bluuebunny/crossref_metadata_2025_split huggingface dataset:
Presidential Communication During the Legislative Process
Authors: Ostrander Ian , Sievert Joel 
Published: April 2020

ObjectivePresidents routinely employ public statements to inform Congress about their position on pending legislation. Position‐taking is strategic, with presidents choosing whether, how, how often, and when to intervene. We move beyond the traditional dichotomies of issuance and position to explore the timing and frequency of presidential position‐taking during the lawmaking process.MethodWe use Statements of Administration Policy (SAPs)–bill‐specific messages addressed to Congress–to analyze presidential communications. Our regression analyses examine both the frequency of SAPs usage on bills and when in the process presidents communicate their position.ResultsWe find that presidents take positions sparingly and most often at the early stages of the lawmaking process.ConclusionPresidential communications during the lawmaking process are more about winnowing options and bargaining over bill text than influencing pivotal votes.
Influence of an Additional Indexing Rotary Axis on Wire Electrical Discharge Machining Performance for the Automated Manufacture of Fir Tree Slots
Authors: Bergs Thomas , Tombul Ugur , Herrig Tim , Klink Andreas , Welling David 
Published: April 2020

Abstract
The demand for higher efficiency in aircraft propulsion engines leads to materials with increasing thermomechanical strengths and new designs inducing filigree geometries of blisks and disks. Because of new designs which induce tighter tolerances, the high mechanical process forces in conventional cutting processes like broaching cause inacceptable geometrical deviations and high tooling costs. Due to the electro-thermal material removal mechanism, electrical discharge machining (EDM) ensures a force free and thus precise machining. The manufacture of fir tree slots in nickel-based alloys by wire EDM has been investigated in the last few years and the process was verified as an alternative technology for broaching. To get a better competitive position, the productivity can be prospectively increased by using an additional indexing rotary axis which ensures a precise and automated production of rotationally symmetric components and reduce production times, e.g., for the manufacture of fir tree slots on a disk. Nevertheless, the application of these axes cause changed flushing conditions and can also affect the electrical contacting as well. Both influence the process performance and demand a technology development or adjustment of standard machining technologies. The influence of these changed machining conditions has not been investigated scientifically to date. In this paper, the surface integrity and process performance of fir tree slots machined by wire EDM on the machine table are compared with the manufacture by using an additional indexing rotary axis.
A Novel Assessment of Delayed Neutron Detector Data in CANDU Reactors
Authors: Aylward Will , Wallace Christopher , West Graeme , McEwan Curtis 
Published: April 2020

Abstract
A common opportunity for nuclear power plant operators is ensuring that routinely collected data are fully leveraged. Exploiting data analytics can enable improvements in anomaly detection and condition monitoring by identifying previously unseen data trends and correlations without major financial investment. One such opportunity is in facilitating the detection of fuel defects by augmenting the delayed neutron (DN) monitoring system deployed in the majority of Canada deuterium uranium (CANDU) reactors. In this paper, we demonstrate using archive data that the detection of fuel defects can be accelerated using this system in combination with the use of a deeper historical dataset and the introduction of a smoothing algorithm. The current defect identification process relies on the analysis of data of high variance and is subject to the judgment of a domain expert, resulting in variable defect identification periods. The proposed approaches seek to mitigate this and alleviate the variable identification time. Initial results presented here show that for an initial batch of 30 defects, identification periods can be meaningfully reduced compared to the current process, with defects potentially visible on an average of 11.4 days earlier. By shortening this identification period, fuel containing defects can be scheduled for earlier removal, reducing the risk of statutory shutdown obligations, protecting personnel, and promoting industry best practice. Exploring a historical dataset identifies previously undocumented trends and we discuss the potential to produce correlations with other reactor parameters. The application of this knowledge can lead to opportunities in the use of machine learning algorithms and, ultimately, more accurate predictions.
A slip law for glaciers on deformable beds
Authors: Zoet Lucas K. , Iverson Neal R. 
Published: April 2020

