bluuebunny/crossref_metadata_2025 huggingface dataset:
MutatedWT1,FLT3-ITD,andNUP98-NSD1Fusion in Various Combinations Define a Poor Prognostic Group in Pediatric Acute Myeloid Leukemia
Authors: Niktoreh Naghmeh , Walter Christiane , Zimmermann Martin , von Neuhoff Christine , von Neuhoff Nils , Rasche Mareike , Waack Katharina , Creutzig Ursula , Hanenberg Helmut , Reinhardt Dirk
Published: July 2019

Acute myeloid leukemia is a life-threatening malignancy in children and adolescents treated predominantly by risk-adapted intensive chemotherapy that is partly supported by allogeneic stem cell transplantation. Mutations in theWT1gene andNUP98-NSD1fusion are predictors of poor survival outcome/prognosis that frequently occur in combination with internal tandem duplications of the juxta-membrane domain ofFLT3(FLT3-ITD).To re-evaluate the effect of these factors in contemporary protocols, 353 patients (<18 years) treated in Germany with AML-BFM treatment protocols between 2004 and 2017 were included. Presence of mutatedWT1andFLT3-ITDin blasts (n=19) resulted in low 3-year event-free survival of 29% and overall survival of 33% compared to rates of 45-63% and 67-87% in patients with only one (onlyFLT3-ITD; n=33,onlyWT1mutation; n=29) or none of these mutations (n=272). IncludingNUP98-NSD1and high allelic ratio (AR) ofFLT3-ITD(AR ≥0.4) in the analysis revealed very poor outcomes for patients with co-occurrence of all three factors or any of double combinations. All these patients (n=15) experienced events and the probability of overall survival was low (27%). We conclude that co-occurrence ofWT1mutation,NUP98-NSD1,andFLT3-ITDwith an AR ≥0.4 as triple or double mutations still predicts dismal response to contemporary first- and second-line treatment for pediatric acute myeloid leukemia.
Primary Cardiac Epithelioid Angiosarcoma in a Latin American Patient: Case Report and Literature Review
Authors: Morgenstern-Kaplan Dan , Aboitiz-Rivera Carlos Manuel , Blachman-Braun Ruben , Vázquez-Manríquez María Eugenia , Sarabia-Ortega Benito , Baltazares-Lipp Mario Enrique
Published: July 2019

Cardiac angiosarcoma is a rare and clinically challenging pathology. It is a high-grade primary malignant tumor of the heart tissue that has many variants, of which the epithelioid variant is rarely present in the heart or the great vessels. As with many other cardiac tumors, it is mainly a diagnosis of exclusion and the initial diagnostic test is an echocardiogram followed by a biopsy with immunohistochemistry analysis to ascertain the type of tumor. The differential diagnosis of cardiac tumors is challenging due to the overlapping clinical manifestations with different cardiac tumors and systemic diseases. Cardiac angiosarcomas are often aggressive with a poor prognosis even with treatment. Herein, we present a case of the epithelioid variant of a cardiac angiosarcoma in addition to a thorough review of the recent literature on the clinical manifestation, diagnosis, and treatment of this type of tumors.
The Block Principal Pivoting Algorithm for the Linear Complementarity Problem with an M-Matrix
Authors: Fang Xi-Ming , Qiao Zhi-Jun , Zhao Heng-Jun
Published: July 2019

The principal pivoting algorithm is a popular direct algorithm in solving the linear complementarity problem, and its block forms had also been studied by many authors. In this paper, relying on the characteristic of block principal pivotal transformations, a block principal pivoting algorithm is proposed for solving the linear complementarity problem with an M-matrix. By this algorithm, the linear complementarity problem can be solved in some block principal pivotal transformations. Besides, both the lower-order and the higher-order experiments are presented to show the effectiveness of this algorithm.
NADPH Oxidase 2-Mediated Insult in the Auditory Cortex of Zucker Diabetic Fatty Rats
Authors: Du Zheng-De , Wei Wei , Yu Shukui , Song Qing-Ling , Liu Ke , Gong Shu-Sheng
Published: July 2019

Clinical data has confirmed that auditory impairment may be a secondary symptom of type 2 diabetes mellitus (T2DM). However, mechanisms underlying pathologic changes that occur in the auditory system, especially in the central auditory system (CAS), remain poorly understood. In this study, Zucker diabetic fatty (ZDF) rats were used as a T2DM rat model to observe ultrastructural alterations in the auditory cortex and investigate possible mechanisms underlying CAS damage in T2DM. The auditory brainstem response (ABR) of ZDF rats was found to be markedly elevated in low (8 kHz) and high (32 kHz) frequencies. Protein expression of NADPH oxidase 2 (NOX2) and its matching subunits P22phox, P47phox, and P67phox was increased in the auditory cortex of ZDF rats. Expression of 8-hydroxy-2-deoxyguanosine (8-OHdG), a marker of DNA oxidative damage, was also increased in the neuronal mitochondria of the auditory cortex of ZDF rats. Additionally, decreases in the mitochondrial total antioxidant capabilities (T-AOC), adenosine triphosphate (ATP) production, and mitochondrial membrane potential (MMP) were detected in the auditory cortex of ZDF rats, suggesting mitochondrial dysfunction. Transmission electron microscopy results indicated that ultrastructural damage had occurred to neurovascular units and mitochondria in the auditory cortex of ZDF rats. Furthermore, cytochrome c (Cyt c) translocation from mitochondria to cytoplasm and caspase 3-dependent apoptosis were also detected in the auditory cortex of ZDF rats. Consequently, the study demonstrated that T2DM may cause morphological damage to the CAS and that NOX2-associated mitochondrial oxidative damage and apoptosis may be partly responsible for this insult.
Training Sequence Design of TDS‐OFDM Signal in Joint Radar and Communication System
Authors: Zuo Jiajun , Yang Ruijuan , Luo Shaohua , Li Xiaobai
Published: July 2019

