bluuebunny/crossref_metadata_2025 huggingface dataset:
Anatomy teaching stuck in time? A 10-year follow-up of anatomy education in Australian and New Zealand medical schools
Authors: Trautman Jodie , McAndrew Darryl , Craig Steven J
Published: September 2019

Objectives

To detail how human anatomy is currently being taught and assessed in Australian and New Zealand medical schools.

Methods

Medical schools in Australia and New Zealand were invited to respond to an online survey of their teaching and assessment of human anatomy in the 2018 academic year. The results are compared with 2008 data. Changes in curricula and teaching methods are reported.

Results

Despite robust media and academic discussion over the last decade, very little has changed in the amount of anatomy teaching or assessment of anatomy in Australasian medical schools. One exception is that most universities have invested in new technology for teaching; however, the use of new technologies is irregular.

Conclusions

Australian and New Zealand medical schools should actively and cohesively respond to the changing requirements for anatomy education, or risk being left behind our international counterparts in the provision of anatomy education, to the detriment of doctors’ training and the healthcare system.
Effect of economic crisis on suicide cases: An ARDL bounds testing approach
Authors: Demirci Şenol , Konca Murat , Yetim Birol , İlgün Gülnur
Published: October 2019

Background:

Suicide events observed in various groups, community or countries, especially in the periods of economic recession. It is thought that suicide cases increase when people’s income decreases dramatically and they lose their jobs.

Aim/Objective:

In this study, it was aimed to investigate whether the 2008 economic crisis had any effect on suicides in the United States.

Methods:

Autoregressive distributed lag method was used. For the purpose of the study, the number of suicide-related deaths was taken as the dependent variable, while unemployment rates and 2008 economic crisis were taken as independent variables.

Findings:

The short-term and long-term relationships obtained within the scope of the study indicated that the 2008 economic crisis had a statistically significant effect on suicide cases in the United States.

Results and Conclusion:

It can be said that the results of this study are consistent with the information which emphasizes that economic crises increase suicide cases in the literature.
The Surprising Breadth of Harbingers of Failure
Authors: Simester Duncan I. , Tucker Catherine E. , Yang Clair
Published: September 2019

Previous research has shown that there exist “harbinger customers” who systematically purchase new products that fail (and are discontinued by retailers). This article extends this result in two ways. First, the findings document the existence of “harbinger zip codes.” If households in these zip codes adopt a new product, this is a signal that the new product will fail. Second, a series of comparisons reveal that households in harbinger zip codes make other decisions that differ from other households. The first comparison identifies harbinger zip codes using purchases from one retailer and then evaluates purchases at a different retailer. Households in harbinger zip codes purchase products from the second retailer that other households are less likely to purchase. The analysis next compares donations to congressional election candidates; households in harbinger zip codes donate to different candidates than households in neighboring zip codes, and they donate to candidates who are less likely to win. House prices in harbinger zip codes also increase at slower rates than in neighboring zip codes. Investigation of households that change zip codes indicates that the harbinger zip code effect is more due to where customers choose to live, rather than households influencing their neighbors’ tendencies.
The Port of Hamburg in the 1940s and 1950s: Physical Reconstruction and Political Restructuring in the Aftermath of World War II
Authors: Strupp Christoph
Published: October 2019

The resilience of cities is usually tested by acute catastrophes such as physical destruction by natural disasters or wars or long-term processes of economic decline. This article discusses another type of catastrophe and the response of the political and economic elite of the city to it in the form of a case study on Germany’s biggest seaport city Hamburg in the aftermath of World War II. Although the air war of 1943-1945 had seriously damaged large parts of the port of Hamburg, the physical reconstruction began soon after the end of the war and made steady progress. This aspect of the disaster of war was to be overcome within a few years. But the war and its aftermath of political confrontation between East and West had changed the geopolitical position of Hamburg and moved it from the center of Europe to the periphery of the West. The hinterland of the port in Eastern Europe was cut off. The founding of the European Economic Community (EEC) in 1957 with its focus on the Rhine-Ruhr area further seemed to marginalize Hamburg. These developments were quickly perceived as a greater disaster than the physical destruction. This article examines the strategies developed by the political and economic leaders in Hamburg in the late 1940s and 1950s for dealing with processes they had no control over and could not directly influence.
Long-term assessment of wave energy in the China Sea using 30-year hindcast data
Authors: Yang Shaobo , Fan Linlin , Duan Shanhua , Zheng Chongwei , Li Xingfei , Li Hongyu , Xu Jianjun
Published: October 2019

In this study, a long-term assessment of the wave energy in the China Sea was performed for a 30-year time interval (1988–2017), using the model WAVEWATCH-III. The reliability of the wave simulation results was increased by means of longer time horizon data compared to other relevant studies in the China Sea. This analysis provided information on the regional distribution as well as on the monthly and seasonal variability. The exploitation and stability of wave energy were taken into consideration, so as to find the advantage of resource exploitation. Results indicated that values of significant wave height and wave power density had obviously differences compared with different months, especially in December with a maximum significant wave height of 2.7 m and 35 kW/m of wave power density. The minimum value of them appeared in May, was 1.0 m and 4.5 kW/m, respectively. The distribution of wave energy was abundant in winter and the poorest in summer. In winter, the significant wave height in most areas was above 1.8 m, while the maximum wave energy density in summer was only 1.2 m. As for the wave power density, in winter values in most areas were above 18 kW/m, while the maximum value in summer was only 12 kW/m. In sight of regional distribution, the highest wave energy potential was located in the Northern South China Sea, the East China Sea, the Ryukyu Islands waters, east of the Taiwan Island and the Luzon Strait, with coefficient of variation was within 2.0 and occurrence of exploitation was above 80%, whereas the Bohai Sea, the northern part of the Yellow sea, the Gulf of Thailand, and the Northern Bay were in poor contribution, with occurrence of exploitation was within 50%.
Flowing material balance method with adsorbed phase volumes for unconventional gas reservoirs
Authors: Han Guofeng , Liu Min , Li Qi
Published: October 2019