Slipping on tillHow do glaciers flow over the ground underlying them? We know that friction, ice stream velocity, and water pressure at the ice bed all matter, but we still do not know how to represent the process over both hard beds (which are solid rock) and soft ones (composed of unconsolidated erosion products called till). Zoet and Iverson present experimental results describing how glacial ice moves over watersaturated till (see the Perspective by Minchew and Joughin). These observations should help to solve the long-standing problem of constructing a generalized slip law that combines the processes of hard-bedded sliding and bed deformation.Science, this issue p.76; see also p.29
Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics
Authors: Wieringa Thomas H , de Wit Maartje , Twisk Jos W R , Snoek Frank J 
Published: April 2020

IntroductionThe Diabetes Symptom Checklist-Revised (DSC-R) is a well-validated patient-reported outcome designed to assess symptom burden in persons with type 2 diabetes mellitus (T2DM) across eight domains. The DSC-R has so far primarily been used in research settings. With the aim to make the DSC-R applicable in clinical practice by improving its interpretability, we sought to identify patient characteristics associated with DSC-R (domain) scores as a first initiative toward reference values.Research design and methodsWe used baseline data from two large observational studies to select patient characteristics significantly associated with DSC-R domain and total scores. Multivariable Tobit analyses with the backward procedure per (domain) score were performed.ResultsData from 1531 participants with T2DM were included. On a 0–100 scale, the median DSC-R total score was 15.88 (7.06–29.41), with domain scores ranging from 5.00 (0.00–22.50) (pain) to 35.00 (10.00–60.00) (fatigue). Low well-being status was most profoundly associated with higher scores across all domains. Persons with one or more complication, as well as one or more symptomatic hypoglycemic episode during the past 3 months, scored higher on (almost) all domains and the total scale.ConclusionsComplications, symptomatic hypoglycemia, and low well-being are important characteristics to take into account when using the DSC-R in individual patients. Further validation of our findings is warranted in diverse patient populations.
Intended and unintended effects: community perspectives on a performance-based financing programme in Malawi
Authors: Petross Chisomo , McMahon Shannon , Lohmann Julia , Chase Rachel P , Muula Adamson S. , De Allegri Manuela 
Published: April 2020

BackgroundSeveral performance-based financing (PBF) evaluations have been undertaken in low-income countries, yet few have examined community perspectives of care amid PBF programme implementation. We assessed community members’ perspectives of Support for Service Delivery Integration - Performance-Based Incentives (‘SSDI-PBI’), a PBF intervention in Malawi, and explored some of the unintended effects that emerged amid implementation.MethodsWe conducted 30 focus group discussions: 17 with community leaders and 13 with mothers within catchment areas of SSDI-PBI implementing facilities. We analysed data using the framework approach.ResultsCommunity leaders and women had mixed impressions regarding the effect of SSDI-PBI on service delivery in facilities. They highlighted several improvements (including improved dialogue between staff and community, and cleaner, better-equipped facilities with enhanced privacy), but also persisting challenges (including inadequate and overworked staff, overcrowded facilities and long distances to facilities) related to services in SSDI-PBI-implementing facilities. Further, respondents described how four targeted service indicators related to maternal risk factor management, antenatal care (ANC) in the first trimester, skilled birth attendance and couple’s HIV testing sparked unintended negative effects as experienced by women and communities. The unintended effects included women returning home for delivery, women feeling uncertain about their pregnancy status, women feeling betrayed or frustrated by the quality of care provided and partnerless women being denied ANC.ConclusionPBF programmes such as SSDI-PBI may improve some aspects of service delivery. However, to achieve system improvement, not only should necessary tools (such as medicines, equipment and human resources) be in place, but also programme priorities must be congruent with cultural expectations. Finally, facilities must be better supported to expect and then address increases in client load and heightened expectations in relation to services.
How primary healthcare workers obtain information during consultations to aid safe prescribing in low-income and lower middle-income countries: a systematic review
Authors: Smith Chris , van Velthoven Michelle Helena , Truong Nguyen Duc , Nam Nguyen Hai , Anh Vũ Phan , AL-Ahdal Tareq Mohammed Ali , Hassan Osama Gamal , Kouz Basel , Huy Nguyen Tien , Brewster Malcolm , Pakenham-Walsh Neil 
Published: April 2020