In the joint radar and communication system, using orthogonal frequency division multiplexing (OFDM) signals, cyclic prefix (CP) and pilots lead to the problem of high peak at the sidelobe (PSL) level in autocorrelation function (ACF), which deteriorates the radar detection performance seriously. To solve this problem, first, a new RadCom signal based on time‐domain synchronization OFDM (TDS‐OFDM) was proposed. TDS‐OFDM adopts training sequence (TS) for guard interval, as well as synchronization and channel estimation, so that CP and pilots can be avoided. And then, ambiguity function (AF) of TDS‐OFDM RadCom signal was analyzed. Finally, TS are optimized to suppress PSL of TDS‐OFDM signal and maintain the autocorrelation properties of TS simultaneously. The results show that the autocorrelation performance of designed TDS‐OFDM RadCom signal is much better than that of CP‐OFDM RadCom signal. Considering the importance of radar target detection, TDS‐OFDM is more appropriate than CP‐OFDM for the RadCom system.
Choledochoplasty with Gallbladder Wall Free Flap: A Novel Technique for Large Bile Duct Defects from Mirizzi Syndrome in High-Risk Patients—A Case Report and Literature Review
Authors: Chai Louis F. , Xiao Gary S.
Published: July 2019

Background. Cholecystectomies are almost universally performed laparoscopically with complication rates similar to open surgery. Possible complications include bleeding and damage to surrounding structures. These often require intervention to repair the damage immediately when recognized intraoperatively or postoperatively. These injuries can cause significant morbidity and mortality, and additional interventions further compound this, especially for high-risk patients. All attempts should be made to a lower risk while performing the safest operation and addressing complications appropriately. We present a case of a surgically high-risk patient who underwent an attempted laparoscopic, converted to open, cholecystectomy for Mirizzi syndrome, during which a biliary defect was found and repaired with a novel technique of choledochoplasty with a gallbladder wall free flap. Case. An 82-year-old female with abdominal pain was diagnosed with a cholecystocholedochal fistula from chronic cholecystitis and Mirizzi syndrome. During cholecystectomy, a large common bile duct defect was noted, and given intraoperative instability, the repair was completed using a gallbladder wall free flap. Postoperatively, the patient recovered well through a 4.5-year follow-up. Conclusion. Complications from laparoscopic cholecystectomy are rare but may result in additional interventions. For patients who are high-risk surgical candidates, gallbladder wall free flap choledochoplasty should be considered to avoid additional morbidity and mortality.
A Deep Learning Segmentation Approach in Free-Breathing Real-Time Cardiac Magnetic Resonance Imaging
Authors: Yang Fan , Zhang Yan , Lei Pinggui , Wang Lihui , Miao Yuehong , Xie Hong , Zeng Zhu
Published: July 2019

Objectives. The purpose of this study was to segment the left ventricle (LV) blood pool, LV myocardium, and right ventricle (RV) blood pool of end-diastole and end-systole frames in free-breathing cardiac magnetic resonance (CMR) imaging. Automatic and accurate segmentation of cardiac structures could reduce the postprocessing time of cardiac function analysis. Method. We proposed a novel deep learning network using a residual block for the segmentation of the heart and a random data augmentation strategy to reduce the training time and the problem of overfitting. Automated cardiac diagnosis challenge (ACDC) data were used for training, and the free-breathing CMR data were used for validation and testing. Results. The average Dice was 0.919 (LV), 0.806 (myocardium), and 0.818 (RV). The average IoU was 0.860 (LV), 0.699 (myocardium), and 0.761 (RV). Conclusions. The proposed method may aid in the segmentation of cardiac images and improves the postprocessing efficiency of cardiac function analysis.
Impact of High-Velocity Oxy-Fuel ZrO2 Coating on Corrosion Resistance and Fatigue Life of AISI 316L Austenitic Stainless Steel
Authors: Kumar J. Jagadesh , Diwakar G. , Satyanarayana Vaddi Venkata
Published: July 2019

Purpose. The purpose of this research paper is to investigate the corrosion and fatigue life of AISI 316L austenitic stainless steel in the absence and presence of high-velocity oxy-fuel ZrO2 coating. Design/Methodology/Approach. AISI 316L austenitic stainless steel is chosen for the investigation, keeping in mind, its widespread usage in naval and marine applications where the members are exposed to corrosive sea water environment. ZrO2 coating is a popular surface treatment provided to mechanical members to improve their corrosion resistance. Being a refractory material, ZrO2 inhibits the corrosion of the AISI 316L austenitic stainless steel in marine applications. But, the study of the effect of ZrO2 coating on the corrosion and fatigue life of the material hitherto is scarce and hence the present investigation is undertaken. The corrosion and fatigue analysis of the coated specimens are carried out by taking two control parameters, namely, rotational speed of job and axial speed of torch, into consideration and applying L4 Taguchi orthogonal array. Findings. The corrosion resistance of the material has increased but the fatigue strength has decreased upon coating of ZrO2 on AISI 316L austenitic stainless steel. The failure has occurred because of the formation of oxide layers on the steel during coating.
Use of Direct Hemoperfusion with Polymyxin B-Immobilized Fiber for the Treatment of Septic Shock Complicated with Lemierre Syndrome Caused by Fusobacterium necrophorum
Authors: Kodama Yoshiyuki , Takahashi Gaku , Kan Shigenori , Masuda Takayuki , Ishibe Yoriko , Akimaru Rise , Nonoguchi Maria , Inoue Yoshihiro
Published: July 2019

