bluuebunny/crossref_metadata_2025 huggingface dataset:
Mixture Modeling for Lifespan Developmental Research
Authors: Morin Alexandre J.S. , Litalien David
Published: March 2019

As part of the Generalized Structural Equation Modeling framework, mixture models are person-centered analyses seeking to identify distinct subpopulations, or profiles, of participants differing quantitatively and qualitatively from one another on a configuration of indicators and/or relations among these indicators. Mixture models are typological (resulting in a classification system), probabilistic (each participant having a probability of membership into all profiles based on prototypical similarity), and exploratory (the optimal model is typically selected based on a comparison of alternative specifications) in nature, and can take different forms. Latent profile analyses seek to identify subpopulations of participants differing from one another on a configuration of indicators and can be extended to factor mixture analyses allowing for the incorporation of latent factors to the model. In contrast, mixture regression analyses seek to identify subpopulations of participants’ differing from one another in terms of relations among profile indicators. These analyses can be extended to the multiple-group and/or longitudinal analyses, allowing researchers to conduct tests of profile similarity across different samples of participants or time points, and latent transition analyses can be used to assess probabilities of profiles transition over time among a sample of participants (i.e., within person stability and change in profile membership). Finally, growth mixture analyses are built from latent curve models and seek to identify subpopulations of participants following quantitatively and qualitatively distinct trajectories over time. All of these models can accommodate covariates, used either as predictors, correlates, or outcomes, and can even be extended to tests of mediation and moderation.
thymos
Authors: Cairns Douglas
Published: March 2019

Thymos (or thumos), cognate with Indo-European words meaning “smoke,” is one of a number of terms in Greek which associate psychological activity with air and breath. In the Homeric poems, thymos is one of a family of terms associated with internal psychological process of thought, emotion, volition, and motivation. Though the range of the term’s applications in Homer is wide, that in itself gives us a sense of the unity of cognitive, affective, and desiderative processes in Homeric psychology. No post-Homeric author can rival that range, but something of the richness of the Homeric conception of thymos as an interrelated set of motivations re-emerges in Plato’s conception of the tripartite soul in the Republic and the Phaedrus. Plato’s thymos represents a pared-down model of human agency typified by one central desire or aim in life but also exhibiting whatever further capacities of persons are necessary to enable it to pursue that aim in interaction with the other elements of the personality. As in Homer, the metaphorical agency of Plato’s thymos does not detract from the notion of the individual as the real centre of agency. Plato’s conception of thymos, in turn, is a fundamental point of reference for Aristotle’s treatment of thymos as a type of desire (orexis). Though Aristotle tends more generally to use the term as a synonym for orgē (anger), there are also traces of older associations between thymos and qualities such as assertiveness and goodwill towards others. Elsewhere, thymos tends to mean “heart” or “mind” (as aspects of mental functioning), “spirit,” “inclination,” or “anger.” A selection of these uses is surveyed, but the article overall concentrates on Homer, Plato, and Aristotle, where the role of thymos is of a different order of importance.
matronalia
Authors: Dolansky Fanny
Published: March 2019

March 1 was the date of the Matronalia festival, which ancient sources generally refer to as either the Kalends of March or the Women’s Kalends. Juno Lucina, goddess of light and childbirth, and Mars, in his more pacific aspects, were the primary recipients of the rites. At Juno Lucina’s temple on the Esquiline Hill in Rome, and presumably at cult sites in other locales, matronae (married freeborn women) offered flowers and prayers to the goddess. The domestic components of the festival involved husbands’ prayers, either for the preservation of their wives or their marriages; a gift exchange; and the feasting of household slaves by their mistresses (dominae). Primarily because of these latter two elements, the Matronalia was regarded by some ancient sources as the female equivalent of the Saturnalia festival, which was observed in December. The Matronalia had a long-recorded history in Italy, and there is evidence that it was celebrated in some provincial locations, including at Carthage and Burdigala (modern Bordeaux).
School-Based Truancy Courts
Authors: Miller Fayneese
Published: March 2019

Truancy, or unexcused chronic absenteeism from school, has been linked to school dropout, early onset criminal behavior, drug use, and other negative behaviors. Given the negative impact of truancy on the future outlook for students and the potential costs for society, many communities have begun to identity programs or collaborations that might reduce truancy and improve academic achievement of students. An increasingly key partner in such efforts is the courts. Truancy is defined as a legal term and the role school-based or affiliated truancy courts play in truancy is significant. The Stop Truancy Reduction Program in the United States needs to be emphasized as a model for the ways in which courts can partner with school personnel, social workers, and other mental health counselors to address truancy and its associated problems.
Mental Illness: Worldwide
Authors: Sowers Karen M. , Dulmus Catherine N. , Linn Braden K.
Published: March 2019

In the 2010s, mental health and related issues such as suicide have become major global issues of public health concern. The indirect costs to the global economy of mental illness—encompassing such factors as loss of productivity and the spending on mental health services and other direct costs—amount to approximately $2.5 trillion a year. Global health experts and economists project this amount will increase to approximately $6 trillion by 2030. When gone untreated, mental illnesses account for 13% of the total global burden of disease. By the year 2030 it is expected that depression alone will be the leading cause of the global disease burden. Unfortunately, many persons suffering with mental illnesses do go untreated or receive marginally effective treatments. However, recent advances in technology, evidence-based treatments, and delivery systems of care provide hope for the world’s mentally ill population.
The Role of Weather on Schooling and Work of Young Adults in Madagascar
Authors: Marchetta Francesca , Sahn David E , Tiberti Luca
Published: March 2019

