bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumor Priming by SMO Inhibition Enhances Antibody Delivery and Efficacy in a Pancreatic Ductal Adenocarcinoma Model
Authors: Wang Jun , Chan Darren K.W. , Sen Arindam , Ma Wen Wee , Straubinger Robert M. 
Published: July 2019

Abstract
Despite frequent overexpression of numerous growth factor receptors by pancreatic ductal adenocarcinomas (PDAC), such as EGFR, therapeutic antibodies have not proven effective. Desmoplasia, hypovascularity, and hypoperfusion create a functional drug delivery barrier that contributes to treatment resistance. Drug combinations that target tumor/stroma interactions could enhance tumor deposition of therapeutic antibodies, although clinical trials have yet to support this strategy. We hypothesize that macromolecular or nanoparticulate therapeutic agents may best exploit stroma-targeting “tumor priming” strategies, based on the fundamental principles of the Enhanced Permeability and Retention phenomenon. Therefore, we investigated the molecular and pharmacologic tumor responses to NVP-LDE225, an SMO inhibitor of sonic hedgehog signaling (sHHI), of patient-derived xenograft models that recapitulate the desmoplasia and drug delivery barrier properties of PDAC. Short-term sHHI exposure mediated dose- and time-dependent changes in tumor microvessel patency, extracellular matrix architecture, and interstitial pressure, which waned with prolonged sHHI exposure, and increased nanoparticulate permeability probe deposition in multiple PDAC patient-derived xenograft isolates. During sHHI-mediated priming, deposition and intratumor distribution of both a nontargeted mAb and a mAb targeting EGFR, cetuximab, were enhanced. Sequencing the sHH inhibitor with cetuximab administration resulted in marked tumor growth inhibition compared with cetuximab alone. These studies suggest that PDAC drug delivery barriers confound efforts to employ mAb against targets in PDAC, and that short-term, intermittent exposure to stromal modulators can increase tumor cell exposure to therapeutic antibodies, improving their efficacy, and potentially minimize adverse effects that may accompany longer-term, continuous sHHI treatment.
Deconstructing Heritage Language Dominance: Effects of Proficiency, Use, and Input on Heritage Speakers’ Production of the Spanish Alveolar Tap
Authors: Kim Ji Young , Repiso-Puigdelliura Gemma 
Published: July 2019

AbstractThis study considers language dominance as a composite of proficiency, use, and input, and examines how these constructs in Spanish influence heritage speakers’ production of Spanish alveolar taps. Two aspects of Spanish tap production were examined: lingual constriction rates and the degree of lingual constriction. Multiple measures associated with Spanish proficiency, use, and input were reduced to a smaller number of dimensions using principal component analysis, and the effects of the components on heritage speakers’ tap production were analyzed using mixed effects modeling. The overall findings suggest that dominance in Spanish may not have an effect on the degree of lingual constriction of heritage speakers’ taps, but it does have an effect on how frequently heritage speakers produce taps with lingual constriction. Spanish use and input were found to be the main contributors to heritage speakers’ target-like production of taps.
Endovascular-First Treatment Is Associated With Improved Amputation-Free Survival in Patients With Critical Limb Ischemia
Authors: Lin Jonathan H. , Brunson Ann , Romano Patrick S. , Mell Matthew W. , Humphries Misty D. 
Published: July 2019

Background:
Critical limb ischemia remains a difficult disease to treat, with limited level one data. The BEST-CLI trial (Best Endovascular vs Best Open Surgical Therapy in Patients with Critical Limb Ischemia) is attempting to answer whether initial treatment with open surgical bypass or endovascular therapy improves outcomes, although it remains in enrollment. This study aims to compare amputation-free survival and reintervention rates in patients treated with initial open surgical bypass or endovascular intervention for ischemic ulcers of the lower extremities.

