allows measuring discrimination in a controlled field setting. Findings show that when applying for a job in Germany, women with a Turkish migration background are less likely to be invited for an interview, and the level of discrimination increases substantially if the applicant wears a headscarf. The results suggest that immigrant women who wear a headscarf suffer discrimination based on multiple stigmas related to ethnicity and religion.
Cardiometabolic Risk and Cognitive Decline: The Role of Socioeconomic Status in Childhood and Adulthood
Authors: Oi Katsuya , Haas Steven
Published: September 2019

Socioeconomic conditions in childhood predict cognitive functioning in later life. It is unclear whether poor childhood socioeconomic status (SES) also predicts the acceleration of cognitive decline. One proposed pathway is via cardiometabolic risk, which has been linked to both childhood SES and earlier onset of cognitive impairment. Using data from the Health and Retirement Study, we examine the impact of childhood SES on cognitive trajectories over six years and test whether it operates through increased cardiometabolic risk and adult SES. We find that higher childhood SES leads to slower cognitive decline, partially due to lower levels of cardiometabolic risk. However, these pathways operate entirely through adult socioeconomic attainment. The results have important implications for future trends in cognitive population health within the context of growing social inequality and reduced social mobility.
Cumulative Effects of Bullying and Racial Discrimination on Adolescent Health in Australia
Authors: Priest Naomi , Kavanagh Anne , Bécares Laia , King Tania
Published: September 2019

This study examined how cumulative exposure to racial discrimination and bullying victimization influences the health of Australian adolescents (n = 2802) aged 10 to 11 years (19.3% visible ethnic minorities [nonwhite, non-Indigenous]; 2.6% Indigenous) using data from three waves (2010–2014) of the nationally representative Longitudinal Study of Australian Children (LSAC). Cumulative exposure to racial discrimination and bullying victimization had incremental negative effects on socioemotional difficulties. Higher accumulated exposure to both stressors across time was associated with increased body mass index z-scores and risk of overweight/obesity. Studies that examine exposure to single risk factors such as bullying victimization or racial discrimination at one time point only are likely to miss key determinants of health for adolescents from stigmatized racial-ethnic backgrounds and underestimate their stressor burden.