This paper presents an improved flowing material balance method for unconventional gas reservoirs. The flowing material balance method is widely used to estimate geological reserves. However, in the case of the unconventional gas reservoirs, such as coalbed methane reservoirs and shale gas reservoirs, the conventional method is inapplicable due to the gas adsorption on the organic pore surface. In this study, a material balance equation considering adsorption phase volume is presented and a new total compressibility is defined. A pseudo-gas reservoir is simulated and the results were compared with the existing formulations. The results show that the proposed formulation can accurately get the geological reserves of adsorbed gas reservoirs. Furthermore, the results also show that the volume of the adsorbed phase has a significant influence on the analysis, and it can only be ignored when the Langmuir volume is negligible.
The Factors Contributing to Efficiency in Surgical Management of Purulent Infections of Deep Neck Spaces
Authors: Rzepakowska Anna , Rytel Adam , Krawczyk Przemysław , Osuch-Wójcikiewicz Ewa , Widłak Iga , Deja Michał , Niemczyk Kazimierz
Published: September 2019

Deep neck infections (DNIs) are still emergency conditions in otorhinolaryngology. Due to rapid disease progression and life-threatening complications, the accurate surgical and medical treatment must be promptly applied. In the present study, we analyzed treatment protocols of 46 adults to assess efficacy of the treatment and search for prognostic factors of the outcomes. We performed retrospective analysis of medical data of 46 patients, who underwent surgical treatment in our department due to purulent DNI in the period from 2009 to 2017. Data investigated included age, sex, hospitalization time, duration of symptoms before drainage, comorbidities, selected laboratory tests results, location and the number of abscesses, results of microbiological cultures, and antibiotic treatment options. The study group consisted of 33 (71.7%) men and 13 (28.3%) women. Patients age ranged from 18 to 82 years. The mean duration of hospital stay was 13.2 ± 8.4 days. The most common site involved was submandibular space (43.5%), followed by parapharyngeal space (28.3%). The majority of patients had single abscess (81.2%), the multiple abscesses were revealed in 8 (18.8%) cases. The mean size of the abscesses was 42 mm. C-reactive protein level was increased in 96.7% patients (mean level 155.5  ±  146.7  mg/L), but the white blood cell count exceeded the normal in 60.9% cases (mean level 16.89  ±  5.59   ×  109/L). Staphylococcus aureus (20.7%) and Peptostreptococcus (20.7%) were the most common species cultured from swabs. The antibiotic treatment included most commonly a combined ceftriaxone and metronidazole (n = 23). Two patients died due to complications. The correlation between different variables and the duration of hospitalization revealed only the hemoglobin level below 12.5 g/dL, a significant predictor of longer hospitalization (16.23 days vs 12.09 days, P = .017). Patients with purulent DNIs and decreased hemoglobin level are predisposed to prolonged recovery following the surgical drainage.
MR volumetry in predicting the aggressiveness of endometrioid adenocarcinoma: correlation with final pathological results
Authors: Cai Shulei , Zhang He , Chen Xiaojun , Wang Tianping , Lu Jiaqi , Liu Xuefen , Zhang Guofu
Published: September 2019

Background

Magnetic resonance (MR) has been widely used in predicting the aggressiveness of endometrioid adenocarcinoma. However, the diagnostic value of the MR volume of the lesion has been controversial.

Purpose

To determine whether the whole-lesion MR volume measurement could be used as a better predictor for evaluating the aggressiveness of endometrioid adenocarcinoma.

Material and Methods

In this retrospective study, we include 357 patients with pathologically demonstrated endometrioid adenocarcinoma at our institution between 1 January 2013 and 31 December 2018. Whole-lesion MR volume was calculated on sagittal T2-weighted images with ITK-SNAP software on a personal computer.

Results

According to the receiver operating characteristics curve analysis, whole-lesion MR volume has the competitive advantage in evaluating deep myometrial invasion compared with the frozen results, generating area under the curve (AUC) values of 0.751 vs. 0.834 ( P = 0.0629, Z = 1.860). The AUC of tumor maximum diameter, simple tumor volume, and whole-lesion MR volume in predicting deep myometrial invasion was 63.8%, 67.6%, and 75.1%, respectively.