Methods and Results:

Using California nonfederal hospital data linked to statewide death data, all patients with lower extremity ulcers and a diagnosis of peripheral artery disease who underwent a revascularization procedure from 2005 to 2013 were identified. Propensity scores were formulated from baseline patient characteristics. Inverse probability weighting was used with Kaplan–Meier analysis to determine amputation-free survival and time to reintervention for open versus endovascular treatment. Mixed-effects Cox proportional hazards modeling was used to adjust for patient ability to manage their disease and hospital revascularization volume. A total of 16 800 patients were identified. Open surgical bypass was the initial treatment in 5970 (36%) while 10 830 (64%) underwent endovascular interventions. Patients in the endovascular group were slightly younger compared with the open group (70 versus 71 years, ±12 years;
P
<0.001). Endovascular-first patients were more likely to have comorbid renal failure (36% versus 24%), coronary artery disease (34% versus 32%), congestive heart failure (19% versus 15%), and diabetes mellitus (65% versus 58%; all
P
values <0.05). After inverse propensity weighting as well as adjustment for patient ability to manage their disease and hospital revascularization experience, open surgery first was associated with a worse amputation-free survival (hazard ratio, 1.16; 95% CI, 1.13–1.20) with no difference in mortality (hazard ratio, 0.94; 95% CI, 0.89–1.11). Endovascular first was associated with higher rates of reintervention (hazard ratio, 1.19; 95% CI, 1.14–1.23).

Conclusions:
Patients with critical limb ischemia have multiple comorbidities, and initial surgical bypass is associated with poorer amputation-free survival compared with an endovascular-first approach, perhaps due to increased severity of wounds at the time of presentation.
Artistic Portraits of Strange-Face Illusions Produced through Eye-to-Eye Gazing in Dyads or Mirror-Gazing
Authors: Caputo Giovanni B. , Lepore Giancarlo 
Published: July 2019

Abstract
Strange-face illusions are apparitional perceptions of deformed faces, unknown people and monstrous beings produced by prolonged staring at one's own face in a mirror or when staring eye to eye at another person in a dyad, at low-level room illumination. In the authors’ experiment, portrait artists drew illusions they perceived during a 10-minute eye-to-eye gazing session while paired in dyads with naive participants. Dissociation was measured through standard self-report questionnaires. Results showed that portraits became more abstract and less figurative as the artists experienced higher levels of nonpathological dissociation. Statistically, a significant correlation was found between art-abstraction ratings and dissociation scores by judges and portrait artists, respectively. Findings are discussed in relationship to portraits à la manière de Scipione and Francis Bacon.
Three Early Tropical Field Experiments
Authors: Garstang Michael , Zipser Edward , Ellingson Robert , Warsh Kenneth , Grose Peter , Ulanski Stanley , Holle Ronald , Seguin Ward , Fitzjarrald David , Greco Steven , Emmitt George D. 
Published: July 2019

AbstractFifty years ago the Line Islands Experiment was launched to obtain in situ surface, soundings, and aircraft observations in a convectively active region of the tropical oceans close to the nadir point of the new geosynchronous meteorological satellite. Two related tropical field experiments, in 1968 and 1969, followed in the vicinity of Barbados in the western Atlantic. Component parts of these three field experiments are recalled in this presentation that resonated over the subsequent half century.
A New Horizontal Length Scale for a Three-Dimensional Turbulence Parameterization in Mesoscale Atmospheric Modeling over Highly Complex Terrain
Authors: Goger Brigitta , Rotach Mathias W. , Gohm Alexander , Stiperski Ivana , Fuhrer Oliver , de Morsier Guy 
Published: July 2019

AbstractThe correct simulation of the atmospheric boundary layer (ABL) in highly complex terrain is a challenge for mesoscale numerical weather prediction models. An improvement in model performance is possible if horizontal contributions to turbulence kinetic energy (TKE) production, such as horizontal shear production, are implemented in the model’s turbulence parameterization. However, 3D turbulence parameterizations often only have a constant horizontal length scale that depends on the horizontal grid spacing. This is unphysical for mesoscale applications, because such parameterizations were initially developed for much smaller model grid spacings (e.g., for large-eddy simulations). In this study, we develop a new physically based horizontal length scale for the high-resolution mesoscale model COSMO. We analyze days dominated by thermally driven circulations (valley wind days) in the Inn Valley, Austria. Results show that the new horizontal length scale improves TKE simulations in the valley, when horizontal shear processes contribute to the overall TKE budget. Vertical profiles of TKE and transects across the valley indicate that the model simulates the ABL in a more realistic way than standard turbulence schemes, because the new scheme is able to account for terrain inhomogeneities. A model validation with 88 stations in Austria for four case study days indicates no change in the mean surface fields of temperature, relative humidity, and wind speed by the new turbulence parameterization.
Radiative Feedbacks Associated with the Madden–Julian Oscillation
Authors: Zhang Bosong , Kramer Ryan J. , Soden Brian J. 
Published: July 2019