We report a case of septic shock treated with PMX-DHP that was complicated with Lemierre syndrome caused by Fusobacterium necrophorum. The patient was a 31-year-old man who was initially diagnosed with influenza. He received treatment; however, because his symptoms gradually worsened, he was transported to our hospital 10 days following his diagnosis. His initial examination revealed symptoms of respiratory distress and an altered level of consciousness. Based on laboratory and imaging results, it became clear that he suffered from septic shock of unknown etiology, disseminated intravascular coagulation, and acute renal and respiratory failure. We initiated treatment with vasopressors, an antibacterial agent, immunoglobulins as well as an appropriate ventilator management; however, his unstable circulatory condition continued. As soon as PMX-DHP was initiated, 2 days following admission to the ICU, his circulatory instability normalized. F. necrophorum was ultimately detected after a culture examination, and contrast-enhanced computed tomography revealed a jugular vein thrombus, which led to the diagnosis of Lemierre syndrome. The patient’s condition gradually improved, and he was discharged from the ICU after 19 days.
Serum PD-1 Is Elevated after Pembrolizumab Treatment but Has No Predictive Value
Authors: Music Milena , Iafolla Marco A.J. , Ren Annie He , Soosaipillai Antoninus , Prassas Ioannis , Diamandis Eleftherios P.
Published: July 2019

Immune-checkpoint blockade (ICB) uses antibody targeting of specific inhibitory receptors and ligands. The major limitations of ICB, such as high cost, limited success rate, and immune-related adverse events (irAE), highlight the need for predictive biomarkers. We analyzed pre-immunotherapy and post-immunotherapy serum samples of 24 patients treated with pembrolizumab for changes in PD-1 and over 1,000 additional protein markers using a multiplex proximity extension assay (PEA) to identify potential predictive biomarkers of response and/or toxicity. Candidates were selected based on the criteria that at least 2 patients within any of 3 patient groups (responders without irAEs, responders with irAEs, or nonresponders with irAEs) had either a ≥4-fold increase or 4-fold decrease in expression post-immunotherapy. Female and male control samples were used as technical duplicates. A patient group with no response and no irAEs was used to exclude candidates. Following treatment with pembrolizumab, there was a relative increase of PD-1 in the serum of all patients, compared with controls (average 4.4-fold). We identified 7 additional serum proteins that met our candidate selection criteria. These candidate markers did not have any significant association with response or toxicity to pembrolizumab. Overall, we show that serum PD-1 increases post-therapy with pembrolizumab treatment but has no predictive value for response or toxicity in this small set of patients.
The Effect of Sulforaphane on the Activity and Mineralization of Osteoblasts under Oxidative Stress
Authors: Chen Qiaofeng , Wu Shanpeng , Lu Tianxiang , Chen Jie , Xu Zhitong , Chen Jianting
Published: July 2019

Sulforaphane (SFN) is considered an antioxidant agent, but the biological effects on hypoxia-treated osteoblasts remain unclear. Therefore, the aims of this study were to investigate the effects of SFN on the activity and mineralization of osteoblasts in hypoxia. Osteoblasts were treated with hypoxia with or without SFN, and apoptosis was assayed with caspase 3 Activity Assay Kit and flow cytometer. The levels of reactive oxygen species (ROS) were measured with DCFH-DA. The levels of glutathione (GSH) and glutathione disulphide were determined by the o-phthalaldehyde fluorimetric assay. Mineralization of Osteoblasts was detected by Alizarin red staining and alkaline phosphatase (ALP) staining, and the relative proteins levels were examined by Western blotting. Our results showed that SFN reduced the hypoxia-mediated apoptosis and ROS levels in osteoblasts. The utilization of SFN improved the inhibitory effect of osteoblast mineralization by hypoxia. Additionally, the effect of alleviating hypoxia by SFN will be an increase in osteoblast activity. These findings clarify the effects of SFN on hypoxia-treated osteogenesis and will help identify novel therapeutic strategies for the protection of skeletal health.
Aortic Calcification Affects Noninvasive Estimates of Central Blood Pressure in Patients with Severe Chronic Kidney Disease
Authors: Carlsen Rasmus Kirkeskov , Winther Simon , Peters Christian D. , Laugesen Esben , Khatir Dinah S. , Bøtker Hans E. , Bøttcher Morten  , Ivarsen Per , Svensson My , Buus Niels Henrik
Published: July 2019