We examine the impact of rainfall variability and cyclones on schooling and work among a cohort of teens and young adults in Madagascar. We estimate a bivariate probit model using a panel survey conducted in 2004 and 2011 in this poor island nation, which is frequently affected by extreme weather events. Our results show that negative rainfall deviations and cyclones reduce the probability of attending school and encourage young men and, to a greater extent, women to enter the work force, and they reduce their French and math test scores. Less wealthy households are most likely to experience this school‐to‐work transition in the face of rainfall shocks. The finding is consistent with poorer households having less savings and more limited access to credit and insurance, which reduces their ability to cope with rainfall shortages. We also find that there are both contemporaneous and lagged effects of the weather shocks, and that they are of a similar magnitude. Our findings are robust to the use of a linear probability model, as well as a wide range of definitions of rainfall variations.
Simultaneous clustering of multiview biomedical data using manifold optimization
Authors: Yu Yun , Zhang Lei-Hong , Zhang Shuqin
Published: March 2019

Motivation

Multiview clustering has attracted much attention in recent years. Several models and algorithms have been proposed for finding the clusters. However, these methods are developed either to find the consistent/common clusters across different views, or to identify the differential clusters among different views. In reality, both consistent and differential clusters may exist in multiview datasets. Thus, development of simultaneous clustering methods such that both the consistent and the differential clusters can be identified is of great importance.

Results

In this paper, we proposed one method for simultaneous clustering of multiview data based on manifold optimization. The binary optimization model for finding the clusters is relaxed to a real value optimization problem on the Stiefel manifold, which is solved by the line-search algorithm on manifold. We applied the proposed method to both simulation data and four real datasets from TCGA. Both studies show that when the underlying clusters are consistent, our method performs competitive to the state-of-the-art algorithms. When there are differential clusters, our method performs much better. In the real data study, we performed experiments on cancer stratification and differential cluster (module) identification across multiple cancer subtypes. For the patients of different subtypes, both consistent clusters and differential clusters are identified at the same time. The proposed method identifies more clusters that are enriched by gene ontology and KEGG pathways. The differential clusters could be used to explain the different mechanisms for the cancer development in the patients of different subtypes.

Availability and implementation

Codes can be downloaded from: http://homepage.fudan.edu.cn/sqzhang/files/2018/12/MVCMOcode.zip.

Supplementary information

Supplementary data are available at Bioinformatics online.
Seeing More, Better Sight: Using an Interprofessional Model of Supervision to Support Reflective Child Protection Practice Within the Health Setting
Authors: Kelly Selina , Green Tracee
Published: March 2019

Despite an extensive history in developing, delivering and leading child protection (CP) services, social workers are not an explicit part of the health-based response to CP in the UK. In this setting, a biomedical discourse dominates, with doctors and nurses fulfilling the roles of named and designated safeguarding professionals. Supervision for these health professionals, while considered necessary, has a multi-layered system of governance with no clear policies to guide its content and purpose. This article will argue that the inclusion of social work expertise in health-based CP services, through an interprofessional approach to supervision, can offer clarity to the operationalisation of supervision and support integrated service development. A model for supervision, with experienced social workers engaged to supervise named safeguarding professionals, is outlined and informed by a psychodynamic perspective. With both CP and supervision an inherent part of the social work tradition, social workers are well placed to use specialist knowledge and insight within the health setting, through supervision, to strengthen reflective practice in this complex area of service delivery.
“May the Force Be With You”: Narendra Modi and the Celebritization of Indian Politics
Authors: Rai Swapnil
Published: March 2019

“May the force be with you” were the Indian Prime Minister Narendra Modi’s parting words as he ended his 2014 address to a rapturous crowd of Indian Americans in New York’s Madison square garden. Modi is the first PM to address the country through his own radio show, actively use social media, as well as technologies such as the 3D hologram. This article examines the ways in which Modi’s celebritized politics is strategically constructed and performed, honing in on Modi’s utilization of media, technology, and popular culture. It interrogates the processes such as the personalization of his political image through social media, the use of film stars to cultivate affect and allure by association, in constructing brand Modi.
Determination of Ibuprofen and Phenylephrine in Tablets by High-Performance Thin Layer Chromatography and in Plasma by High-Performance Liquid Chromatography with Diode Array Detection
Authors: Ragab Marwa A A , Abdel-Hay Mohamed H , Ahmed Hytham M , Mohyeldin Sara M
Published: March 2019