AbstractRadiative kernels derived from CloudSat/CALIPSO measurements are used to diagnose radiative feedbacks induced by the Madden–Julian oscillation (MJO). Over the Indo-Pacific warm pool, positive cloud and water vapor feedbacks are coincident with the convective envelope of the MJO during its active phases, whereas the lapse rate feedback shows faster eastward propagation than the convective envelope. During phase 2/3, when the convective envelope is over the Indian Ocean, water vapor exhibits a vertically coherent response, with the largest anomalies and strongest feedback in the midtroposphere. Though spatial structures of the feedbacks vary, the most prominent difference lies in the magnitude. Cloud changes induce the largest radiative perturbations associated with the MJO. It is also found that the strength of the cloud feedback per unit of precipitation is greater for strong MJO events, suggesting that the strength of individual MJO events is largely dictated by the magnitude of cloud radiative heating of the atmosphere. In addition, stronger radiative heating due to water vapor and clouds helps the MJO survive the barrier effect of the Maritime Continent, leading to farther eastward propagation. These results offer process-oriented metrics that could help to improve model simulations and predictions of the MJO in the future.
Using Digital and Physical Simulation to Focus on Human Factors and Ergonomics in Aviation Maintainability
Authors: Bernard Fabien , Zare Mohsen , Sagot Jean-Claude , Paquin Raphael 
Published: July 2019

Objective: This research aimed to evaluate the differences in the assessments made by three simulation tools used in a maintainability design office to perform human factor/ergonomics (HFE) analysis: digital human modeling (DHM), virtual reality (VR), and physical mock-up (PMU). Background: Maintainability engineers use digital/physical simulation tools in the early design phase to analyze whether the design is well adapted for maintenance operators. Knowing the potential of these simulation tools would encourage maintainability stakeholders to integrate HFE in the design process more efficiently. Method: Eleven maintenance tasks were analyzed from the participation of six maintenance operators. Various HFE indicators including physical, cognitive, and organizational indicators were assessed. Each operator repeated 11 maintenance tasks on VR and PMU. Based on the anthropometric parameters, six manikins were created to analyze 11 maintenance tasks on DHM. Results: A significant difference was found for the organizational indicators between VR and PMU, whereas the physical and cognitive indicators are similar. DHM, VR, and PMU are compared with the common HFE indicators for the physical dimension and present a significant difference for individual tasks. Conclusion: To reduce the gap between simulation tools, a better physical representation is requested on the VR platform, improving the perception of work sequences in the virtual world. Concerning DHM, a new paradigm is proposed to study a few tasks per work area instead of studying each task independently. Application: This study will help develop a new methodology and tools specifically for non-HFE experts in the maintainability department.
Aging: Older Adults’ Driving Behavior Using Longitudinal and Lateral Warning Systems
Authors: Souders Dustin J. , Charness Neil , Roque Nelson A. , Pham Hellen 
Published: July 2019