Conclusion

Whole-lesion MR volume is a good diagnostic tool for prediction of deep myometrial invasion, lymph node metastasis, and lymphovascular invasion. MR volumetry could reflect the aggressiveness of endometrioid adenocarcinoma more accurately than traditional lesion measurements.
Evaluation of Time to Therapeutic Anticoagulation and Associated Outcomes in Critically Ill, Obese Patients With Pulmonary Embolism Receiving Unfractionated Heparin
Authors: Sutton Lauren H. , Tellor Bethany R. , Pope Hannah E. , Riney Jennifer N. , Weaver Katherine L.
Published: September 2019

Background:

Delays in time to therapeutic activated partial thromboplastin time (aPTT) have been associated with poor outcomes in patients with acute pulmonary embolism (PE).

Objective:

To investigate the relationship between time to therapeutic anticoagulation and in-hospital mortality in critically ill, obese patients with acute PE.

Methods:

This study examined 204 critically ill patients with a body mass index (BMI) ≥30 kg/m2 receiving unfractionated heparin (UFH) for PE treatment. Patients achieving therapeutic anticoagulation within 24 hours of UFH initiation (early) were compared to those in >24 hours (delayed). Additional end points included 30-day mortality, median time to therapeutic aPTT, proportion of therapeutic and supratherapeutic aPTT values, hemodynamic deterioration, thrombolytic therapy after UFH initiation, length of stay, and bleeding.

Results:

No difference in in-hospital or 30-day all-cause mortality was seen (odds ratio [OR]: 1.33, confidence interval [CI]: 0.647-2.72; OR: 1.003, CI: 0.514-1.96). Patients in the early group had a greater proportion of therapeutic aPTT values (66.7% vs 50%, P < .001) and higher percentage of supratherapeutic aPTT values (20.9% vs 11.3%, P < .001); however, no increase in clinically significant bleeding was evident (15.2% vs 10.9%, P = .366).

Conclusion:

In this population, a shorter time to therapeutic aPTT was not associated with improved survival.
Janet–Schwartz–Ellenberger: the history of a triangular relationship through their unpublished correspondence (1926–48)
Authors: Serina Florent
Published: October 2019

Leonhard Schwartz’s importance in the history of psychology has probably not been fully appreciated, and this article is dedicated to the life and work of the Basel neurologist. It highlights the triangular relationship he maintained for 20 years with Pierre Janet, of whom he was a disciple, and Henri F. Ellenberger, to whom he passed on his passion for Janet’s oeuvre.
Propensity score matching for treatment delay effects with observational survival data
Authors: Hade Erinn M , Nattino Giovanni , Frey Heather A , Lu Bo
Published: October 2019

In observational studies with a survival outcome, treatment initiation may be time dependent, which is likely to be affected by both time-invariant and time-varying covariates. In situations where the treatment is necessary for the study population, all or most subjects may be exposed to the treatment sooner or later. In this scenario, the causal effect of interest is the delay in treatment reception. A simple comparison of those receiving treatment early vs. those receiving treatment late might not be appropriate, as the timing of the treatment reception is not randomized. Extending Lu’s matching design with time-varying covariates, we propose a propensity score matching strategy to estimate the treatment delay effect. The goal is to balance the covariate distribution between on-time treatment and delayed treatment groups at each time point using risk set matching. Our simulation study shows that, in the presence of treatment delay effects, the matching-based analyses clearly outperform the conventional regression analysis using the naive Cox proportional hazards model. We apply this method to study the treatment delay effect of 17 alpha-hydroxyprogesterone caproate (17P) for patients with recurrent preterm birth.
The contribution of supply and demand factors to the reproduction of hierarchies online: The case of crowdfunding of scientific research
Authors: Davidson Roei , Tsfati Yariv
Published: October 2019

We conceptualize mechanisms that explain how social uses of media technologies, especially online platforms and crowds, reproduce, or modify inequalities, and explore these in the context of the crowdfunding of science. We distinguish between “supply side” factors related to the ability of actors given their institutional standing to use this funding approach, and “demand side” factors related to the crowd’s sensitivity to the institutional standing of those actors. We collected data on scientists requesting funding for their studies on Experiment.com , arguably the most popular scientific crowdfunding platform, and investigated the factors contributing to initiation and success. Supply side factors were important: crowdfunding appeals tended to come from scientists affiliated with larger, wealthier, and more active and prestigious institutions. However, demand side factors were not as important at the institutional level. Crowdfunding projects’ success was not predicted by the institution’s status, but rather by the number of appeals from an institution.
Application properties of a cyclophosphamide-core polyamidoamine dendritic montmorillonite in natural rubber composites
Authors: Cheng Liu , Jincheng Wang , Wen Zhao , Shiqiang Song
Published: October 2019

This work focused on investigation of application properties of organoclay-modified natural rubber (NR) composites. This organoclay, flame-retardant (FR) dendrimer-modified organic montmorillonite (G-OMMT), was composed of dendrimer and montmorillonite. Different generations of G-OMMT were prepared. G3.0-OMMT was selected and FR composites were fabricated. Their tensile properties, thermal stability, flame-retardance, and other properties were compared. The tensile strength and elongation at break of NR/G3.0-OMMT-15 were 18.8 MPa and 586%, respectively, which were about 12.6% and 23.6% higher than that of pure NR, 16.7 MPa and 474%. In addition, when 10 phr of G3.0-OMMT was added, the wearing loss volume was 0.231 cm3, which was 42.4% lower compared with that of pure NR, 0.401 cm3. The NR composites also possessed better thermal stability. When the amount of this organoclay was 10 phr, T 5% and T 10% were 306.4°C and 349.5°C, respectively. They were 102.3°C and 29.2°C higher than that of pure NR. Moreover, the burning rate was decreased from 30.15 mm min−1 for pure NR to 19.48 mm min−1 for NR/G3.0-OMMT-20, and the limited oxygen index value was increased from about 18% for pure NR to about 28% for NR/G3.0-OMMT-20. Scanning electron microscopy analysis demonstrated that the layered silicates dispersed uniformly in these composites and possessed a good compatibility with the polymeric matrix.
Pattern and Predictors of Tobacco Use in India: Evidence from National Family Health Survey (2015–2016)
Authors: Pradhan Manas Ranjan , Patel Surendra Kumar , Prusty Ranjan Kumar
Published: October 2019