Two chromatographic methods (high performance thin layer chromatography (HPTLC) and high performance liquid chromatography–diode array detector (HPLC-DAD)), were addressed for the analysis of a mixture consisted of phenylephrine hydrochloride and ibuprofen in two forms bulk and their combined dosage form. This binary mixture is considered to be a challenging one as the two drugs differ greatly in their chemical and physical properties. Not only this affects their simultaneous analysis, but also hinders their simultaneous extraction from biological fluids as plasma. That is the reason the literature lacks any report for the simultaneous extraction and analysis of these drugs from biological fluids. The concentration ranges of both drugs were 0.1–2.5 μg/spot and 0.1–100 μg/mL by HPTLC and HPLC, respectively. Not only was the HPLC-DAD method applied to the investigated drugs determination in pharmaceutical preparations, but also in spiked human plasma. Extensive study was conducted to optimize their simultaneous extraction from plasma as it was a crucial step for the in vivo analysis. The results obtained by proposed methods and a reference one were statistically comparable by analysis of variance test. No significant difference was recorded between the mean percent levels determined by the proposed methods and the reference one.
Emerging zoonotic viral infections of occupational health importance
Authors: Vonesch Nicoletta , Binazzi Alessandra , Bonafede Michela , Melis Paola , Ruggieri Anna , Iavicoli Sergio , Tomao Paola
Published: March 2019

Emerging viral infections represent a public health risk pointed out by the spreading of pathogens with potential zoonotic risk. Moreover, the risk of zoonosis has probably been underestimated in occupational settings. A literature review between 2007 and 2018 was performed to identify evidences concerning the epidemiological associations between some emerging viruses and occupational diseases. Observational studies and case-reports were selected and analyzed. West Nile Virus (WNV) disease, Crimean-Congo Hemorrhagic Fever (CCHF) disease and Hepatitis E virus (HEV) infection were included in the review for their potential zoonotic transmission. The most important risk factor for acquiring WNV infection and CCHF infection is the exposure to infected mosquitoes and ticks, respectively; therefore, outdoor workers are at risk of infection. HEV is responsible for epidemics and endemics of acute hepatitis in humans, that can become infected through waterborne, foodborne and zoonotic transmission routes. A total of 10, 34 and 45 eligible studies for WNV, CCHF virus (CCFHV) and HEV, respectively, were analyzed by year, country, study design, risk group and outcomes. The occupational risk groups mainly included farm and agricultural workers, veterinarians, slaughterers, animal handlers, healthcare workers and soldiers. These findings support the need to develop effective interventions to prevent transmission of emerging viruses.
Intestinal dysbiosis promotes epithelial-mesenchymal transition by activating tumor-associated macrophages in ovarian cancer
Authors: Xu Shuyun , Liu Zhenzhen , Lv Meihua , Chen Yuli , Liu Ya
Published: March 2019

We aimed to investigate the relationship of intestinal dysbiosis (IDB) and ovarian cancer progression, and understand its underlying signaling mechanisms. IDB was induced with high dose antibiotics. The xenograft mouse model was used to assess the tumor progression. Real-time polymerase chain reaction and immunoblotting are commonly used quantitative methods, and they were used to quantify epithelial-mesenchymal transition (EMT) markers in this paper. Meanwhile, cellular proliferation was also measured. First, IDB could promote the growth of xenograft tumors and induce the EMT. Serum levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 also increased remarkably. In addition, the production and secretion of TNF-α and IL-6 in macrophages isolated from IDB model mice were observably higher. In vitro, conditioned medium could significantly stimulate the development of EMT in ovarian cancer cells. Loss of macrophages completely offset the pro-tumor effects of IDB. IDB can stimulate the activation of tumor-associated macrophages in ovarian cancer, which is achieved by secreting pro-inflammatory cytokines IL-6 and TNF-α, and ultimately induces the development of EMT.
Use of Chemical and Nonchemical Methods for the Control of Varroa destructor (Acari: Varroidae) and Associated Winter Colony Losses in U.S. Beekeeping Operations
Authors: Haber Ariela I , Steinhauer Nathalie A , vanEngelsdorp Dennis
Published: March 2019

The parasitic mite Varroa destructor (Acari: Varroidae) is a major cause of overwintering honey bee (Apis mellifera) colony losses in the United States, suggesting that beekeepers must control Varroa populations to maintain viable colonies. Beekeepers have access to several chemical varroacides and nonchemical practices to control Varroa populations. However, no studies have examined large-scale patterns in Varroa control methods in the United States. Here we used responses from 4 yr of annual surveys of beekeepers representing all regions and operation sizes across the United States to investigate use of Varroa control methods and winter colony losses associated with use of different methods. We focused on seven varroacide products (amitraz, coumaphos, fluvalinate, hop oil, oxalic acid, formic acid, and thymol) and six nonchemical practices (drone brood removal, small-cell comb, screened bottom boards, powdered sugar, mite-resistant bees, and splitting colonies) suggested to aid in Varroa control. We found that nearly all large-scale beekeepers used at least one varroacide, whereas small-scale beekeepers were more likely to use only nonchemical practices or not use any Varroa control. Use of varroacides was consistently associated with the lowest winter losses, with amitraz being associated with lower losses than any other varroacide product. Among nonchemical practices, splitting colonies was associated with the lowest winter losses, although losses associated with sole use of nonchemical practices were high overall. Our results suggest potential control methods that are effective or preferred by beekeepers and should therefore inform experiments that directly test the efficacy of different control methods. This will allow beekeepers to incorporate Varroa control methods into management plans that improve the overwintering success of their colonies.
The course of the Orphan Stream in the Northern Galactic hemisphere traced with Gaia DR2
Authors: Fardal Mark A , van der Marel Roeland P , Sohn Sangmo Tony , del Pino Molina Andres
Published: March 2019