Background: Central blood pressure (BP) assessed noninvasively considerably underestimates true invasively measured aortic BP in chronic kidney disease (CKD) patients. The difference between the estimated and the true aortic BP increases with decreasing estimated glomerular filtration rates (eGFR). The present study investigated whether aortic calcification affects noninvasive estimates of central BP. Methods: Twenty-four patients with CKD stage 4–5 undergoing coronary angiography and an aortic computed tomography scan were included (63% males, age [mean ± SD ] 53 ± 11 years, and eGFR 9 ± 5 mL/min/1.73 m2). Invasive aortic BP was measured through the angiography catheter, while non-invasive central BP was obtained using radial artery tonometry with a SphygmoCor® device. The Agatston calcium score (CS) in the aorta was quantified on CT scans using the CS on CT scans. Results: The invasive aortic systolic BP (SBP) was 152 ± 23 mm Hg, while the estimated central SBP was 133 ± 20 mm Hg. Ten patients had a CS of 0 in the aorta, while 14 patients had a CS >0 in the aorta. The estimated central SBP was lower than the invasive aortic SBP in patients with aortic calcification compared to patients without (mean difference 8 mm Hg, 95% CI 0.3–16; p = 0.04). The brachial SBP was lower than the aortic SBP in patients with aortic calcification compared to patients without (mean difference 10 mm Hg, 95% CI 2–19; p = 0.02). Conclusion: In patients with advanced CKD the presence of aortic calcification is associated with a higher difference between invasively measured central aortic BP and non-invasive estimates of central BP as compared to patients without calcifications.
Loop Diuretics in Acute Kidney Injury Prevention, Therapy, and Risk Stratification
Authors: Patschan Daniel , Patschan Susann , Buschmann Ivo , Ritter Oliver
Published: July 2019

Background: Loop diuretics (LD) are widely used in emergency and intensive care medicine. Summary: The substances increase the clearance of electrolytes and water; thus, they allow us to control hypervolemia and to prevent patients from pulmonary edema. LD are also frequently applied to patients with an acute decrease in glomerular filtration rate, namely, acute kidney injury (AKI). Nevertheless, volume depletion may be associated with reduced renal perfusion and possibly slower restitution or even aggravation of kidney dysfunction. Several trials on the preventive or therapeutic efficacy of LD have been published since the early 1970s. Our review article is intended to summarize the most important references related to this topic. In addition, we discuss the diagnostic value of the so-called furosemide stress test. The currently available data indicate that LD may act in a beneficial manner as long as euvolemia is maintained (matched hydration). Key Massages: LD are not beneficial for AKI treatment if kidney-related endpoints are considered. In certain situations, AKI prevention with LD can be associated with favorable outcomes as long as euvolemia is maintained. LD can help to identify AKI subjects at a higher risk of AKI progression, but the exact clinical consequences need to be determined.
Laparoendoscopic Single-Site Surgery for Urachal Remnants: A Single-Center Experience
Authors: Yanishi Masaaki , Kinoshita Hidefumi , Matsuzaki Tomoaki , Yoshida Takashi , Ohsugi Haruyuki , Taniguchi Hisanori , Sugi Motohiko , Matsuda Tadashi
Published: July 2019

Introduction: Urachal remnants are relatively rare. Generally, urachal remnants are detected in young people, and the removed specimen is small, comprising a good indication for laparoscopic surgery. Laparoendoscopic single-site surgery (LESS) for urachal remnants is considered to be safe and result in an excellent cosmetic outcome. Therefore, we report our single-center experience with LESS for urachal remnants. Methods: We retrospectively reviewed 30 patients with urachal remnants who underwent LESS from January 2011 to December 2017. The patients’ characteristics, surgical data, postoperative pain, and cosmetic assessment results were retrospectively collected and analyzed. Results: Mean total operative time was 151 min, mean pneumoperitoneal surgery time was 83 min, and mean estimated blood loss was 5.0 mL. All patients were started on an oral diet and began ambulating on postoperative day 1. Mean hospital stay was 5.5 days. LESS was completed successfully in all patients, with no conversion to conventional or open surgery. Conclusions: LESS is a viable option for the surgical treatment of urachal remnants. This technique may result in less pain than conventional techniques. Further accumulation of surgical outcomes (especially regarding safety and cosmesis) is required for LESS to become an established treatment for urachal remnants.
High-Flux versus High-Retention-Onset Membranes: In vivo Small and Middle Molecules Kinetics in Convective Dialysis Modalities
Authors: Cordeiro Isis S.F. , Cordeiro Lilian , Wagner Carolina S. , Araújo Luiza Karla R.P. , Pereira Benedito J. , Abensur Hugo , Elias Rosilene M. , Silva Bruno C.
Published: July 2019

Background: Patients undergoing maintenance hemodialysis (HD) exhibit increased levels of uremic toxins, which are associated with poor outcomes. Recently, new dialysis membranes have allowed clearance of solutes with higher molecular weight, without significant albumin losses high-retention-onset-HD (HRO-HD). Methods: Prospective crossover trial, in which 16 prevalent patients switched from high-flux HD (HF-HD) to online hemodiafiltration (olHDF) and HRO-HD for 4 weeks. The following variables were evaluated: pre- and post-dialysis serum concentrations of albumin, urea, phosphate (P), beta-2 microglobulin (β2M), and total mass (TM) extraction and dialyzer clearance of urea, P, and β2M. Results: Comparing HF-HD, olHDF, and HRO-HD, respectively, there were no differences regarding pre-dialysis serum concentrations of albumin (3.94 ± 0.36, 4.06 ± 0.22, and 3.93 ± 0.41 g/dL, p = 0.495), urea (166 ± 29, 167 ± 30, and 164 ± 27 mg/dL, p = 0.971), P (4.9 ± 2.1, 5.2 ± 1.6, and 4.9 ± 2.1 mg/dL, p = 0.879), and β2M (31.3 ± 7.1, 32.6 ± 8.6, and 33.7 ± 5.9 µg/mL, p = 0.646). β2M clearance was significantly lower in HF-HD in comparison to both olHDF and HRO-HD: 43 (37–53) versus 64 (48–85) mL/min, p = 0.013, and 69 (58–86) mL/min, p = 0.015, respectively. Post-dialysis β2M serum concentration was higher in HF-HD in comparison to olHDF and HRO-HD: 11.6 (9.6–12.4) vs. 5.7 (4.5–7.0) µg/mL, p = 0.001, and 5.6 (5.3–7.6) µg/mL, p = 0.001, respectively. TM extraction of urea, P, and β2M were similar across the 3 dialysis modalities. Conclusions: olHDF and HRO-HD were superior to HF-HD regarding β2M clearance, leading to lower post-dialysis β2M levels.
The Eighth Edition of the American Joint Committee on Cancer Distant Metastases Stage Classification for Metastatic Pancreatic Neuroendocrine Tumors Might Be Feasible for Metastatic Pancreatic Ductal Adenocarcinomas
Authors: Wen Junmiao , Chen Jiayan , Liu Di , Xu Xinyan , Fan Min , Zhang Zhen
Published: July 2019