Tobacco use continues to be of research interest due to the significant amount of tobacco-attributable non-communicable diseases and deaths in India. This study examines the pattern and predictors of smoking, chewing, and any tobacco use among adults of age 15–49 years in India. This study used secondary data from the fourth round of the National Family and Health Survey (NFHS, 2015–2016) which collected information on tobacco use from men and women in the age group 15–49 ( n = 803097). Bivariate and multivariate analyses were conducted to understand the socio-economic and demographic predictors. GIS maps have been used to show inter-state variation in smoking, chewing, and any tobacco use by gender. About one out of every ten adults aged 15–49 use any tobacco, predominantly in chewing forms. Women are significantly less likely to smoke (odds ratio [OR]: 0.05, confidence interval [CI]: 0.04–0.05), chew (OR: 0.25, CI: 0.24–0.25), and use any tobacco (OR: 0.14, CI: 0.13–0.14) compared with men. Tobacco usage was found more common among the uneducated and economically weak people. There is considerable inter-state heterogeneity in the prevalence and type of tobacco use, and adults in the north-east region are among the most vulnerable population subgroups. Tobacco use continues to be a significant burden due to its magnitude and different forms of use in India. The higher use among males, illiterates, economically weak, socially backward and alcohol users suggest the need for targeted efforts to improve their knowledge and awareness about the harmful effects of tobacco use and stronger enforcement of tobacco control policies.
Book review: Aseema Sinha, Globalizing India: How Global Rules and Markets are Shaping India’s Rise to Power
Authors: Pant Harsh V
Published: October 2019

Aseema Sinha, Globalizing India: How Global Rules and Markets are Shaping India’s Rise to Power. New Delhi: Cambridge University Press, 2016, pp. 354, ₹2509, ISBN 9781108447706.
Book review: Yan Xuetong, Leadership and the Rise of Great Powers
Authors: Rajagopalan Rajesh
Published: October 2019

Yan Xuetong, Leadership and the Rise of Great Powers. Princeton, NJ: Princeton University Press, 2019, pp. 280. ISBN 9780691190082.
The discomfort of Thorne v Kennedy: Law, love and money
Authors: Grossi Renata
Published: October 2019

The 2017 High Court case of Thorne v Kennedy highlighted and sparked discussion around the injustice of financial agreements and when they may constitute unconscionability and undue influence. However, the case also raises another important discussion about the relationship between love and money. This article picks up this conversation. How does society navigate the distinctions we make between economic exchange and romance? Between altruism and commodification? And how should this be manifested in the law in general, and the law governing financial agreements specifically?
A Distinctive Genomic and Immunohistochemical Profile for NOTCH3 and PDGFRB in Myofibroma With Diagnostic and Therapeutic Implications
Authors: Koo Selene C. , Janeway Katherine A. , Harris Marian H. , Fryer Christy J. , Aster Jon C. , Al-Ibraheemi Alyaa , Church Alanna J.
Published: October 2019

Introduction. Myofibromas are rare tumors of pericytic lineage, typically affecting children, and are sometimes aggressive. A subset of sporadic and familial myofibromas have activating variants in PDGFRB. The relationship of myofibroma and PDGFRB to the NOTCH pathway has not yet been described. Methods. Ten myofibroma cases were sequenced with a targeted panel of 447 genes, including copy number variation and selected fusions. Immunohistochemical analysis of total NOTCH3 and activated NOTCH3 was assessed for all 10 myofibroma cases, and a series of histologic mimics (n = 20). Results. Alterations identified by next-generation sequencing included PDGFRB sequence variants in 8/10 cases (80%), a NOTCH3 variant in 1/10 cases (10%), and a NOTCH2 variant in 1/10 cases (10%). All 10 cases also showed a pattern of low-amplitude (1.5- to 2-fold) copy number alterations including gains in PDGFRB and NOTCH3. Ten of 10 myofibromas (100%) showed cytoplasmic staining for total NOTCH3 and 9 of 10 cases (90%) showed nuclear staining for activated NOTCH3. Within the control cohort of histologic mimics, 3 of 3 nodular fasciitis cases (100%) were positive for activated and total NOTCH3, and the remaining 17 cases were negative for pan NOTCH3, while 3 of 3 desmoid-type fibromatosis cases (100%) showed patchy weak nuclear staining for activated NOTCH3. Discussion. Our findings suggest a common pathway of PDGFRB/NOTCH3 activation in myofibromas, even in cases that lack PDGFRB sequence variants. These results support the pericytic lineage of myofibroma. Identification of the characteristic genomic alterations or immunohistochemical staining pattern may facilitate a difficult pathologic diagnosis, and support the use of targeted treatments.
Cabozantinib use in metastatic renal cell carcinoma patients in clinical practice: Evaluation of dosing patterns, tolerability, and outcomes compared to clinical trials
Authors: McElwee Jessica H , Gourdin Theodore S , Mikoll Jennifer , Weeda Erin , Sion Amy M
Published: September 2019