The Orphan Stream is one of the most prominent tidal streams in the Galactic halo. Using data on red giants, RR Lyrae, and horizontal branch stars from Gaia and other surveys, we determine the proper motion of the Orphan Stream over a path of more than 90° on the sky. We also provide updated tracks for the sky position, distance, and radial velocity of the stream. Our tracks in these latter dimensions mostly agree with previous results. However, there are significant corrections to the earlier distance and latitude tracks as the stream approaches the Galactic disc. Stream stars selected with three-dimensional kinematics display a very tight red giant sequence. Concordantly, we find that applying a proper motion cut removes the most metal-rich stars from earlier spectroscopic samples of stream stars, though a significant dispersion remains, indicating a dwarf galaxy origin. The deceleration of the stream towards its leading end suggests a circular velocity of $\sim \!200 \, \mbox{km}\, \mbox{s}^{-1}$ at a galactocentric radius $\sim \!30 \, \mbox{kpc}$, consistent with other independent evidence. However, the track of the stream departs significantly from an orbit; the spatial track does not point along the same direction as the velocity vector, and it exhibits a lateral wiggle that is unlikely to match any reasonable orbit. The low metallicity and small dispersion of the stream in the various coordinates point to a progenitor with a relatively low dynamical mass $\sim \!10^8 \, \mathrm{ M}_{\odot }$.
Opacity, variability, and kinematics of AGN jets
Authors: Kutkin A M , Pashchenko I N , Sokolovsky K V , Kovalev Y Y , Aller M F , Aller H D
Published: March 2019

Synchrotron self-absorption in active galactic nuclei (AGN) jets manifests itself as a time delay between flares observed at high and low radio frequencies. It is also responsible for the observing frequency-dependent change in size and position of the apparent base of the jet, aka the core shift effect, detected with very long baseline interferometry (VLBI). We measure the time delays and the core shifts in 11 radio-loud AGN to estimate the speed of their jets without relying on multi-epoch VLBI kinematics analysis. The 15–8 GHz total flux density time lags are obtained using Gaussian process regression, the core shift values are measured using VLBI observations and adopted from the literature. A strong correlation is found between the apparent core shift and the observed time delay. Our estimate of the jet speed is higher than the apparent speed of the fastest VLBI components by the median coefficient of 1.4. The coefficient ranges for individual sources from 0.5 to 20. We derive Doppler factors, Lorentz factors, and viewing angles of the jets, as well as the corresponding de-projected distance from the jet base to the core. The results support evidence for acceleration of the jets with bulk motion Lorentz factor Γ ∝ R0.52±0.03 on de-projected scales R of 0.5–500 parsecs.
Milky Way globular clusters in γ-rays: analysing the dynamical formation of millisecond pulsars
Authors: de Menezes Raniere , Cafardo Fabio , Nemmen Rodrigo
Published: March 2019

Globular clusters (GCs) are evolved stellar systems containing entire populations of millisecond pulsars (MSPs), which are efficient γ-ray emitters. Observations of this emission can be used as a powerful tool to explore the dynamical processes leading to binary system formation in GCs. In this work, 9 yr of Fermi Large-Area Telescope data were used to investigate the γ-ray emission from all GCs in the Milky Way. Twenty-three clusters were found as γ-ray bright, with two of them never having been reported before. It was also found that magnetic braking probably has a smaller impact on the formation rate of binary systems in metal-rich GCs than previously suggested, while a large value for the two-body encounter rate seems to be a necessary condition. The influence of the encounter rate per formed binary was for the first time explored in conjunction with γ-ray data, giving evidence that if this quantity is very high, binary systems will get destroyed before having time to evolve into MSPs, thus decreasing the total number of MSPs in a GC. No extended emission was found even for clusters whose optical extent is ≈0.5°; all of them are point-like sources spatially in agreement with the optical cores of the GCs, supporting previous X-ray results of heavier objects sinking into the clusters’ cores via dynamical friction. The possibility of extrapolating these results to ultra-compact dwarf galaxies is discussed, as these systems are believed to be the intermediate case between GCs and dwarf galaxies.
Snake envenomation: is the 20 min whole blood clotting test (WBCT20) the optimum test for management?
Authors: Dsilva A A , Basheer A , Thomas K
Published: March 2019

Background

The 20 min whole blood clotting test (WBCT20) is a simple bedside test recommended by World Health Organization (WHO) to assess hemotoxic envenomation and guide administration of polyvalent anti-snake venom (ASV). However, reliability and validity of this test has not been well documented in literature.

Methods

Sixty consecutive patients with history of snake bite were prospectively evaluated at a teaching hospital in India over 2 years. Envenomation was established by clinical and laboratory criteria. WBCT20 was done at 0, 4 and 12 h using standardized protocol. Prothrombin time (PT) with international normalized ratio (INR) was estimated at similar intervals to detect venom-induced consumption coagulopathy. Sensitivity, specificity and likelihood ratios (LR) were determined for WBCT20 using envenomation criteria as gold standard. WBCT20 was compared with PT/INR at cutoff values of ≥1.4 and ≥1.2. Two observers performed test–retest correlation to determine inter-observer variability of WBCT20.