Background: Significant modifications have been made to the 8th edition of the American Joint Committee on Cancer (AJCC) distant metastases (M) stage classification for metastatic pancreatic neuroendocrine tumors (PanNETs). We aimed to validate this revised classification among metastatic PanNET patients using the Surveillance, Epidemiology, and End Results database. We further sought to evaluate the feasibility of applying this classification to metastatic pancreatic neuroendocrine carcinoma (PanNEC) and pancreatic ductal adenocarcinoma (PDAC) patients. Methods: Stage IV pancreatic neuroendocrine neoplasm (PanNEN, including G1/G2 PanNET and G3 PanNEC classified according to the World Health Organization [WHO] 2010 grading scheme) and PDAC patients with metastatic disease diagnosed between 2010 and 2015 were identified and restaged according to the revised M stage classification for PanNET. Overall survival (OS) was compared using Kaplan-Meier analysis and log-rank test. Uni- and multivariate Cox regression models were utilized to identify prognostic factors. Results: A total of 1,371 stage IV PanNEN and 634 PDAC patients were included. Among PanNEN patients, liver (75.0%) was the most common metastatic site, followed by distant lymph nodes (8.5%), lung (8.4%), bone (7.3%), and brain (1.0%). The 5-year OS for PanNET patients with M1a, M1b, and M1c stage was 44.15, 53.32, and 19.70%, respectively. However, survival comparison showed no significant difference between M1a and M1b stages among PanNET patients. Similar findings were noted after applying this classification to PanNEC patients. Multivariate analysis showed that the age at diagnosis and the number of distant metastatic sites were independent prognostic factors for metastatic PanNEN patients. Interestingly, excellent survival discrimination by M stage among stage IV PDAC patients was noted (M1a vs. M1b vs. M1c, 5-year OS: 5.42, 2.46, and 0%, respectively). Conclusion: Our study is the first large sample-based validation of the AJCC 8th M stage classification for PanNET. The revised classification did not effectively stratify metastatic PanNEN patients. However, further study is warranted to validate this classification for PanNET patients according to the WHO 2017 classification. Interestingly, the revised M stage classification might be feasible for PDAC patients with metastatic disease.
A Phase II Study of Ibrutinib in Advanced Neuroendocrine Neoplasms
Authors: Al-Toubah Taymeyah , Schell Michael J. , Cives Mauro , Zhou Jun-Min , Soares Heloisa P. , Strosberg Jonathan R.
Published: July 2019

Background: Ibrutinib is an orally administered inhibitor of Bruton’s tyrosine kinase (Btk). Preclinical data suggest that mast cells are recruited within neuroendocrine neoplasms (NENs) where they stimulate angiogenesis and tumor growth. Ibrutinib inhibits mast cell degranulation and has been associated with regression of tumors in a mouse insulinoma model. Methods: A prospective, phase II trial evaluated patients with advanced gastrointestinal (GI)/lung NENs and pancreatic NENs (pNENs) who had evidence of progression within 12 months of study entry on at least one prior therapy. Patients received ibrutinib 560 mg daily until unacceptable toxicity, progression of disease, or withdrawal of consent. The primary endpoint was objective response rate. Results: Twenty patients were enrolled on protocol from November 2015 to December 2017 (15 advanced GI/lung NENs and 5 pNENs). No patient reached an objective response. Median PFS was 3.0 months. A total of 44 drug-related adverse events (AEs) were captured as probably or definitely associated with ibrutinib. Five patients experienced probably or definitely related grade 3 AEs, and 1 patient experienced a probably related grade 4 AE. Five patients discontinued treatment prior to radiographic assessment. Conclusions: Ibrutinib does not show significant evidence of activity in well-differentiated gastroenteropancreatic and lung NENs.
Un modèle pour le Japon? Nakae Chômin et la Constitution Brésilienne de 1824
Authors: Dufourmont Eddy
Published: July 2019

L’article analyse la traduction de la Constitution brésilienne de 1824, parue dans la revue dirigée par Nakae Chômin, Ôbei seiri sôdan. Replacer cette traduction dans son contexte et la comparer avec le texte original français utilisé permet d’éclaircir l’enjeu politique qui lui était sous-jacent : à un moment où le Japon connaissait des luttes politiques intenses entre les démocrates et le gouvernement, qui désirait une constitution autoritaire centrée sur l’empereur, la traduction de la Constitution de 1824 permettait de promouvoir une monarchie constitutionnelle.
Japan’s declining population and demographic challenges
Authors: Panda Rajaram
Published: July 2019