BackgroundWe systematically reviewed the evidence on how primary healthcare workers obtain information during consultations to support decision-making for prescribing in low and lower middle-income countries.MethodsWe searched electronic databases, consulted the Healthcare Information For All network, hand searched reference lists, ran citation searches of included studies and emailed authors of identified papers. Two reviewers extracted data and appraised quality with relevant tools.ResultsOf 60 497 records found, 23 studies met our inclusion criteria. Fourteen studies were observational and nine were interventional. Frequently mentioned sources of information were books, leaflets, guidelines, aids and the internet. These sources were sometimes out of date and health workers reported being confused which to use. Internet access varied and even when it was available, use was limited by technical issues. Of the five electronic tools that were assessed, four had positive outcomes. Tools assisted prescribers with medicine selection and dosage calculations, which increased prescribing accuracy. The quality of reporting varied but was overall low.DiscussionStudies indicated a lack of up-to-date and relevant medicine information in low and lower middle-income settings. Internet-based sources appeared to be useful when it is possible to download content for offline use and to update when there is internet access. Electronic tools showed promise, but their accuracy needs to be validated and they should focus on giving actionable advice to guide prescribers.PROSPERO registration numberCRD42018091088.
Awareness of oral and genital human papillomavirus (HPV) infection in young adolescents prior to gender-neutral vaccination
Authors: Knight Gillian , Roberts Ben 
Published: April 2020

IntroductionOral human papillomavirus (HPV) and oropharyngeal cancer prevalence are increasing, particularly in men. Raising greater awareness of male HPV disease is perceived as an important intervention strategy. This study investigated the effectiveness of HPV education on adolescents’ perception of HPV disease and the impact of HPV vaccination on their sexual health.MethodsAn HPV questionnaire was completed by 357 UK-based adolescents, aged 12–13 years.ResultsMost adolescents knew HPV causes cervical cancer and HPV vaccination prevents this. A minority acknowledged HPV causes other genital cancers, with under one-fifth knowing HPV causes genital warts. Adolescents’ awareness of HPV transmission activities were limited. There was very poor awareness of oral HPV infection or HPV-induced oropharyngeal cancer. Half of the participants stated HPV vaccination reduced their concerns about sexually transmitted infection contraction. Over half the males said they may take more sexual risks following vaccination, while a similar proportion of females did not expect their partner to take more risks.ConclusionsAdolescents had little awareness of male HPV infection and the role HPV vaccination can play in preventing these diseases. With variable rates of HPV vaccination uptake in males reported worldwide, this study indicates that in the UK greater emphasis on male HPV disease within educational information is required, to raise better awareness of how HPV affects both genders. As both genders preferred to receive education via healthcare professionals, educating a wider range of healthcare professionals on oral HPV could help facilitate awareness of HPV’s role in head and neck cancer.
Normalising abortion: what role can health professionals play?
Authors: Maxwell Karen J , Hoggart Lesley , Bloomer Fiona , Rowlands Sam , Purcell Carrie 
Published: April 2020

BackgroundDespite being a common gynaecological procedure, abortion continues to be widely stigmatised. The research and medical communities are increasingly considering ways of reducing stigma, and health professionals have a role to play in normalising abortion as part of routine sexual and reproductive healthcare (SRH). We sought to investigate how health professionals may normalise abortion and challenge prevailing negative sociocultural narratives.MethodsAs part of the Sexuality and Abortion Stigma Study (SASS), qualitative secondary analysis was conducted on two datasets containing health professionals’ accounts of providing abortion in Scotland and England. A subsample of 20 interviews were subjected to in-depth, thematic analysis.ResultsFour key themes were identified in heath professionals’ accounts: (1) encountering resistance to abortion from others working in SRH; (2) contending with prevailing negative sociocultural narratives of abortion; (3) enacting overt positivity towards abortion provision; and (4) presenting abortion as part of normal, routine healthcare.ConclusionsIt is clear that negative attitudes toward abortion persist both inside and outside of healthcare systems, and need to be challenged in order to destigmatise those accessing and providing services. Health professionals can play a key role in normalising abortion, through the ways in which they frame their work and present abortion to women they treat, and others more widely. Our analysis suggests a key way to achieve this is by presenting abortion as part of normal, routine SRH, but that appropriate support and structural change are essential for normalisation to become embedded.
Cell death induced by cytotoxic CD8+T cells is immunogenic and primes caspase-3–dependent spread immunity against endogenous tumor antigens
Authors: Jaime-Sanchez Paula , Uranga-Murillo Iratxe , Aguilo Nacho , Khouili Sofia C , Arias Maykel A , Sancho David , Pardo Julian 
Published: April 2020

