bluuebunny/crossref_metadata_2025_split huggingface dataset:
Klinefelter syndrome: From pediatrics to geriatrics
Authors: Shiraishi Koji , Matsuyama Hideyasu 
Published: December 2018

AbstractBackgroundKlinefelter syndrome (KS) is one of the major causes of nonobstructive azoospermia (NOA). Microdissection testicular sperm extraction (micro‐TESE) is often performed to retrieve sperm. Infertility specialists have to care for KS patients on a lifelong basis.MethodsBased on a literature review and our own experience, male infertility treatment and KS pathophysiology were considered on a lifelong basis.Main findingsPatients diagnosed early often have an increased number of aberrant X chromosomes. Cryptorchidism and hypospadias are often found, and surgical correction is required. Cryopreservation of testicular sperm during adolescence is an issue of debate because the sperm retrieval rate (SRR) in KS patients decreases with age. The SRR in adult KS patients is higher than that in other patients with NOA; however, low testosterone levels after micro‐TESE will lower the general health and quality of life. KS men face a number of comorbidities, such as malignancies, metabolic syndrome, diabetes, cardiovascular disease, bone disease, and immune diseases, which ultimately results in increased mortality rates.ConclusionA deeper understanding of the pathophysiology of KS and the histories of KS patients before they seek infertility treatment, during which discussions with multidisciplinary teams are sometimes needed, will help to properly treat these patients.
The household as a source of labor for entrepreneurs: Evidence from New York City during industrialization
Authors: Ruef Martin 
Published: December 2018

Research SummaryThis article conceptualizes households as a crucial pool of labor for small entrepreneurs. The household varied historically in its scope (depending on whether bonded workers were included) and work intensity (depending on the authority or coercion exercised by household heads). Drawing on data that enumerate over 100,000 households in New York City, I examine how the shift from institutions of unfree labor to wage labor affected business proprietorship between 1790 and 1850. Given the disproportionate importance of unfree household labor to small entrepreneurs, the contraction of this labor source may offer one general explanation for their decline.Managerial SummaryHow does household scope and composition affect the ability of an individual to run their own business? Historical archives can provide useful insights into this question. They track long‐term declines in family size and the emancipation of non‐family members—such as apprentices, indentured servants, and slaves—from the authority of household heads. Examining records from early New York City, this study shows that business ownership was strongly linked with the ownership of slaves and the presence of dependent males after the American Revolution. Large households and unfree laborers were especially important for entrepreneurship among individuals with limited wealth. For modern economies, the results suggest that policymakers consider potential tensions between small business ownership and the development of free and equitable labor markets.
Acidification Impacts and Goals for Gauging Recovery of Brook Trout Populations and Fish Communities in Streams of the Western Adirondack Mountains, New York, USA
Authors: Baldigo Barry P. , George Scott D. , Lawrence Gregory B. , Paul Eric A. 
Published: December 2018

AbstractResults from several long‐term monitoring programs in the western Adirondack Mountains, New York, indicate that acid–base chemistry of headwater streams has remained unchanged or improved only marginally since the 1990s. A paucity of quantitative fishery data, however, limits our understanding of the pre‐acidified communities as well as present‐day impacts of acidification on fish assemblages, which impedes efforts to evaluate temporal trends and biological recovery in streams of the region. Fish communities were characterized at 48 streams (chemistry was assessed at 47 streams) in the western Adirondacks at least once during summer 2014–2016 to assess present‐day effects of acidification on fish assemblages, refine important relations, and identify biological targets and chemical effect thresholds that could help gauge biological recovery across the region. Concentrations of inorganic aluminum (Ali) exceeded chronic and acute toxicity thresholds (1.0 and 2.0 μmol/L) in 21.3% and 8.5%, respectively, of 47 study streams sampled during summer 2014–2016 and in 64.0% and 44.0% of 25 streams sampled during spring 2014–2015. In streams with summer Ali concentrations less than 1.0 μmol/L, community richness, density, and biomass averaged 2.0 species, 444.2 fish/0.1 ha, and 1,924.4 g/0.1 ha, respectively, whereas density and biomass of Brook Trout Salvelinus fontinalis populations averaged 280.8 fish/0.1 ha and 1,384.0 g/0.1 ha, respectively. These findings identify defensible targets for biological recovery and show that Ali toxicity is not a major concern for fish assemblages in most streams during summer base flow periods but is potentially a serious issue for fish in as many as two‐thirds of streams during spring high flows. Though additional data are needed to address several limitations and information gaps, results from this study provide a sound foundation to gauge biological recovery, detect future effects of climatic stressors, and help ensure that functional stream ecosystems can be sustained or restored in parts of the Adirondacks.
An experimental medicine study of the phosphodiesterase-4 inhibitor, roflumilast, on working memory-related brain activity and episodic memory in schizophrenia patients
Authors: Gilleen James , Farah Yakub , Davison Cate , Kerins Sarah , Valdearenas Lorena , Uz Tolga , Lahu Gez , Tsai Max , Ogrinc Frank , Reichenberg Avi , Williams Steve C. , Mehta Mitul A. , Shergill Sukhi S. 
Published: December 2018