Results

 

Seventeen of 60 patients had evidence of hemotoxic envenomation. Four patients had combined neurotoxicity and hemotoxicity. Sensitivity and specificity of WBCT20 were 94 and 76%; positive and negative LR were 3.9 and 0.08, respectively. No inter-observer variability was noted.

Conclusions

WBCT20 is a highly sensitive test with excellent reliability for detecting envenomation. However, the false positive rate in this study was 24%. Asymptomatic snake bite patients with a positive WBCT20 but no corresponding clinical signs of envenomation should be tested using PT/INR before receiving ASV to prevent unnecessary waste of anti-venom.
The impact of journal re-grading on perception of ranking systems: Exploring the case of the Academic Journal Guide and Business and Management scholars in the UK
Authors: Walker James T , Salter Ammon , Fontinha Rita , Salandra Rossella
Published: March 2019

The marked increase in the use of metrics, such as journal lists, to assess research has had a profound effect on academics’ working lives. While some view the diffusion of rankings as beneficial, others consider their diffusion as a malicious development, which further acerbates a tendency towards managerialism in academia, and undermine the integrity and diversity of academic research. Using data from a large-scale survey and a re-grading of journals in a ranking used by Business and Management UK scholars—the Academic Journal Guide—as a pseudo-experiment, we examine what determines negative and positive perceptions of rankings. We find that the individuals who published in outlets that were upgraded were less hostile to the ranking than those who did not benefit from these changes, and that individuals were also less hostile to the ranking if outlets in their field had benefited from re-grading in the new list. We also find that the individuals who published in outlets that were upgraded were more positive to the ranking than those who did not benefit from these changes, and that individuals were also more positive to the ranking if outlets in their field had benefited from re-grading in the new list.
Increased expression of Fas on group 2 and 3 innate lymphoid cells is associated with an interferon signature in systemic lupus erythematosus and Sjögren’s syndrome
Authors: Blokland Sofie L M , van den Hoogen Lucas L , Leijten Emmerik F A , Hartgring Sarita A Y , Fritsch Ruth , Kruize Aike A , van Roon Joel A G , Radstake Timothy R D J
Published: March 2019

Objective

The role of innate lymphoid cells (ILCs) in the pathophysiology of rheumatic diseases is emerging. Evidence from animal studies implicate type I IFN, produced by plasmacytoid dendritic cells, to be involved in regulating the survival of group 2 and group 3 ILCs (ILC2s and ILC3s) via the upregulation of Fas (CD95) expression. For the first time, we explored the frequency and phenotype of circulating ILCs in SLE and primary Sjögren’s syndrome (pSS) in relationship to the IFN signature.

Methods

Frequencies and phenotypes of ILC subsets and plasmacytoid dendritic cells were assessed by flow cytometry in peripheral blood of patients with SLE (n = 20), pSS (n = 20) and healthy controls (n = 17). Patients were stratified by the presence or absence of an IFN signature as assessed by RT-qPCR on circulating mononuclear cells.

Results

ILC1 frequencies were increased in peripheral blood of patients with SLE as compared with healthy controls and correlate with disease activity in pSS patients. Overall, the frequencies of ILC2s or ILC3s did not differ between patients with SLE, pSS and healthy controls. However, patients with a high type I IFN signature expressed elevated levels of Fas on ILC2s and ILC3s, which coincided with decreased frequencies of these cells in blood.

Conclusion

The presence of a type I IFN signature is related to Fas expression and frequencies of circulating ILC2s and ILC3s in patients with SLE and pSS, potentially altering the homeostatic balance of ILCs.
LOCAL DRLS FOR PAEDIATRIC CT EXAMINATIONS BASED ON SIZE-SPECIFIC DOSE ESTIMATES IN KERMANSHAH, IRAN
Authors: Mohammadbeigi Ahmad , Khoshgard Karim , Haghparast Abbas , Eivazi Mohammad Taghi
Published: March 2019

Due to the radiosensitivity of paediatric patients to X-ray, it is necessary to survey the paediatric DRLs using size-specific dose estimates (SSDE). In the present study, we determined the local diagnostic reference levels (DRLs) for paediatric chest, head and abdomen-pelvis CT examinations and their Surview scans in Kermanshah city, Iran. For ≤1 year, 1–5 years, 5–10 years and 10–15 years the DRLs (mGy) based on SSDE were determined N/A, 6.00, 6.25, 8.27 for abdomen-pelvis, and 8.74, 7.45, 11.15, 10.45 for chest and 19.05, 18.33, 18.22, 20.14 for head examinations, respectively. The differences between body size and default phantom defined in CT scanners are significant and should be considered when determining the DRLs. Based on our findings, use of CTDIv and SSDE parameters for determining DRLs leads to significant different results in children; thus SSDE is suggested as a more accurate index than CTDIV for establishing DRLs in paediatric CT examinations.
Efficacy of Double Nickel LC (Bacillus amyloliquefaciens D747 Strain) for Management of White Mold in Snap and Dry Bean
Authors: Pethybridge Sarah J. , Gugino Beth K. , Kikkert Julie R.
Published: March 2019