Objective This study assessed older drivers’ driving behavior when using longitudinal and lateral vehicle warning systems together. Background Advanced driver assistance systems (ADAS) can benefit drivers of all ages. Previous research with younger to middle-aged samples suggests that safety benefits are not necessarily additive with additional ADAS. Increases in following distance associated with the use of forward collision warning (FCW) decreased when drivers also used lane departure warning (LDW), likely due to attending to the LDW more than the FCW. Method The current study used a driving simulator to provide 128 older drivers experience with FCW and/or LDW system(s) during a ~25-min drive to gauge their usage’s effects on driving performance and subjective workload. Results There were no significant differences found in headway distance between older drivers who used different combinations of FCW and LDW systems, but those who used an FCW system showed significantly longer time-to-collision (TTC) when approaching the critical event than those who did not. Users of LDW systems did not show reductions in standard deviation of lane position. Analyses of subjective workload measures showed no significant differences between conditions. Conclusion Findings suggest that FCW could increase older drivers’ TTC over the course of a drive. Contrary to previous findings in younger samples, concurrent use of FCW and LDW systems did not adversely affect older drivers’ longitudinal driving performance and subjective workload. Application Potential applications of this research include the assessment of older drivers’ use of vehicle warning systems and their effects on subjective workload.
The foaming dynamic characteristics of polyurethane foam
Authors: Zhang Cui , Tong Xinglin , Deng Chengwei , Wen Hongqiao , Huang Di , Guo Qian , Liu Xinrui 
Published: July 2019

Polyurethane foam is a kind of polymer composite material. The foaming turgidity and reaction temperature of polyurethane foam are closely related to its mechanical properties. According to our present knowledge, this study is the first time that fiber optic sensing technology has been applied to monitor the dynamics change in the foaming turgidity and reaction temperature of polyurethane foam during its preparation. The effects on the foaming expansion force, contractile force, and reaction temperature are studied through changing proportion of water among the ingredients of the polyurethane foam. The results have shown that the fiber optic Bragg grating wavelength varies due to the reaction temperature and foaming power. In the reaction process, the foaming expansion force can make the maximum wavelength change of fiber optic Bragg grating 1–3.5 nm, equivalent to 1000–3541 micro strain. And the highest temperature of the reaction was 42.6°C. The wavelength shifts of the fiber optic Bragg gratings were closely related to the reaction temperature and foaming power. The results show that fiber optic sensing technology can be used for the online kinetics monitoring of the reaction process of polyurethane foam plastics. The data obtained from the fiber optic Bragg grating could be used for the design and performance prediction of new polyurethane foam materials.
Monitoring the organizational wellness of a physician residency program: A quality improvement process
Authors: Talen Mary R , Edberg Deb , Pence Ari , Khan Laura 
Published: July 2019

Background Burnout and depression throughout physicians’ career cycles have been increasing. There has been a call for medical education leaders to devote resources to bolster the next generation of providers and shift the culture of medicine to organizational initiatives that impact physician well-being. Objective: The goal of this project has been to monitor and improve the organizational wellness of a residency program based on four core organizational areas: (1) culture of meaning and mission, (2) work capacity, (3) control and flexibility in decision-making, and (4) creativity in work–life balance. Method: A quality improvement strategy was implemented to monitor organizational wellness. The wellness was assessed five times over the course of 18 months. The survey was designed to evaluate the four core components. At each time interval, improvement strategies were implemented to address the wellness drains and strengthen drivers. Results: The four time series evaluations (residents: n = 19) indicated that culture of meaning, teamwork, and personal creativity are consistent wellness drivers. Work capacity and lack of control over decision-making were consistent drains. From first until last measurement, there was a slight improvement in control-decision-making; however, the burden of electronic medical record (EMR) charting and strains of coverage continue to drain our residency. Discussion and Conclusions: This model incorporates four categories for assessing organizational wellness within a residency program. The conceptual model is used as a framework to define, measure, analyze, and improve on organizational wellness. This process provides programs with a feedback approach to continually monitor and reassess the wellness of the organizational systems.
Flexible Endoscopic Zenker’s Diverticulotomy with an Articulating Bipolar Energy Sealer
Authors: Weissbrod Philip A. , Jafari Aria , Liu Shanglei , Horgan Santiago , Weisman Robert A. 
Published: July 2019