Japan is sitting on a demographic time bomb. The declining birth rate because of changing societal and economic factors impacting on priorities in human lives, and accentuated by a rapidly growing population poses a new challenge to policy makers. The governmental responses have been inadequate and need to be seriously addressed in the interests of the future of the country. Other Asian countries in the path of modernisation and fast economic growth are also falling into such trap. Like in the economic development Japan was the leader that led to the faster growth in other Asian countries, Japan ought to emerge as the new leader in addressing this demographic challenge so that other Asian countries could emulate Japan’s example.
Teatro Kabuki: das origens à contemporaneidade
Authors: Sá Michele Eduarda Brasil de
Published: July 2019

Este trabalho objetiva estudar o gênero kabuki, partindo de um panorama histórico para então comentar algumas performances recentes, como a do ator Kirk Nishikawa Dixon no filme curto “The Lion” e o denominado chôkabuki (que significa, literalmente, “super kabuki”), apresentando Konjaku Hana Kurabe Senbonzakura (“A festa das mil cerejeiras de ontem e de hoje”), com Shidô Nakamura e a vocaloid Hatsune Miku, um dos maiores ícones pop da atualidade no Japão. Discorre-se sobre a adaptabilidade do gênero kabuki e as características que permaneceram em meio a tantas mudanças: o papel do ator e sua relação com o público, o toque velado de transgressão e a inovação constante, corroborando o kabuki como um teatro popular do seu início até a contemporaneidade.
Generating Rhythmic Graphic Patterns and Paul Klee’s Concept of the Active Line
Authors: Maden Seçkin
Published: July 2019

Most studies that investigate auditory influence on visual design scenarios disregard the inherent temporal nature of sonic entities. This article addresses problems posed in the interaction of multiple data types—e.g. the visual representation of musical data—and the ways in which one type of information may shape another in simultaneous generations. The author’s proposed method for analogy takes advantage of the structural organization behind several rhythmic sequences to generate visual geometric patterns in which the temporal characteristics of the former affect the spatial features of the latter. The structural analysis of auditory rhythms shows that similar cyclical organizations also exist in their geometric correspondents.
Cladistic analysis of the family Marginellidae (Mollusca, Gastropoda) based on phenotypic features
Authors: SOUZA PAULINO JOSÉ SOARES JR. , SIMONE LUIZ RICARDO L.
Published: July 2019

As part of a project intended to review the taxa of Marginellidae worldwide, the phylogenetic relationships of its main representatives are provided based on comparative phenotypy. Characters from most structures and organs are investigated and used for a phylogenetic analysis, resulting in the following cladogram: ((((Marginellona gigas ((Eratoidea watsoni ((Prunum sp—Leptegouana guttata) (Volvarina brasiliana (Prunum prunum—P. rubens)))) (Austroginella muscaria (Marginella ealesae ((Marginella rosea (M. glabella—M. sebastiani)) (Dentimargo bruneolus (Eratoidea scalaris (Dentimargo sp—D. aureocincta)))))))) Pachycymbiola brasiliana*) Persicula sagitatta*) Buccinanops gradatus*). Those marked with * are outgroups functionally analyzed as part of the ingroup (respectively a volutid, a cystiscid and a nassariid); the root is based on Trophon geversianus (Muricidae). The genera Prunum, Marginella and Dentimargo are revealed as non-monophyletic. The monophyly of the family Marginellidae is supported by 17 synapomorphies. The volutids appear to be its sister taxon, and the possibility of Marginellidae being only a branch of Volutidae is discussed.
Peripus, a new genus of Xanthopygina (Coleoptera: Staphylinidae) from South America
Authors: CHATZIMANOLIS STYLIANOS , HIGHTOWER HANNAH J
Published: July 2019

We describe a new genus of Xanthopygina as Peripus gen. n. Chatzimanolis & Hightower and include the following species: P. brunkei sp. n. Chatzimanolis & Hightower, P. didontus sp. n. Chatzimanolis & Hightower, P. madrededios sp. n. Chatzimanolis & Hightower, and P. monodontus sp. n. Chatzimanolis & Hightower. Peripus belongs in the Isanopus group of genera of Xanthopygina. We provide photographs, illustrations and a key for the identification of species.
Two new species of Amphiglena (Sabellidae, Annelida), with an assessment of hidden diversity in the Mediterranean
Authors: TILIC EKIN , FEERST KATHRYN G. , ROUSE GREG W.
Published: July 2019

Amphiglena is a clade of sabellid annelids that has 12 named species from around the world. New COI and 18S sequences were combined with some available data to generate a molecular phylogeny for Amphiglena. Two new species of Amphiglena are described as a result, using an integrative approach combining molecular evidence with morphological descriptions using histology, 3D reconstructions and electron microscopy. Amphiglena seaverae n. sp is described from Florida, USA and Amphiglena joyceae n. sp. from Edithburgh, South Australia. Our analyses also reveal a previously underemphasized species complex in the Mediterranean, with up to six undescribed species. This highlights the potential diversity of these minute annelid worms yet to be named.
Nocturnal Convection Initiation during PECAN 2015
Authors: Weckwerth Tammy M. , Hanesiak John , Wilson James W. , Trier Stanley B. , Degelia Samuel K. , Gallus William A. , Roberts Rita D. , Wang Xuguang
Published: July 2019