White mold caused by Sclerotinia sclerotiorum is a serious disease affecting snap and dry bean production. Management is reliant upon fungicides to protect flowers from infection by ascospores. The inability to use conventional fungicides in organic production represents a substantial hurdle, although products approved by the National Organic Program (NOP) offer a substitute for disease management. In many cases, copper-based products are central to disease management programs in organic production, but the potential for crop loss from premature flower abscission in snap and dry bean owing to phytotoxicity when applied at high temperatures and for other undesirable environmental outcomes has driven interest in biopesticides registered by the NOP as alternatives. Five small-plot, replicated field trials (three in snap bean and two in light red kidney bean) were conducted across three years (2016 to 2018) to evaluate the efficacy of the biopesticide Double Nickel LC (Bacillus amyloliquefaciens D747 strain) for the management of white mold. Trials were inoculated with S. sclerotiorum ascospores to ensure uniform disease potential. The incidence of white mold in plots receiving two applications of Double Nickel LC (2.34 liters/ha) was not significantly different from the conventional fungicide standards. No significant difference in white mold incidence was found between 2.34 and 4.68 liters/ha of Double Nickel LC in either crop. Responses in pod yield components from improved white mold management in either crop were variable. The potential of Double Nickel LC for use in organic production of snap and light red kidney bean for management of white mold is discussed.
First Report of Erysiphe fallax Causing Powdery Mildew on Phasey Bean (Macroptilium lathyroides) in the United States
Authors: Poudel Bindu , Zhang Shouan
Published: March 2019

Phasey bean (Macroptilium lathyroides) is a member of the family Fabaceae and is native to tropical America. During the fall of 2017, the leaves of phasey bean plants in Homestead, FL, showed white powdery fungal growth. The morphological characteristics suggested that the pathogen was powdery mildew. For further identification, genomic DNA was extracted from conidia. BLAST results showed that the sequence of FL-1 shares 99% identity to an Erysiphe fallax. Phylogenetic analysis confirmed the closest proximity of FL-1 isolate to E. fallax. Koch’s postulates were performed to confirm the pathogenicity.
Support for My Video is Support for Me:
Authors: Forgeron Paula A. , McKenzie Emily , O’Reilly Jenna , Rudnicki Erika , Caes Line
Published: March 2019

Objectives:

Adolescents are heavy users of social media as a venue to share experience and obtain information. Adolescents with chronic pain may be no different. Given that adolescents with chronic pain report feelings of social isolation, of being different, and lack peer understanding, social media may help them obtain social support. We conducted a scoping review of YouTube to identify how adolescents with chronic pain use this platform to connect with other adolescents.

Materials and Methods:

The terms “youth with chronic pain” and “teens with chronic pain” were entered into the YouTube search bar to locate videos. Videos in English, targeted at and including an adolescent with chronic pain were included. Videos were screened for eligibility until 20 consecutive videos listed on the main page were excluded. For each included video the first 5 related videos suggested by YouTube in the sidebar were also screened for eligibility.

Results:

This selection process resulted in 18 included videos, with a total of 936 viewer comments. Recurring comment themes were identified using qualitative content analysis. Video content mainly covered multidisciplinary treatment options, alternative treatments, and impact of pain on daily life. Although a variety of treatment options were discussed, details of treatment were lacking. Comments reflected the overarching message “you are not alone!” and mainly focused on providing and receiving support, sharing suffering, and revealing the impact of pain on relationships and daily life.

Discussion:

Despite potential challenges associated with social media, YouTube may be a promising platform for provision of social support for adolescents with chronic pain.
Shared Decision-Making Framework for Pelvic Examinations in Asymptomatic, Nonpregnant Patients
Authors: Chor Julie , Stulberg Debra B. , Tillman Stephanie
Published: March 2019

Controversy exists regarding whether to perform pelvic examinations for asymptomatic, nonpregnant patients. However, several professional organizations support the notion that health care providers should no longer recommend that asymptomatic patients receive a yearly pelvic examination. At minimum, health care providers must respect patients' autonomy in decision making around this examination and initiate a joint discussion about whether to proceed with a pelvic examination. Shared decision making is a model used in other aspects of medicine that can aid such discussions. This model recognizes two experts in these clinical encounters—the health care provider is the expert regarding medical information and the patient is the expert regarding their values, preferences, and lived experiences. When shared decision making is used, not only is each expert valued for their knowledge, but the power differential shifts to a shared power model. This commentary aims to educate about shared decision making, explain why shared decision making is appropriate to use when discussing whether to perform a pelvic examination, and provide a framework for using shared decision making in discussing whether to proceed with a pelvic examination with asymptomatic, nonpregnant patients.
Educating Obstetrics and Gynecology Residents on Transgender Patients
Authors: Vinekar Kavita , Rush Shannon K. , Chiang Seine , Schiff Melissa A.
Published: March 2019

OBJECTIVE:

To describe education on transgender health provided by obstetrics and gynecology residency programs and to identify the facilitators and barriers to providing this training.

METHODS:

We conducted a cross-sectional survey to evaluate transgender health education in residency among a representative sample of 100 of the 236 obstetrics and gynecology residency programs listed in the 2015 Electronic Residency Application Service catalogue. We compared programs that did and did not offer transgender education on demographics, presence and type of transgender education offered, and reasons for and barriers to offering transgender health education using χ2 or Fisher's exact testing.