The surgical management of Zenker’s diverticula is performed through open or endoscopic approaches. The purpose of this report is to review our early experience with flexible endoscopic diverticulotomy with an articulating bipolar energy sealer for cricopharyngeal and diverticular wall division in a series of 5 patients where transoral rigid access was not possible. In addition to technical details, safety and efficacy data are included. The average diverticulum size was 2.5 cm. All patients reported symptom resolution, and there were no surgical complications. Liquid diet was initiated on postoperative day 1 for all patients and solids on day 11.8 ± 14.4 (mean ± SD) per protocol. Results demonstrate that treatment of Zenker’s diverticula can safely and successfully be performed with flexible endoscopic visualization and utilization of an articulating bipolar energy sealer to perform diverticulotomy in a population of patients where transoral diverticulotomy would not otherwise be feasible due to anatomic constraints. Early results support obtaining further experience to study this technology as an alternative to open surgery, especially when visualization and access are suboptimal with rigid endoscopy.
Application of zero echo time MR angiography in follow-up of intracranial aneurysm remnant and in-stent lumen after embolization: a comparison study with digital subtraction angiography
Authors: Song Yan , Qi Peng , Huang Juan , Jiao Sheng , Zhang Jintao , Wang Daming , Chen Min 
Published: July 2019

Background Intracranial aneurysm with endovascular treatment needs to be followed-up with a proper imaging method. Purpose To evaluate the performance of magnetic resonance angiography (MRA) with zero echo time at 1.5-T in assessing the intracranial aneurysm remnant and in-stent lumen as compared with time-of-flight MRA, with digital subtraction angiography as the gold standard. Material and Methods A total of 46 patients (17 men; mean age = 56.6±13.7 years) with 54 aneurysms who underwent coil embolization with or without stent were enrolled in this study. The presence of aneurysm remnant and the visualization of in-stent lumen were evaluated. The agreement of remnant identification between MRA with zero echo time and time-of-flight MRA with digital subtraction angiography was evaluated using Cohen’s kappa analysis. The performance of in-stent lumen visualization between MRA with zero echo time and time-of-flight MR angiography was compared with Chi-square test. Results Of 54 aneurysms, 27 were found to have remnants by digital subtraction angiography. The kappa value in identification of remnant of aneurysm was 0.852 between MRA with zero echo time and digital subtraction angiography and 0.741 between time-of-flight MRA and digital subtraction angiography. In detecting remnant of aneurysm, the sensitivity, specificity, positive predictive value, and negative predictive value were 96.3%, 88.9%, 89.7%, and 96.0% for MRA with zero echo time and 91.7%, 83.3%, 81.5%, and 92.6% for time-of-flight MRA, respectively. In visualizing in-stent lumen, MRA with zero echo time had better performance than time-of-flight MRA ( P < 0.001). Conclusion MR angiography with zero echo time might be a better non-invasive approach in assessing remnant of aneurysms and in-stent lumen as compared with time-of-flight MRA.
Comparison of survival and perioperative outcomes following simple and radical hysterectomy for stage II endometrial cancer: a single-institution, retrospective, matched-pair analysis
Authors: Jiang Yahui , Jia Nan , Zhu Menghan , He Yuan , Che Xiaoxia , Lv Tianjiao , Feng Weiwei 
Published: July 2019

Objective We aimed to compare the survival and perioperative outcomes of patients with stage II endometrial cancer (EC) undergoing simple hysterectomy (SH) or radical hysterectomy (RH), to validate the various guidelines. Methods A total of 155 consecutive patients diagnosed with stage II EC from 2000 to 2014 were reviewed. We identified 40 pairs of patients (40 SH and 40 RH) who were matched in terms of age, pathological type, and lymphovascular space invasion status using matched-pair analysis. Patient data were collected from medical records and outcomes were determined by telephone follow-up. Results Among the 80 patients in the two groups, seven died from tumor recurrence. However, cancer-related survival rates were not significantly different between the SH and RH groups. The 3-year cancer-related survival rates in the SH and RH groups were 94.97% and 92.53%, and the 5-year survival rates were 92.40% and 90.03%, respectively. Regarding perioperative outcomes, the SH group had significantly less intraoperative bleeding and a significantly shorter catheter-indwelling time than the RH group. Conclusions SH provides similar survival outcomes and a superior perioperative quality of life compared with RH in patients with stage II EC.