Abstract
Rationale
Schizophrenia is associated with impairments in cognitive functioning yet there are no approved drugs to treat these deficits.

Objectives
Based on animal models, we investigated the potential for roflumilast, a selective inhibitor of phosphodiesterase type 4 (PDE4), to improve cognition, which may act by increasing intracellular cyclic adenosine monophosphate in brain regions underlying cognitive deficits in schizophrenia.

Methods
This study consisted of a randomised, double-blind, placebo-controlled, crossover design involving 15 schizophrenia patients. In 3 treatment periods, patients were given 8 days of placebo or one of the two doses of roflumilast (100 and 250 μg daily) with 14 days of washout between treatments. The primary endpoints were dorsolateral prefrontal cortex (DLPFC) activation during a visuospatial working memory task measured with fMRI on dosing day 8 and verbal memory and working memory performance change from baseline to day 8. Least square mean change scores were calculated for behavioural outcomes; fMRI data were analysed in SPM12 with bilateral DLPFC as regions of interest.

Results
Verbal memory was significantly improved under 250 μg roflumilast (effect size (ES) = 0.77) compared to placebo. fMRI analyses revealed that increasing dose of roflumilast was associated with reduction of bilateral DLPFC activation during working memory compared to placebo, although this was not statistically significant (ES = 0.31 for the higher dose). Working memory was not improved (ES = 0.03).

Conclusions
Results support the mechanistic validation of potential novel strategies for improving cognitive dysfunction in schizophrenia and suggest that PDE4 inhibition may be beneficial for cognitive dysfunction in schizophrenia.

Trial registration
NCT02079844.
A Transdisciplinary Complex Adaptive Systems (T-CAS) Approach to Developing a National School-Based Culture of Prevention for Health Improvement: the School Health Research Network (SHRN) in Wales
Authors: Murphy Simon , Littlecott Hannah , Hewitt Gillian , MacDonald Sarah , Roberts Joan , Bishop Julie , Roberts Chris , Thurston Richard , Bishop Alexa , Moore Laurence , Moore Graham 
Published: December 2018

AbstractThe paper reflects on a transdisciplinary complex adaptive systems (T-CAS) approach to the development of a school health research network (SHRN) in Wales for a national culture of prevention for health improvement in schools. A T-CAS approach focuses on key stages and activities within a continuous network cycle to facilitate systems level change. The theory highlights the importance of establishing transdisciplinary strategic partnerships to identify and develop opportunities for system reorientation. Investment in and the linking of resources develops the capacity for key social agents to take advantage of disruption points in the re-orientated system, and engagement activities develop the network to facilitate new social interactions and opportunities for transdisciplinary activities. A focus on transdisciplinary action research to co-produce interventions, generate research evidence and inform policy and practice is shown to play an important part in developing new normative processes that act to self-regulate the emerging system. Finally, the provision of reciprocal network benefits provides critical feedback loops that stabilise the emerging adaptive system and promote the network cycle. SHRN is shown to have embedded itself in the system by securing sustainability funding from health and education, a key role in national and regional planning and recruiting every eligible school to the network. It has begun to reorient the system to one of evidence generation (56 research studies co-produced) and opportunities for data-led practice at multiple levels. Further capacity development will be required to capitalise on these. The advantages of a complex systems approach to address barriers to change and the transferability of a T-CAS network approach across settings and cultures are highlighted.
Ki-67 labeling index in glioblastoma; does it really matter?
Authors: Alkhaibary Ali , Alassiri Ali H. , AlSufiani Fahd , Alharbi Mohammed A. 
Published: December 2018