BackgroundElimination of cancer cells by some stimuli like chemotherapy and radiotherapy activates anticancer immunity after the generation of damage‐associated molecular patterns, a process recently named immunogenic cell death (ICD). Despite the recent advances in cancer immunotherapy, very little is known about the immunological consequences of cell death activated by cytotoxic CD8+T (Tc) cells on cancer cells, that is, if Tc cells induce ICD on cancer cells and the molecular mechanisms involved.MethodsICD induced by Tc cells on EL4 cells was analyzed in tumor by vaccinating mice with EL4 cells killedin vitroorin vivoby Ag-specific Tc cells. EL4 cells and mutants thereof overexpressing Bcl-XLor a dominant negative mutant of caspase-3 and wild-type mice, as well as mice depleted of Tc cells and mice deficient in perforin, TLR4 and BATF3 were used.Ex vivocytotoxicity of spleen cells from immunized mice was analyzed by flow cytometry. Expression of ICD signals (calreticulin, HMGB1 and interleukin (IL)-1β) was analyzed by flow cytometry and ELISA.ResultsMice immunized with EL4.gp33 cells killed in vitro or in vivo by gp33-specific Tc cells were protected from parental EL4 tumor development. This result was confirmed in vivo by using ovalbumin (OVA) as another surrogate antigen. Perforin and TLR4 and BATF3-dependent type 1 conventional dendritic cells (cDC1s) were required for protection against tumor development, indicating cross-priming of Tc cells against endogenous EL4 tumor antigens. Tc cells induced ICD signals in EL4 cells. Notably, ICD of EL4 cells was dependent on caspase-3 activity, with reduced antitumor immunity generated by caspase-3–deficient EL4 cells. In contrast, overexpression of Bcl-XLin EL4 cells had no effect on induction of Tc cell antitumor response and protection.ConclusionsElimination of tumor cells by Ag-specific Tc cells is immunogenic and protects against tumor development by generating new Tc cells against EL4 endogenous antigens. This finding helps to explain the enhanced efficacy of T cell-dependent immunotherapy and provide a molecular basis to explain the epitope spread phenomenon observed during vaccination and chimeric antigen receptor (CAR)-T cell therapy. In addition, they suggest that caspase-3 activity in the tumor may be used as a biomarker to predict cancer recurrence during T cell-dependent immunotherapies.
Call to action for health systems integration of point-of-care testing to mitigate the transmission and burden of sexually transmitted infections
Authors: Toskin Igor , Govender Veloshnee , Blondeel Karel , Murtagh Maurine , Unemo Magnus , Zemouri Charifa , Peeling Rosanna W , Kiarie James 
Published: April 2020

ObjectivesIn 2016, WHO estimated 376 million new cases of the four main curable STIs: gonorrhoea, chlamydia, trichomoniasis and syphilis. Further, an estimated 290 million women are infected with human papillomavirus. STIs may lead to severe reproductive health sequelae. Low-income and middle-income countries carry the highest global burden of STIs. A large proportion of urogenital and the vast majority of extragenital non-viral STI cases are asymptomatic. Screening key populations and early and accurate diagnosis are important to provide correct treatment and to control the spread of STIs. This article paints a picture of the state of technology of STI point-of-care testing (POCT) and its implications for health system integration.MethodsThe material for the STI POCT landscape was gathered from publicly available information, published and unpublished reports and prospectuses, and interviews with developers and manufacturers.ResultsThe development of STI POCT is moving rapidly, and there are much more tests in the pipeline than in 2014, when the first STI POCT landscape analysis was published on the website of WHO. Several of the available tests need to be evaluated independently both in the laboratory and, of particular importance, in different points of care.ConclusionThis article reiterates the importance of accurate, rapid and affordable POCT to reach universal health coverage. While highlighting the rapid technical advances in this area, we argue that insufficient attention is being paid to health systems capacity and conditions to ensure the swift and rapid integration of current and future STI POCT. Unless the complexity of health systems, including context, institutions, adoption systems and problem perception, are recognised and mapped, simplistic approaches to policy design and programme implementation will result in poor realisation of intended outcomes and impact.
Subliminal aspects concerning the Lounesto’s classification
Authors: Rogerio R. J. Bueno 
Published: April 2020