Nocturnal convection initiation (NCI) is more difficult to anticipate and forecast than daytime convection initiation (CI). A major component of the Plains Elevated Convection at Night (PECAN) field campaign in the U.S. Great Plains was to intensively sample NCI and its near environment. In this article, we summarize NCI types observed during PECAN: 1 June–16 July 2015. These NCI types, classified using PECAN radar composites, are associated with 1) frontal overrunning, 2) the low-level jet (LLJ), 3) a preexisting mesoscale convective system (MCS), 4) a bore or density current, and 5) a nocturnal atmosphere lacking a clearly observed forcing mechanism (pristine). An example and description of each of these different types of PECAN NCI events are presented. The University of Oklahoma real-time 4-km Weather Research and Forecasting (WRF) Model ensemble forecast runs illustrate that the above categories having larger-scale organization (e.g., NCI associated with frontal overrunning and NCI near a preexisting MCS) were better forecasted than pristine. Based on current knowledge and data from PECAN, conceptual models summarizing key environmental features are presented and physical processes underlying the development of each of these different types of NCI events are discussed.
Our Skill in Modeling Mountain Rain and Snow is Bypassing the Skill of Our Observational Networks
Authors: Lundquist Jessica , Abel Mimi Rose , Gutmann Ethan , Kapnick Sarah
Published: July 2019

In mountain terrain, well-configured high-resolution atmospheric models are able to simulate total annual rain and snowfall better than spatial estimates derived from in situ observational networks of precipitation gauges, and significantly better than radar or satellite-derived estimates. This conclusion is primarily based on comparisons with streamflow and snow in basins across the western United States and in Iceland, Europe, and Asia. Even though they outperform gridded datasets based on gauge networks, atmospheric models still disagree with each other on annual average precipitation and often disagree more on their representation of individual storms. Research to address these difficulties must make use of a wide range of observations (snow, streamflow, ecology, radar, satellite) and bring together scientists from different disciplines and a wide range of communities.
Differing Responses of the Diurnal Cycle of Land Surface and Air Temperatures to Deforestation
Authors: Chen Liang , Dirmeyer Paul A.
Published: July 2019

Recent studies have shown the impacts of historical land-use land-cover changes (i.e., deforestation) on hot temperature extremes; contradictory temperature responses have been found between studies using observations and climate models. However, different characterizations of surface temperature are sometimes used in the assessments: land surface skin temperature Ts is more commonly used in observation-based studies while near-surface air temperature T2m is more often used in model-based studies. The inconsistent use of temperature variables is not inconsequential, and the relationship between deforestation and various temperature changes can be entangled, which complicates comparisons between observations and model simulations. In this study, the responses in the diurnal cycle of summertime Ts and T2m to deforestation are investigated using the Community Earth System Model. For the daily maximum, opposite responses are found in Ts and T2m. Due to decreased surface roughness after deforestation, the heat at the land surface cannot be efficiently dissipated into the air, leading to a warmer surface but cooler air. For the daily minimum, strong warming is found in T2m, which exceeds daytime cooling and leads to overall warming in daily mean temperatures. After comparing several climate models, we find that the models agree in daytime land surface (Ts) warming, but different turbulent transfer characteristics produce discrepancies in T2m. Our work highlights the need to investigate the diurnal cycles of temperature responses carefully in land-cover change studies. Furthermore, consistent consideration of temperature variables should be applied in future comparisons involving observations and climate models.
Contrasting Pre-Mei-Yu and Mei-Yu Extreme Precipitation in the Yangtze River Valley: Influencing Systems and Precipitation Mechanisms
Authors: Wang Xiaokang , Dong Xiquan , Deng Yi , Cui Chunguang , Wan Rong , Cui Wenjun
Published: July 2019

The mei-yu season over the Yangtze–Huai Rivers basin, typically occurring from mid-June to mid-July, is one of three heavy-rainfall periods over China and can contribute 50% of the annual precipitation. In this study, the first and second heaviest daily precipitation events at the Wuhan station have been selected to represent typical mei-yu and pre-mei-yu precipitation events where the differences in the atmospheric thermodynamic characteristics, precipitation nature, influencing systems, and mechanisms are investigated. During the mei-yu case, moist air mainly came from the South China Sea. Precipitation occurred south of the mei-yu front where abundant moisture and favorable thermodynamic conditions were present. The main influencing systems include a stable blocking pattern and strong and stable western Pacific subtropical high in the midtroposphere, and a small yet intense mesoscale cyclonic vortex in the low troposphere. Rainfall in Wuhan was continuous, caused by a well-organized convective line. A heavy rainband was located along the narrow band between the elongated upper-level jet (ULJ) and the low-level jet (LLJ) where the symmetric instability was found in the midtroposphere near Wuhan. Quite differently, for the pre-mei-yu precipitation case, moist air primarily came from the Beibu Gulf and the Bay of Bengal. Precipitation happened in the low-level convective instability region, where a short-wave trough in the midtroposphere and a mesoscale cyclonic vortex in the low-troposphere were found. Precipitation in Wuhan showed multiple peaks associated with independent meso-β-scale convective systems. A rainstorm occurred at the exit of the LLJ and the right entrance of the ULJ, where convective instability exited in the mid- to low troposphere.
Regional and Temporal Variability of Lateral Mixing in the North Atlantic
Authors: Bolton Thomas , Abernathey Ryan , Zanna Laure
Published: July 2019