Introduction

Despite first-line approval in metastatic renal cell carcinoma (mRCC), the tyrosine kinase inhibitor cabozantinib is associated with frequent treatment-limiting side effects. Dose reductions in published trials of the drug and in clinical practice are commonplace. We analyzed our institution’s real-world experience with cabozantinib dosing in patients with mRCC to assess strategies to improve tolerability and patient outcomes.

Objectives

The purpose of our study is to retrospectively analyze dose intensity, tolerability, and duration of exposure in mRCC patients who received cabozantinib at our institution.

Methods

In this retrospective, single-center chart review, we identified 35 adult patients who received at least one cycle cabozantinib for mRCC during a two-year period. Dosing patterns were reviewed for each patient to allow calculation of median dose intensity and median duration of exposure.

Results

The median dose intensity for cabozantinib was 55.4% and the median actual daily dose was 33.2 mg. Median duration of cabozantinib exposure was 10.4 months. Several alternative dosing strategies were employed with 60% of patients requiring at least one dose intervention to manage toxicities.

Conclusions

Patients in this analysis received a median actual daily dose of 33.4 mg, less than the reported median doses in the METEOR and CABOSUN trials. However, our median duration of cabozantinib treatment was 10.4 months compared to 8.3 months and 6.5 months in these respective trials. Further investigation is warranted to determine if alternative dosing strategies and lower median actual daily doses produce survival results comparable to published clinical trials.
Kynurenines, Neuropsychiatric Symptoms, and Cognitive Prognosis in Patients with Mild Dementia
Authors: Hafstad Solvang Stein-Erik , Nordrehaug Jan Erik , Aarsland Dag , Lange Johannes , Ueland Per Magne , McCann Adrian , Midttun Øivind , Tell Grethe S , Giil Lasse Melvaer
Published: September 2019

Introduction:

Circulating tryptophan (Trp) and its downstream metabolites, the kynurenines, are potentially neuroactive. Consequently, they could be associated with neuropsychiatric symptoms and cognitive prognosis in patients with dementia.

Objective:

The objective of this study was to assess associations between circulating kynurenines, cognitive prognosis, and neuropsychiatric symptoms.

Methods:

We measured baseline serum Trp, neopterin, pyridoxal 5′-phosphate (PLP), and 9 kynurenines in 155 patients with mild dementia (90 with Alzheimer’s disease, 65 with Lewy body dementia). The ratios between kynurenine and Trp and kynurenic acid (KA) to kynurenine (KKR) were calculated. The Mini-Mental State Examination (MMSE) and the Neuropsychiatric Inventory (NPI) were administered at baseline and annually over 5 years. Associations between baseline metabolite concentrations with MMSE and the NPI total score were assessed using a generalized structural equation model (mixed-effects multiprocess model), adjusted for age, sex, current smoking, glomerular filtration rate, and PLP. Post hoc associations between KKRs and individual NPI items were assessed using logistic mixed-effects models. False discovery rate (0.05)–adjusted P values ( Q values) are reported.

Results:

Kynurenine had a nonlinear quadratic relationship with the intercept of the MMSE scores over 5 years ( Q < 0.05), but not with the slope of MMSE decline. Kynurenine was associated with a higher NPI total score over time ( Q < 0.001). Post hoc, both KKR and KA were associated with more hallucinations ( Q < 0.05).

Conclusions:

Kynurenine has a complex relationship with cognition, where both low and high levels were associated with poor cognitive performance. A higher KKR indicated risk for neuropsychiatric symptoms, especially hallucinations.
Hypercholesterolemia Due to Lipoprotein X: Case Report and Thematic Review
Authors: Kattah Laura , Gómez Andrés , Gutiérrez Sebastián , Puerto Kathalina , Moreno-Pallares Eiman D , Jaramillo Andrés , Mendivil Carlos O
Published: September 2019

The liver is a key organ in lipid and lipoprotein metabolism, hence hepatic diseases often manifest as lipid disturbances. Cholestatic liver diseases are frequently associated with an important increase in total cholesterol at the expense of lipoprotein X (LpX), an abnormal lipoprotein isolated and characterized in the 1960s to 1970s in patients with obstructive jaundice. Lipoprotein X is rich in phospholipids, albumin, and free cholesterol, has a density similar to low-density lipoprotein (LDL), and a size similar to very low-density lipoprotein (VLDL), which has hampered its detection through routine laboratory tests. Unlike LDL, LpX has no apoB-100, so it is not removed from circulation via the LDL receptor, and it is not clear whether or not it can be atherogenic. Although LpX was initially described in patients with cholestasis, it has also been found in patients with genetic deficiency of lecithin-cholesterol acyltransferase (LCAT), in patients who receive lipid-rich parenteral nutrition and most recently in patients with graft versus host disease of the liver. In the presence of LpX, plasma total cholesterol can rise up to 1000 mg/dL, which may lead to the development of skin xanthomas and hyperviscosity syndrome. Treatment of LpX-dependent hypercholesterolemia with conventional hypolipidemic drugs is frequently ineffective, and definitive treatment relies on correction of the underlying cause of cholestasis. Here, we present the case of a patient with LpX-dependent hypercholesterolemia in the context of primary biliary cholangitis.
Steady-state performance of elliptical contact lubricated with micropolar fluids
Authors: Dewangan Dhanendra , Sarangi Mihir
Published: September 2019