Objective/Background:
Glioblastoma (GB) is the most common primary malignant brain tumor in adults. Ki-67 is a nonhistone nuclear protein that is expressed by cells entering the mitotic cycle and is associated with the transcription of ribosomal RNA (rRNA). In gliomas, the extent of expression of Ki-67 is roughly proportional to the histologic grade. Over the years, association studies were conducted trying to link the poor outcome in different types of malignant tumors to the Ki-67 proliferative index. This study is designed to investigate the relationship between the proliferation marker, Ki-67, and the overall survival amongst glioblastoma patients diagnosed between 2006 and 2012 at a single institution in Riyadh, Saudi Arabia.

Methods:
This is a retrospective cohort study which investigated the status of Ki-67 labeling index in glioblastoma patients diagnosed at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2006 and 2012. The Kaplan–Meier survival analysis was used to assess the overall survival (OS) and the Mantel–Cox log-rank test was used to compare the survival curves. Multivariate analysis using Cox proportional-hazards model was used to investigate other factors that might influence the overall survival.

Results:
A total of 44 glioblastoma patients were included in the study. The median age at diagnosis was 56 (1–91) years. The 12-month survival rate for all glioblastoma patients was 48%. The median survival for patients with Ki-67 labeling index of ≤27%, and >27% was 11 months and 14 months, respectively.

Conclusion:
The difference between the survival curves of patients with Ki-67 labeling index of ≤27%, and Ki-67 of >27% was statistically insignificant (p = .130). Therefore, Ki-67 labeling index alone cannot predict survival in glioblastoma patients.
Diverting transverse colostomy in a midline incision, a case report
Authors: Sugarbaker Paul H. 
Published: December 2018

ABSTRACT

A diverting ostomy to increase the safety or treat complications of a colorectal anastomosis is a time honored surgical procedure. Most surgeons choose to construct a diverting loop ileostomy. Under some clinical conditions a diverting transverse colostomy may be advantageous. The transverse colostomy may be placed in the midline abdominal incision.
A patient who required an emergency fecal diversion on his 19th postoperative day had a loop transverse colostomy through the midline abdominal incision. A diverting loop transverse colostomy was performed with ease. The transverse colon crossed the abdomen at the level of the apex of the midline abdominal incision. It was brought to the skin level with minor dissection and exteriorized by a plastic rod. Construction of a diverting loop ileostomy was not possible because of extensive adhesions from multiple prior surgeries.
When a diversion of the fecal stream is needed in a patient with extensive adhesions, a loop transverse colostomy in the apex of a midline incision should be considered. This procedure has not been previously reported.

Highlights:
The Prevalence of Ptosis and Nystagmus in Rural Population
Authors: Hashemi Hassan , Molaei Leila , Yekta Abbasali , Aghamirsalim Mohammadreza , Ostadimoghaddam Hadi , Jabbari-Azad Frida , Khabazkhoob Mehdi 
Published: December 2018

Purpose:
To determine the prevalence of ptosis and nystagmus in the general rural population in Iran.

Methods:
Two villages were selected from the north and southwest of Iran using a multi-stage cluster sampling approach. After selection of the participants and inviting them to a complete eye exam, they all had vision tests and an ophthalmic examination. Vision tests included measurement of visual acuity, refraction, and the cover test. Then the slit-lamp exam was performed, and the diagnosis of ptosis and nystagmus was determined by an ophthalmologist.