RESULTS:

We found that 31 out of 61 (51%, 95% CI 38–64%) programs completing the survey offered transgender health education in residency. Compared with programs that offered no education, residency programs offering education were more likely to report that transgender health education was very important (19/31, 61% [95% CI 42–78%] vs 7/30, 23% [95% CI 9–42%]), resident interest (20/31, 64% [95% CI 45–81%] vs 11/30, 37% [95% CI 20–56%]), and the presence of a transgender population requesting services (28/31 or 90% [95% CI 74–98%] vs 16/30 or 53% [95% CI 34–72%]). Among the 31 programs that offered transgender health education, 30 (97%; 95% CI 83–99%) provided formal didactic sessions and 20 (64%; 95% CI 45–81%) offered health screening for both male-to-female and female-to-male transgender patients, but 17 (55%; 95% CI 36–73%) did not offer gender-affirming hormone therapy. Among the 30 programs that did not currently offer transgender health education, 24 (80%; 95% CI 61–92%) planned to establish a transgender education program in the next year.

CONCLUSION:

Our survey of obstetrics and gynecology residency programs highlights the interest in transgender health education for a systemically underserved population of patients.
Change in Second-Trimester Abortion After Implementation of a Restrictive State Law
Authors: White Kari , Baum Sarah E. , Hopkins Kristine , Potter Joseph E. , Grossman Daniel
Published: March 2019

OBJECTIVE:

To assess whether indicators of limited access to services explained changes in rates of second-trimester abortion after implementation of a restrictive abortion law in Texas.

METHODS:

We used cross-sectional vital statistics data on abortions performed in Texas before (November 1, 2011–October 31, 2012) and after (November 1, 2013–October 31, 2014) implementation of Texas' abortion law. We conducted monthly mystery client calls for information about abortion facility closures and appointment wait times to calculate distance from women's county of residence to the nearest open Texas facility, the number of open abortion facilities in women's region of residence (facility network size), and days until the next consultation visit. We estimated mixed-effects logistic regression models to assess the association between obtaining abortion care after the law's implementation and having a second-trimester abortion (12 weeks of gestation or more), after adjustment for distance, network size, and wait times.

RESULTS:

Overall, 64,902 Texas-resident abortions occurred in the period before the law was introduced and 53,174 occurred after its implementation. After implementation, 14.5% of abortions were performed at 12 weeks of gestation or more, compared with 10.5% before the law (P<.001; unadjusted odds ratio [OR] 1.45; 95% CI 1.40–1.50). Adjusting for distance to the nearest facility and facility network size reduced the odds of having a second-trimester abortion after implementation (OR 1.17; 95% CI 1.10–1.25). Women living 50–99 miles from the nearest facility (vs less than 10 miles) had higher odds of second-trimester abortion (OR 1.24; 95% CI 1.11–1.39), as did women in regions with less than one facility per 250,000 reproductive-aged women compared with women in areas that had 1.5 or more facilities (OR 1.57; 95% CI 1.41–1.75). After implementation, women waited 1 to 14 days for a consultation visit; longer waits were associated with higher odds of second-trimester abortion.

CONCLUSION:

Increases in second-trimester abortion after the law's implementation were due to women having more limited access to abortion services.
An Alternate Approach to Using Candy Cane Stirrups in Vaginal Surgery
Authors: Sze Eddie H. M.
Published: March 2019

BACKGROUND:

Candy cane stirrups are widely used for vaginal surgery because they provide sufficient operating space. When placed in the standard perpendicular alignment, however, these stirrups cause excessive flexion, abduction, and external rotation of the thigh, which may injure the femoral, lateral femoral cutaneous, sciatic, and common peroneal nerves.

TECHNIQUE:

We corrected this deficiency by positioning the stirrups parallel to the operating table, just above and tilting slightly toward its lower break. After placing the patient in stirrups, we inserted a double-layer foam pad between her knee and the stirrup and adjusted the height of each stirrup until both thighs were flexed 90 degrees and both knees flexed 100 degrees. We then pushed the L-shaped lower stirrup toward or pulled it away from the operating table until each thigh was vertical, with minimal abduction or adduction. Finally, we rotated the curved upper stirrups medially until each leg was pointing slightly laterally.

EXPERIENCE:

Of 1,576 vaginal cases, there were eight (0.5%) instances of postoperative sensory neuropathy, which usually involved the lateral femoral cutaneous nerve.

CONCLUSION:

This simple modification to the candy cane stirrups allows placement of patients in dorsal lithotomy with their legs in an anatomically and neurologically neutral position.
Locally Applied Simvastatin as an Adjunct to Promote Spinal Fusion in Rats
Authors: Iyer Sravisht , Donnelly Patrick E. , Spaniel George , Young Kelsey , Oh Kevin , Cunningham Matthew E.
Published: March 2019

Study Design.

Basic Science.

Objective.

To determine if locally delivered simvastatin can enhance bone formation in a rat spinal fusion model.

Summary of Background Data.

The bone-anabolic properties of statins in fracture healing are well established, however, few studies have evaluated the impact of locally delivered statins in spinal fusion.

Methods.