Geostrophic eddies contribute to the mixing of heat, carbon, and other climatically important tracers. A passive tracer driven by satellite-derived surface velocity fields is used to study the regional and temporal variability of lateral eddy mixing in the North Atlantic. Using a quasi-Lagrangian diffusivity diagnostic, we show that the upstream region (80°–50°W) of the Gulf Stream jet exhibits a significant mixing barrier (with diffusivity of ≈1 × 103 m2 s−1), compared to the downstream region (50°–10°W), which displays no mixing suppression (≈10 × 103 m2 s−1). The interannual variability is 10%–20% of the time mean in both regions. By analyzing linear perturbations of mixing-length diffusivity expression, we show that the across-jet mixing in the upstream region is driven by variations in the mean flow, rather than eddy velocity. In the downstream region, both the mean flow and eddy velocity contribute to the temporal variability. Our results suggest that an eddy parameterization must take into account the along-jet variation of mixing, and within jets such diffusivities may be a simple function of jet strength.
The Relationship between Prejudice and Wage Penalties for Gay Men in the United States
Authors: Burn Ian
Published: July 2019

This article estimates the empirical relationship between prejudicial attitudes toward homosexuality and the wages of gay men in the United States. It combines data on prejudicial attitudes toward homosexuality from the General Social Survey with data on wages from the U.S. Decennial Censuses and American Community Surveys—both aggregated to the state level. The author finds that a one standard deviation increase in the share of individuals in a state who are prejudiced toward homosexuals is correlated with a decrease in the wages of gay men of between 2.7% and 4.0%. The results also suggest that the prejudice of managers is responsible for this correlation. The author finds that a one standard deviation increase in the share of the managers in a state who are prejudiced toward homosexuals is associated with a 1.9% decrease in the wages of gay men. The author finds no evidence that the wage penalty for gay men is correlated with the prejudice of customers or co-workers.
Perception of social support and psychotic symptoms among persons with schizophrenia: A strategy to lessen caregiver burden
Authors: Peng Man-Man , Zhang Tian-Ming , Liu Ke-Zhi , Gong Ke , Huang Chao-Hua , Dai Guang-Zhi , Hu Shi-Hui , Lin Fu-Rong , Chan Sherry Kit Wa , Ng Siuman , Ran Mao-Sheng
Published: July 2019

Background:

Improving patients’ perception of social support is significant not only for their re-adaptation to life but also for alleviating caregivers’ burden.

Aim:

This study aims to examine an integrated model regarding social support, psychotic symptoms and caregiver burden.

Methods:

Persons with schizophrenia ( N1 = 300) and their family caregivers ( N2 = 300) in Xinjin County, Chengdu, China, completed the survey to report their demographics, patients’ perception of social support (Duke Social Support Index), psychotic symptoms (Positive and Negative Syndrome Scale) and caregiver burden (Burden Scale for Family Caregivers, Short Version). Structural equation modelling was utilised to test the proposed model.

Results:

The degree of caregiver burden differed significantly within subgroups of patients’ gender and education, as well as caregivers’ gender, education and employment. Caregiver burden was negatively related to patients’ age and household income. Social interaction partially mediated the relationship between instrumental and subjective social support (total effect = 0.451, p < .01). Subjective social support fully mediated the impact of social interaction on psychotic symptoms (total effect = −0.099, p < .05). In the final model, instrumental social support was positively associated with social interaction ( p < .001) and increased subjective social support ( p < .05). Increased subjective social support showed correlation with a lower degree of psychotic symptoms ( p < .01), which was related to a lower level of caregiver burden ( p < .001).

Conclusion:

This study shows the associations of patients’ social support with psychotic symptoms and caregiver burden. Culture-specific psychosocial interventions should be provided for both patients and caregivers to enrich external support and reduce psychotic symptoms and caregivers’ burden within the health care environment.
Romiplostim as a transfusion saving strategy in 20 patients after heart or lung transplantation: a single centre before-after pilot study
Authors: Vourc’h Mickael , Senage Thomas , Lepoivre Thierry , Volteau Christelle , Fortuit Camille , Pattier Sabine , Guimbretiere Guillaume , Roussel Jean-Christian , Rozec Bertrand
Published: July 2019

Background:

Thrombocytopenia is a common disorder after heart or lung transplantation. Platelet transfusion is often required to maintain haemostasis but represents a specific cause of morbidity and mortality in this setting including alloimmunisation and graft rejection.

Study design and methods:

As part of a health-care quality improvement project, in a single-centre before–after pilot study, the relevance of a platelet transfusion saving strategy based on romiplostim administration after transplantation was assessed in patients with platelet count <100 × 109/L. Transfusions on days 28 and 90 were compared using propensity matched score for adjustment of demographic characteristics at baseline. The primary outcome was platelet transfusion until day 28 after transplantation.

Results:

Ninety-three patients were analysed (73 before vs. 20 after). The median [interquartile range] number of platelet concentrate was 1 [0;4.0] before versus 0.5 [0;2.0] in the after period, mean difference 0.5 confidence interval 95% [−0.7 to 1.7], p  = 0.39. On day 28, median [interquartile range] red blood cell transfusion was significantly higher in the before versus the after period, 7 [2.0;13.5] versus 6 [1.5;8.5], mean difference 3.2 CI 95% [0.4-6.0], p = 0.02. At 6 months, the rate of patients with de novo anti-human leukocyte antigen alloimmunisation was 45% before versus 53% in the after period (p = 0.56). Deep venous thrombosis was detected in nine patients (12%) before versus seven patients (35%) in the after period (p = 0.04).

Conclusion:

Romiplostim did not significantly reduce platelet transfusion after heart or lung transplantation. Its relevance and safety in a global transfusion strategy remains to be studied in this setting in a large randomised study.