Results:
Of the 3851 invitees, 3314 people participated in the study. The prevalence of ptosis in this study was 2.23% [95% confidence interval (CI): 1.73-2.74], and 45.3% of the cases were bilateral ptosis. The prevalence of ptosis was lowest in the 21-30 year (0.2%) and the under 5 year (0.8%) age groups, and the highest prevalence was observed in people over 70 years of age (6.7%) (P < 0.001). The prevalence of ptosis was higher in illiterate people than those with an academic education level (P = 0.012). The prevalence of astigmatism was 62.8% in those with ptosis and 34.2% in those without ptosis (P < 0.001). The prevalence of nystagmus was 0.39% (13 cases).

Conclusions:
This study found that the prevalence of ptosis is relatively high in the general rural population in Iran, and the prevalence increases with age. Astigmatism is significantly high among cases with ptosis, and its prevalence has an inverse relation with the level of education. Nystagmus also had a high prevalence in this population.
The Outer Radiation Belt Response to the Storm Time Development of Seed Electrons and Chorus Wave Activity During CME and CIR Driven Storms
Authors: Bingham S. T. , Mouikis C. G. , Kistler L. M. , Boyd A. J. , Paulson K. , Farrugia C. J. , Huang C. L. , Spence H. E. , Claudepierre S. G. , Kletzing C. 
Published: December 2018

AbstractGyroresonant wave‐particle interactions with very low frequency whistler mode chorus waves can accelerate subrelativistic seed electrons (hundreds of keV) to relativistic energies in the outer radiation belt during geomagnetic storms. In this study, we conduct a superposed epoch analysis of the chorus wave activity, the seed electron development, and the outer radiation belt electron response between L* = 2.5 and 5.5, for 25 coronal mass ejection and 35 corotating interaction region storms using Van Allen Probes observations. Electron data from the Magnetic Electron Ion Spectrometer and Relativistic Electron Proton Telescope instruments are used to monitor the storm‐phase development of the seed and relativistic electrons, and magnetic field measurements from the Electric and Magnetic Field Instrument Suite and Integrated Science instrument are used to identify the chorus wave activity. Our results show a deeper (lower L*), stronger (higher flux), and earlier (epoch time) average seed electron enhancement and a resulting greater average radiation belt electron enhancement in coronal mass ejection storms compared to the corotating interaction region storms despite similar levels and lifetimes of average chorus wave activity for the two storm drivers. The earlier and deeper seed electron enhancement during the coronal mass ejection storms, likely driven by greater convection and substorm activity, provides a higher probability for local acceleration. These results emphasize the importance of the timing and the level of the seed electron enhancements in radiation belt dynamics.
Alfvénic Heating in the Cusp Ionosphere‐Thermosphere
Authors: Lotko William , Zhang Binzheng 
Published: December 2018

AbstractThe effect of electromagnetic variability on cusp‐region ionosphere‐thermosphere heating is examined. The study is motivated by observed correlations between anomalous thermospheric density enhancements at F region altitudes and small‐scale field‐aligned currents, previously interpreted as evidence of ionospheric Alfvén resonator modes. Height‐integrated and height‐dependent heating rates for Alfvén waves incident from the magnetosphere at frequencies from 0.05 to 2 Hz and perpendicular wavelengths from 0.5 to 20 km have been calculated. The velocity well in Alfvén speed surrounding the F region plasma density maximum facilitates energy deposition by slowing, trapping, and intensifying resonant waves. The Alfvénic Joule heating rate maximizes at the resulting resonances. F region Joule heating resulting from quasistatic and Alfvénic variability with the same root‐mean‐square amplitude in the F region are shown to be comparable. At the same time, Alfvénic variability deposits little electromagnetic power in the E region, whereas quasistatic variability greatly enhances E region heating. When measured electric and magnetic fields are used to constrain the amplitude and spectral content of superposed Alfvén waves incident from the magnetosphere, the calculated F region heating rate ranges from 5 to 10 nW/m3.
Simulations of the Generation of Energetic Electrons and the Formation of Descending Artificial Plasma Layers During HF Heating at Arecibo
Authors: Eliasson B. , Milikh G. M. , Liu T. C. , Shao X. , Papadopoulos K. 
Published: December 2018