We formulated poly(lactic-co-glycolic acid) (PLGA) nanoparticles by adapting previously published techniques. Two types of nanoparticles were created: simvastatin nanoparticles (SimNP) and nanoparticles without simvastatin (BlankNP). Drug elution from SimNP was characterized. Osteoblastic differentiation was analyzed using MC3T3-E1 cells cultured in differentiation medium containing SimNP or BlankNP. Forty male 12 week old outbred Wistar rats underwent uninstrumented posterolateral fusion using iliac crest bone graft and BlankNP, SimNP or simvastatin drug. X-rays to assess bone formation were obtained at 4 weeks and 9 weeks post-operatively. Spines were explanted at 9 weeks for micro-CT analysis, and a blinded manual assessment of fusion (MAF).

Results.

SimNP achieved a release efficiency of 74.1% with ∼50% release occurring in the first day. Simvastatin and SimNP treated cells showed significantly greater expression of osteopontin (OPN) and osteocalcin (OCN). On micro-CT analysis, SimNP animals had higher bone volume and percent bone volume (bone volume/total volume) than control animals. SimNP rats had higher X-ray scores at 4 weeks (p=0.010) and 9 weeks (p<0.001) relative to BlankNP. MAF showed that SimNP had a higher fusion rate than BlankNP (42.9% vs. 0%, p=0.006).

Conclusion.

We were able to validate that sustained release of simvastatin via a PLGA nanoparticle. SimNP was able to induce an increase in mineralization as well as an increase in markers of bone formation. X-ray analysis, micro-CT quantification, and MAF assessment of SimNP treated rats showed significantly greater bone formation and fusion mass strength relative to vehicle treated animals. Simvastatin may be a safe, cost-effective bone anabolic agent for use in spinal fusion.

Level of Evidence.

N/A
The association of metabolic syndrome and its components with serum prostate-specific antigen levels
Authors: Gao Xiaoshuai , Bao Ting , Yang Hanwei , Lei Yali , Jiang Xianwen , Huang Yan , Huang Wenxia , Tang Huairong
Published: March 2019

Metabolic syndrome (MetS) can increase the risk of prostate cancer. Prostate-specific antigen (PSA) is the marker for prostate cancer puncture screening. The aim of our study was to investigate the association between MetS and its components with PSA levels. Data were obtained from 482 943 healthy men who underwent routine health check-ups from January 2010 to December 2017. We used linear regression analysis to evaluate the effects of MetS and its components on PSA levels. To explore the cumulative effect of MetS components, analysis of variance trend analysis was carried out. The PSA levels in the group with MetS were significantly lower than those without MetS (P = 0.001). In the multivariate regression model, age (P < 0.001) and hypertension (P < 0.001) were correlated positively with PSA levels; nevertheless, obesity (P < 0.001), hypertriglyceridemia (P < 0.001), hyperglycemia (P < 0.001), and low high-density lipoprotein cholesterol level (P < 0.001) had a negative correlation. In addition, after adjustment for age, increasing sums of positive MetS components were associated with a linear decrease in PSA levels (P<0.001). In conclusion, MetS, obesity, hypertriglyceridemia, hyperglycemia, and low high-density lipoprotein cholesterol levels are associated with decreased PSA levels. For patients with PSA levels at the critical value of prostate puncture, the effect of these diseases in reducing PSA levels should be taken into account.
Adjuvant Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors (TKIs) in Resected Non–Small Cell Lung Cancer (NSCLC)
Authors: Raphael Jacques , Vincent Mark , Boldt Gabriel , Shah Prakesh S. , Rodrigues George , Blanchette Phillip
Published: March 2019

The role of adjuvant tyrosine kinase inhibitors (TKIs) in non–small cell lung cancer (NSCLC) is not well defined. Recent randomized controlled trials showed a disease-free survival (DFS) benefit in patients harboring an epidermal growth factor receptor (EGFR) mutation. Yet, older trials on patients with any EGFR status did not demonstrate the same benefit. We aimed to assess the efficacy and safety of adjuvant TKIs in NSCLC patients. The electronic databases Medline (PubMed) and EMBASE were searched for relevant randomized controlled trials. Random effect models were used. The primary outcome was DFS measured as hazard ratio (HR). The secondary outcomes were overall survival (OS) measured as HR, 2-year DFS and toxicity expressed as risk ratio and odds ratio (OR), respectively. Subgroup analyses assessed DFS by trial design. Six trials incorporating 1860 patients were included. In patients harboring an EGFR mutation, adjuvant TKIs decreased the risk of disease recurrence by 48% (HR: 0.52, 95% confidence interval [CI]: 0.35-0.78), improved 2-year DFS (HR: 0.53, 95% CI: 0.43-0.66) but did not improve OS (HR: 0.64, 95% CI: 0.22-1.89). The risk of developing ≥grade 3 skin toxicity (OR: 6.07, 95% CI: 4.34-8.51) and diarrhea (OR: 4.05; 95% CI: 2.44-6.74) was increased. In subgroup analyses, the DFS benefit was more pronounced in trials using TKIs over chemotherapy compared with trials using TKIs postchemotherapy. In conclusion, adjuvant TKIs decrease the risk of recurrence in NSCLC patients harboring an EGFR mutation but do not improve OS. Longer follow-up is needed for a definitive assessment of OS and to define the role of adjuvant TKI for NSCLC in the clinical practice.