bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental Evaluation of Critical Heat Flux in Downward-Facing Boiling on SS304 L Flat Plate Relevant to In-Calandria Retention in PHWRs
Authors: Prasad Sumit V. , Nayak A. K. 
Published: August 2019

Abstract
Retention of corium inside the calandria vessel (CV) by externally cooling it by calandria vault water is essential to mitigate severe accidents in pressurized heavy water reactor (PHWR). The thermal failure of CV can be prevented by effective decay heat removal on the outer surface of CV using vault water, which depends on the heat transfer behavior from the outer surface of CV to the vault water. Determination of limiting heat removal capability of vault subcooled water through outer surface of CV is very important. Since the CV has a very large diameter and length, the bottom most part of the CV almost behaves as a flat plate with downward natural convection boiling heat transfer. The natural convection heat transfer is lesser on the flat surface as compared to the curved surface of the CV. Thus, the critical heat flux (CHF) on the flat surface under downward boiling condition is the limiting CHF of the CV under external surface boiling scenario. In order to estimate CHF in this configuration with local boiling, experiments were carried out on a downward facing SS304 L flat plate simulating the conditions of CV of 700 MWel Indian PHWR. The pool boiling CHF obtained in this study is also compared with other earlier works.
A prospective trial of adjuvant therapy for high-risk uveal melanoma: assessing 5-year survival outcomes
Authors: Binkley Elaine , Triozzi Pierre L , Rybicki Lisa , Achberger Susan , Aldrich Wayne , Singh Arun 
Published: August 2019

Background/aimsSurvival after diagnosis of metastasis from uveal melanoma is poor. Identifying individuals at high risk for metastasis and developing adjuvant therapy to prevent clinically apparent metastasis could improve survival. We conducted an adjuvant trial of sequential, low-dose dacarbazine (DTIC) and interferon-alpha-2b (IFN-α−2b) in patients with cytogenetic high-risk uveal melanoma.MethodsPatients diagnosed with iris, ciliary body or choroidal melanoma with high-risk tumour cytogenetics (monosomy 3) were offered adjuvant treatment with low-dose DTIC and IFN-α−2b following primary therapy. Eligible but not enrolled patients were observed for comparison. DTIC was administered at 850 mg/m2 intravenously on days 1 and 28. IFN-α−2b was administered at 3 million units three times a week subcutaneously for 24 weeks beginning at week 9. Hepatic imaging was performed prior to adjuvant therapy and then at least every 6 months. Survival data were collected for 5 years after enrolment.Results33 patients (22%) were enrolled (treatment group), 29 (19%) were eligible but did not enrol (observation group) and 88 (59%) were not eligible. The 5-year metastasis-free survival (MFS) was 64%±9% for treated and 33%±10% for observed patients (p=0.05). The 5-year overall survival (OS) rate was 66%±9% for treated and 37%±10% for observed patients (p=0.02).ConclusionsWhen adjusted for differences in age, tumour size and initial treatment, survival between treated and observed patients was no longer significant (p=0.56 MFS and p=0.92 OS). Differences in baseline tumour characteristics between treated and observed patients can influence interpretation of results.Trial registration numberNCT01100528.
Can even experienced orthopaedic surgeons predict who will benefit from surgery when patients present with degenerative meniscal tears? A survey of 194 orthopaedic surgeons who made 3880 predictions
Authors: van de Graaf Victor A , Bloembergen Coen H , Willigenburg Nienke W , Noorduyn Julia C A , Saris Daniel BF , Harris Ian A , Poolman Rudolf W 
Published: August 2019

Objectives
To examine the ability of surgeons to predict the outcome of treatment for meniscal tears by arthroscopic partial meniscectomy (APM) and exercise therapy in middle-aged patients.

Design and setting
Electronic survey. Orthopaedic surgeon survey participants were presented 20 patient profiles. These profiles were derived from a randomised clinical trial comparing APM with exercise therapy in middle-aged patients with symptomatic non-obstructive meniscal tears. From each treatment group (APM and exercise therapy), we selected five patients with the best (responders) and five patients with the worst (non-responders) knee function after treatment. 1111 orthopaedic surgeons and residents in the Netherlands and Australia were invited to participate in the survey.

Interventions
For each of the 20 patient profiles, surgeons (unaware of treatment allocation) had to choose between APM and exercise therapy as preferred treatment and subsequently had to estimate the expected change in knee function for both treatments on a 5-point Likert Scale. Finally, surgeons were asked which patient characteristics affected their treatment choice.

Main outcomes
The primary outcome was the surgeons’ percentage correct predictions. We also compared this percentage between experienced knee surgeons and other orthopaedic surgeons, and between treatment responders and non-responders.