AbstractHigh‐frequency (HF)‐induced descending artificial plasma layers (DAPLs) are artificially ionized plasma layers with plasma density in excess of that of the F2 peak. They were discovered during HF heating experiments at the High‐Frequency Active Auroral Research Program where they descended up to 70 km from the initial O mode wave reflection height. The DAPLs were attributed to the ionization of the neutral gas by high‐energy electrons accelerated by the artificial ionospheric turbulence. Recently, DAPL formation was reported during the HF heating experiment at Arecibo (Bernhardt et al., 2017, https://ies2017.bc.edu/). This result was unexpected since Arecibo has the effective radiated power 4–5 times lower than that at High‐Frequency Active Auroral Research Program, and since the experiment at Arecibo also has an unfavorable geometry, where the HF beam is directed vertically while the inclination of the geomagnetic field is 43.5°, allowing the fast electrons to escape the volume where their interaction with the artificial plasma turbulence occurs. However, the presence of photoelectrons due to the ultraviolet radiation from the Sun at the low latitude of Arecibo could magnify the flux of hot electrons. A model of artificial plasma layers created by the Arecibo HF facility is presented. It shows that Langmuir turbulence due to the HF heating can accelerate part of the ambient photoelectrons to energies above the ionization threshold of the neutral gas, leading to the formation of DAPLs. The present model results are in quantitative agreement with the experiments of Bernhardt et al. (2017).
Permutation Entropy Analysis of Magnetic Field Turbulence at 1AU Revisited
Authors: Olivier C. P. , Engelbrecht N. E. , Strauss R. D. 
Published: December 2018

AbstractPermutation entropy analysis is a relatively recent addition to the palette of techniques used to study spacecraft observations of heliospheric magnetic field fluctuations at Earth, allowing one to characterize the underlying processes driving the observed fluctuations. This study investigates the effects of data averaging, data gaps, and underlying periodicities on the results of such an analysis, utilizing synthetic data sets and thereby developing efficient treatments for each of these effects. Furthermore, WIND spacecraft observations are employed to validate the results of an earlier permutation entropy analysis by Weck et al. (2015, https://doi.org/10.1103/PhysRevE.91.023101), confirming the results of that study and showing how dat averaging effects can significantly affect the results so acquired. Lastly, as a novel application of this technique, Advanced Composition Explorer spacecraft data taken from 1998 to 2008 are analyzed to investigate whether the permutation entropy so calculated displays a solar cycle dependence. It is shown that although solar cycle dependencies have been reported for observed turbulence quantities such as the magnetic variance, there is no significant dependence discernible in the permutation entropy, and therefore in the underlying processes driving the turbulence.
Observations and Fokker‐Planck Simulations of the L‐Shell, Energy, and Pitch Angle Structure of Earth's Electron Radiation Belts During Quiet Times
Authors: Ripoll J.‐F. , Loridan V. , Denton M. H. , Cunningham G. , Reeves G. , Santolík O. , Fennell J. , Turner D. L. , Drozdov A. Y. , Cervantes Villa J. S. , Shprits Y. Y. , Thaller S. A. , Kurth W. S. , Kletzing C. A. , Henderson M. G. , Ukhorskiy A. Y. 
Published: December 2018

AbstractThe evolution of the radiation belts in L‐shell (L), energy (E), and equatorial pitch angle (α
0) is analyzed during the calm 11‐day interval (4–15 March) following the 1 March 2013 storm. Magnetic Electron and Ion Spectrometer (MagEIS) observations from Van Allen Probes are interpreted alongside 1D and 3D Fokker‐Planck simulations combined with consistent event‐driven scattering modeling from whistler mode hiss waves. Three (L, E, α
0) regions persist through 11 days of hiss wave scattering; the pitch angle‐dependent inner belt core (L ~ <2.2 and E < 700 keV), pitch angle homogeneous outer belt low‐energy core (L > ~5 and E~ < 100 keV), and a distinct pocket of electrons (L ~ [4.5, 5.5] and E ~ [0.7, 2] MeV). The pitch angle homogeneous outer belt is explained by the diffusion coefficients that are roughly constant for α
0 ~ <60°, E > 100 keV, 3.5 < L < L

pp
~ 6. Thus, observed unidirectional flux decays can be used to estimate local pitch angle diffusion rates in that region. Top‐hat distributions are computed and observed at L ~ 3–3.5 and E = 100–300 keV.