In this work, the numerical investigation is done for the steady-state performance of elliptical contacts lubricated with micropolar fluids. The Eringen’s micro-continuum theory is applied to deduce the modified Reynolds equation for micropolar fluids. The modified Reynolds equation is discretized by the finite difference technique and evaluated by a multigrid technique for finding the steady-state pressure distribution; simultaneously, the elasticity equation is solved with the multilevel multi-integration method. The numerical solution is achieved under isothermal conditions and considering the exponential variation of viscosity with pressure. The effect of micropolar parameters, i.e. nondimensional characteristics length defines the molecular length of the blended additives, and coupling number measures the coupling between the angular and linear momentum of molecules, and operating parameters are studied. Owing to the analysis, the pronounced effect of the micropolar parameters on the elastohydrodynamic lubrication of elliptical contacts is observed and which cannot be avoided. Lubricants added with solid additives and coupling between linear and angular momentum improved the overall film thickness and pressure and enhanced the load-carrying capacity. Also, a nominal rise in the traction coefficient is noticed, but this increase in the traction coefficient is quite less when compared to Newtonian fluids.
Pharmacology and social media: Potentials and biases of web forums for drug mention analysis—case study of France
Authors: Audeh Bissan , Calvier François-Elie , Bellet Florelle , Beyens Marie-Noëlle , Pariente Antoine , Lillo-Le Louet Agnès , Bousquet Cedric
Published: October 2019

The aim of this study is to analyze drug mentions in web forums to evaluate the utility of this data source for drug post-marketing studies. We automatically annotated over 60 million posts extracted from 21 French web forums. Drug mentions detected in this corpus were matched to drug names in a French drug database (Theriaque®). Our analysis showed that a high proportion of the most frequent drug mentions in the selected web forums correspond to drugs that are usually prescribed to young women, such as combined oral contraceptives. The most mentioned drugs in our corpus correlated weakly to the most prescribed drugs in France but seemed to be influenced by events widely reported in traditional media. In this article, we conclude that web forums have high potential for post-marketing drug-related studies, such as pharmacovigilance, and observation of drug utilization. However, the bias related to forum selection and the corresponding population representativeness should always be taken into account.
Together divided–divided together: Intersections of symbolic boundaries in the context of ex-Yugoslavian immigrant communities in Vienna
Authors: Mijić Ana
Published: October 2019

The inspiration for the following research arose from an identified ambivalence regarding the question of how relevant ethnic belonging – being Bosniak, being Croat, being Serb – is in everyday life of ex-Yugoslavian Viennese people. A qualitative analysis of narrative interviews as well as participant observations on Vienna’s Ottakringer Straße, a neighbourhood highly frequented by immigrants from the former Yugoslavia and their descendants, indicates that ethnicity indeed matters, particularly when it comes to questions of partner choice. The research, however, also reveals that there are further, intersecting boundaries encompassing or dividing the ‘ex-Yugoslavian community’: In light of being othered by the Austrian majority society and defined as ‘incomplete self’ Maria Todorova, i.e. as representatives of a sphere between the own and the foreign, educationally alienated young adults across ethnic boundaries notably celebrate the culture of ‘turbo folk’ on Ottakringer Straße – a lifestyle that emphasises their own ‘glamour and passion’ as opposed to Austrian ‘bleakness’. Therewith they reinforce the image of the ‘Balkan Other’. Simultaneously, ‘ex-Yugoslavian’ Viennese with higher education levels exhibit a substantial need to not only distinguish themselves from turbo folk and (night-)life on Ottakringer Straße, but also from the image of the ‘Balkan Other’. By emphasising their own ‘more sophisticated’ taste, they express their social position in terms of a specific lifestyle and set themselves apart from the ‘uneducated and common immigrants’. Hence, the analysis shows that, with regard to the ‘ex-Yugoslavian communities’ in Vienna, different symbolic boundaries are at work: the ethnic boundaries – (re-)constructed and (re-)enforced by the wars in the former Yugoslavia – the ‘Balkanised’ symbolic boundaries between ex-Yugoslavian minorities and the Austrian majority as well as the milieu-specific symbolic boundaries within the community itself.
Development of an Instrument for Measuring Self-Care Behaviors After Left Ventricular Assist Device Implantation
Authors: Kato Naoko P. , Jaarsma Tiny , Casida Jesus M. , Lee Christopher S. , Strömberg Anna , Gal Tuvia Ben
Published: October 2019

Background:

Successful long-term left ventricular assist device (LVAD) therapy necessitates a high degree of self-care. We aimed to develop an instrument that measures self-care behaviors in adult patients living with an LVAD.