AbstractIn the present communication we employ a split programme applied to spinors belonging to the regular and singular sectors of the Lounesto’s classification (Clifford algebras and spinors, Cambridge University Press, Cambridge), looking towards unveil how it can be built (or defined) upon two spinors arrangement. We separate the spinors into two distinct parts and investigate to which class within the Lounesto’s classification each part belong. The machinery here developed open up the possibility to better understand how spinors behave under such classification. As we shall see, the resulting spinor from the arrangement of other spinors (belonging to a distinct class or not) does not necessarily inherit the characteristics of the spinors that compose them, as example, such characteristics stands for the class, dynamic or the encoded physical information.
A Historic Perspective and Overview of H-Ras Structure, Oncogenicity, and Targeting
Authors: Shu Lihua , Wang Dongsheng , Saba Nabil F. , Chen Zhuo G. 
Published: April 2020

AbstractH-Ras is a unique isoform of the Ras GTPase family, one of the most prominently mutated oncogene families across the cancer landscape. Relative to other isoforms, though, mutations of H-Ras account for the smallest proportion of mutant Ras cancers. Yet, in recent years, there have been renewed efforts to study this isoform, especially as certain H-Ras–driven cancers, like those of the head and neck, have become more prominent. Important advances have therefore been made not only in the understanding of H-Ras structural biology but also in approaches designed to inhibit and impair its signaling activity. In this review, we outline historic and present initiatives to elucidate the mechanisms of H-Ras–dependent tumorigenesis as well as highlight ongoing developments in the quest to target this critical oncogene.
Cancer Immunoprevention: A Case Report Raising the Possibility of “Immuno-interception”
Authors: Mancuso Jessica G. , Foulkes William D. , Pollak Michael N. 
Published: April 2020

Abstract
Immune checkpoint blockade therapy provides substantial benefits for subsets of patients with advanced cancer, but its utility for cancer prevention is unknown. Lynch syndrome (MIM 120435) is characterized by defective DNA mismatch repair and predisposition to multiple cancers. A variant of Lynch syndrome, Muir–Torre syndrome (MIM 158320), is characterized by frequent gastrointestinal tumors and hyperplastic or neoplastic skin tumors. We report the case of a man with Muir–Torre syndrome who had 136 cutaneous or visceral hyperplastic or neoplastic lesions over a period of 19 years (mean 7.5 neoplasms/year, range 2–26) prior to receiving pembrolizumab immunotherapy as part of multi-modality treatment for invasive bladder cancer. He not only had a complete response of the bladder cancer, but also was noted to have an absence of new cancers during a 22-month follow-up period. This case adds to the rationale for exploring the utility of immune checkpoint blockade for cancer prevention, particularly for patients with DNA repair deficits.
<p><strong><em>Peliosanthes ligniradicis</em></strong><strong>, a new species (Asparagaceae) from Arunachal Pradesh, NE India</strong></p>
Authors: TARAM MOMANG , BORAH DIPANKAR , TANAKA NORIYUKI 
Published: April 2020

A new species of Peliosanthes named P. ligniradicis from Arunachal Pradesh, NE India, is described and illustrated here. It somewhat resembles P. subspicata described from NE India, but is distinguishable by the thicker, stilt-like, semi-woody roots, somewhat elongate (sub) moniliform stem, ovate-oblong or oblong perianth segments, and basally hexagonal and apically 6-crenate.