Methods:

We used the method to develop patient-reported outcomes recommended by the US Food and Drug Administration. Prior to developing the instrument, a literature review was conducted to generate items using the middle-range theory of self-care of chronic illness as a guiding framework. A 2-round Delphi method, involving 17 clinicians with expertise in heart failure and assist devices from the Netherlands, Israel, United States, Canada, and Japan, was used to generate and select items. In the first Delphi survey, the levels of importance, relevance, and clarity of items in the instrument were evaluated. The second Delphi survey was performed to gain consensus on the final selection of items. We also examined face validity.

Results:

A preliminary 37-item version of the Self-Care Behavior Scale was produced. The first panel judged 33 items as important and relevant, taking out 4 items due to vague wording and duplication and adding in 4 items. In the final 33-item version, 19 items address self-care maintenance behaviors, 10 items address self-care monitoring behaviors, and 4 items address self-care management behaviors. Patients (N = 25) did not have any difficulties understanding items and report any missing items.

Conclusion:

The 33-item Self-Care Behavior Scale for patients with heart failure having an LVAD has been developed and is ready for further psychometric testing.
Prediction of IDH Status Through MRI Features and Enlightened Reflection on the Delineation of Target Volume in Low-Grade Gliomas
Authors: Ding Haixia , Huang Yong , Li Zhiqiang , Li Sirui , Chen Qiongrong , Xie Conghua , Zhong Yahua
Published: September 2019

Isocitrate dehydrogenase mutational status defines distinct biologic behavior and clinical outcomes in low-grade gliomas. We sought to determine magnetic resonance imaging characteristics associated with isocitrate dehydrogenase mutational status to evaluate the predictive roles of magnetic resonance imaging features in isocitrate dehydrogenase mutational status and therefore their potential impact on the determination of clinical target volume in radiotherapy. Forty-eight isocitrate dehydrogenase-mutant and 28 isocitrate dehydrogenase–wild-type low-grade gliomas were studied. Isocitrate dehydrogenase mutation was related to more frequency of cortical involvement compared to isocitrate dehydrogenase–wild-type group (34/46 vs 6/24, P = .0001). Peritumoral edema was less frequent in isocitrate dehydrogenase–mutant tumors (32.6% vs 58.3% for isocitrate dehydrogenase–wild-type tumors, P = .0381). Isocitrate dehydrogenase–wild-type tumors were more likely to have a nondefinable border, while isocitrate dehydrogenase–mutant tumors had well-defined borders (66.7% vs 39.1%, P = .0287). Only 8 (17.4%) of 46 of the isocitrate dehydrogenase–mutant tumors demonstrated marked enhancement, while this was 66.7% in isocitrate–wild-type tumors ( P < .0001). Choline–creatinine ratio for isocitrate dehydrogenase–wild-type tumors was significantly higher than that for isocitrate dehydrogenase–mutant tumors. In conclusion, frontal location, well-defined border, cortical involvement, less peritumoral edema, lack of enhancement, and low choline–creatinine ratio were predictive for the definition of isocitrate dehydrogenase–mutant low-grade gliomas. Magnetic resonance imaging can provide an advantage in the detection of isocitrate dehydrogenase status indirectly and indicate the need to explore new design for treatment planning in gliomas. Choline–creatinine ratio in magnetic resonance spectroscopy could be a potential more reasonable reference for the new design of delineation of target volume in low-grade gliomas.
Radiogenomics in Clear Cell Renal Cell Carcinoma: Correlations Between Advanced CT Imaging (Texture Analysis) and MicroRNAs Expression
Authors: Marigliano Chiara , Badia Stefano , Bellini Davide , Rengo Marco , Caruso Damiano , Tito Claudia , Miglietta Selenia , Palleschi Giovanni , Pastore Antonio Luigi , Carbone Antonio , Fazi Francesco , Petrozza Vincenzo , Laghi Andrea
Published: September 2019

Purpose:

A relevant challenge for the improvement of clear cell renal cell carcinoma management could derive from the identification of novel molecular biomarkers that could greatly improve the diagnosis, prognosis, and treatment choice of these neoplasms. In this study, we investigate whether quantitative parameters obtained from computed tomography texture analysis may correlate with the expression of selected oncogenic microRNAs.

Methods:

In a retrospective single-center study, multiphasic computed tomography examination (with arterial, portal, and urographic phases) was performed on 20 patients with clear cell renal cell carcinoma and computed tomography texture analysis parameters such as entropy, kurtosis, skewness, mean, and standard deviation of pixel distribution were measured using multiple filter settings. These quantitative data were correlated with the expression of selected microRNAs (miR-21-5p, miR-210-3p, miR-185-5p, miR-221-3p, miR-145-5p). Both the evaluations (microRNAs and computed tomography texture analysis) were performed on matched tumor and normal corticomedullar tissues of the same patients cohort.

Results:

In this pilot study, we evidenced that computed tomography texture analysis has robust parameters (eg, entropy, mean, standard deviation) to distinguish normal from pathological tissues. Moreover, a higher coefficient of determination between entropy and miR-21-5p expression was evidenced in tumor versus normal tissue. Interestingly, entropy and miR-21-5p show promising correlation in clear cell renal cell carcinoma opening to a radiogenomic strategy to improve clear cell renal cell carcinoma management.

Conclusion:

In this pilot study, a promising correlation between microRNAs and computed tomography texture analysis has been found in clear cell renal cell carcinoma. A clear cell renal cell carcinoma can benefit from noninvasive evaluation of texture parameters in adjunction to biopsy results. In particular, a promising correlation between entropy and miR-21-5p was found.
Learning to Transform Through Interplay Between the Confucian and Western Cultural Heritages: A Case Study of School Leadership Development in Beijing, China
Authors: Kang Haijun , Sun Qi , Lyu Lei
Published: September 2019

Taking a case study approach and utilizing Hoggan’s transformative learning (TL) typology and criteria as a framework, we examined the self-reported TL experiences of 12 local school leaders in Beijing, China. These local school leaders gained cross-cultural learning from a school leadership development program that was designed to prepare school leaders for education internationalization. Our data analysis indicated that these 12 local school leaders had experienced significant changes in their educational epistemology, self-identity, and school leadership practices. Further examining these changes at the intersection of the Confucian and Western cultural heritages, we discovered that these school leaders had developed an integrated approach to education, started to consciously reflect on what their social- and self-identities entail, and began the process of transitioning from conservative to appreciative school leadership practices.
Fifty Percent Reduction in Narcotic Use After Minimally Invasive Cardiac Surgery Using Liposomal Bupivacaine
Authors: Castillo-Sang Mario , Bartone Cheryl , Palmer Cassady , Truong Vien T. , Kelly Brian , Voeller Rochus K. , Griffin Jeffrey , Smith Timothy , Raidt Hilary , Answini Geoffrey A.
Published: September 2019

Objective

Minimally invasive cardiac surgery via a right minithoracotomy (RMT) is a common approach to different valve pathologies, tumor resection, and atrial septal defect (ASD) closure. We studied intraoperative field block using liposomal bupivacaine (LB) in these operations.

Methods

Consecutive 171 minimally invasive RMTs (fourth intercostal space) were studied, and patients in cardiogenic or septic shock, intravenous drug abuse, and those re-explored were excluded ( n = 12). An early cohort was treated with standard postoperative analgesia while another underwent intraoperative field block with LB immediately after incision. We compared postoperative pain level, narcotic utilization (morphine milligram equivalent), and intensive care unit (ICU) and hospital length of stay.

Results

The procedures included 48 isolated mitral valve replacements (MVR); 2 MVR with other procedures; 93 mitral valve repairs (MVRr); 9 MVRr with other procedures; 4 isolated tricuspid valve repairs; 2 myxoma resections; 1 ASD closure. There were 13 patients in the non-LB group and 146 patients in the LB group. Use of LB decreased mean postoperative narcotic utilization by 50% ( P = 0.003). The LB group had lower pain levels on postoperative day 1 ( P = 0.039), which continued through postoperative day 5 ( P = 0.030). We found no difference in ICU or hospital length of stay between groups. There were no complications from LB field block.

Conclusions

LB field block decreases postoperative pain and narcotic utilization after cardiac surgery via a RMT, but it does not reduce length of stay. The technique is safe and should be considered in all patients undergoing RMT cardiac surgery.
Effect of geometrical factors interactions on design optimization process of a natural gas ejector
Authors: Hassan Amin Amin , Elbadawy Ibrahim , Elgendy E , Fatouh M
Published: October 2019

Enhancing the ejector entrainment ratio plays an important role in the ejector performance. In this article, a surrogate-based optimization approach along with computational fluid dynamics technique has been employed to optimize the entrainment ratio of a single-phase ejector working with natural gas. Nine ejector geometrical factors have been varied to maximize the ejector entrainment ratio. Validation results of the presented computational fluid dynamics model were in a good agreement with the experimental data from the literature with an average error of 0.6% in the critical mode. Reported results showed that the optimum design achieves entrainment ratio of 19.45% at 12, 2, and 5.2 MPa motive pressure, induced pressure, and discharge pressure, respectively. Moreover, the primary nozzle convergent angle and throat length are insignificant factors. Furthermore, secondary nozzle inclination angle has a minor effect on the entrainment ratio of the optimum design.
Optimum manipulator path generation based on improved differential evolution constrained optimization algorithm
Authors: Fan Shimeng , Xie Xihua , Zhou Xuanyi
Published: September 2019

A new improved differential evolution constrained optimization algorithm is proposed to determine the optimum path generation of a rock-drilling manipulator with nine degrees of freedom. This algorithm is developed to minimize the total joint displacement without compromising the pose accuracy of the end-effector. Considering the rule for optimal operation time and smooth joint motion, total joint displacement and minimization of the end-effector pose error are respectively taken as the optimization objective and constraints. In the proposed algorithm, the inverse kinematics solution is computed by self-adaptive mutation differential evolution constrained optimization (SAMDECO) algorithm. Unlike conventional differential evolution (DE) algorithms, in the process of selection operation, the proposed algorithm takes full advantages of the information of excellent infeasible solutions in the contemporary population and scales the contribution of position constraint and orientation constraint. Consequently, the search process is guided to approach the optimal solution from both feasible and infeasible regions, which tremendously improves convergence accuracy and convergence rate. Some contrastive experiments are conducted with the basic self-adaptive mutation differential evoluton (SAMDE) algorithm. The results indicate that the proposed algorithm outperforms the basic SAMDE algorithm in terms of compliance of joints, which raises operation efficiency and plays an important role in engineering services value.