Results
We received 194 (17%) complete responses for all 20 patient profiles, resulting in 3880 predictions. Overall, 50.0% (95% CI 39.6% to 60.4%) of the predictions were correct, which equals the proportion expected by chance. Experienced knee surgeons were not better in predicting outcome than other orthopaedic surgeons (50.4% vs 49.5%, respectively; p=0.29). The percentage correct predictions was lower for patient profiles of non-responders (34%; 95% CI 21.3% to 46.6%) compared with responders (66.0%; 95% CI 57.0% to 75.0%; p=0.01).
In general, bucket handle tears, knee locking and failed non-operative treatment directed the surgeons’ choice towards APM, while higher level of osteoarthritis, degenerative aetiology and the absence of locking complaints directed the surgeons’ choice towards exercise therapy.

Conclusions
Surgeons’ criteria for deciding that surgery was indicated did not pass statistical examination. This was true regardless of a surgeon’s experience. These results suggest that non-surgical management is appropriate as first-line therapy in middle-aged patients with symptomatic non-obstructive meniscal tears.

Clinical trial registration

ClinicalTrials.gov Identifier:
NCT03462134
.
Intensive Statin Treatment in Acute Ischaemic Stroke Patients with Intracranial Atherosclerosis: a High-Resolution Magnetic Resonance Imaging study (STAMINA-MRI Study)
Authors: Chung Jong-Won , Cha Jihoon , Lee Mi Ji , Yu In-Wu , Park Moo-Seok , Seo Woo-Keun , Kim Sung Tae , Bang Oh Young 
Published: August 2019

ObjectiveIntracranial atherosclerosis is a major cause of ischaemic stroke worldwide. A number of studies have shown the effects of statin treatment on coronary and carotid artery plaques, but there is little evidence on the effects of statin treatment on intracranial atherosclerotic plaques.MethodsThe Intensive Statin Treatment in Acute Ischaemic Stroke Patients with Intracranial Atherosclerosis - High-Resolution Magnetic Resonance Imaging (STAMINA-MRI) Trial is a single-arm, prospective, observational study monitoring imaging and clinical outcomes of high-dose statin treatment among statin-naive patients with acute ischaemic stroke caused by symptomatic intracranial atherosclerosis. The primary outcome was the change in vascular remodelling and plaque characteristics before and after 6 months (median: 179 days, IQR 163–189 days) of statin treatment measured by high-resolution MRI (HR-MRI).ResultsA total of 77 patients (mean age: 62.6±13.7 years, 61.0% women) were included in this study. Low-density lipoprotein cholesterol (LDL-C) levels (mg/dL) at initial and follow-up assessments were 125.81±35.69 and 60.95±19.28, respectively. Overall, statin treatment significantly decreased enhancement of plaque volume (mm3, 32.07±39.15 vs 17.06±34.53, p=0.013), the wall area index (7.50±4.28 vs 5.86±4.05, p=0.016) and stenosis degree (%, 76.47±20.23 vs 64.05±21.29, p<0.001), but not the remodelling index (p=0.195). However, 35% patients showed no change or increased enhancement volume and stenosis degree after statin treatment. Higher reduction of LDL-C and longer duration of statin treatment were associated with decreased enhancement volume after statin treatment.ConclusionsHigh-dose statin treatment effectively stabilised symptomatic intracranial atherosclerotic plaques as documented by HR-MRI. Further study is needed to determine laboratory and genetic factors associated with poor response to statins and alternative therapeutic options, such as proprotein convertase subtilisin-kexin type 9 inhibitors, for these patients.Trial registration numberClinicalTrials.govNCT02458755.
Psychological and utility-based quality of life impact of screening test results for anal precancerous lesions in gay and bisexual men: baseline findings from the Study of the Prevention of Anal Cancer
Authors: Cvejic Erin , Poynten Isobel Mary , Kelly Patrick J , Jin Fengyi , Howard Kirsten , Grulich Andrew E , Templeton David J , Hillman Richard J , Law Carmella , Roberts Jennifer M , McCaffery Kirsten 
Published: August 2019

Objective
Gay, bisexual and other men who have sex with men (GBMSM), particularly HIV-positive GBMSM, are at increased anal cancer risk compared with the general population. This study examined the psychological and quality of life (QoL) impact of receiving abnormal anal cancer screening results during the baseline visit of the Study of the Prevention of Anal Cancer (SPANC).

Methods
SPANC was a prospective cohort study of the natural history of anal human papillomavirus (HPV) and associated abnormalities in GBM aged 35 years and over. Participants completed questionnaires including aspects of health-related QoL (HR-QoL) and psychosocial functioning at baseline. Participants underwent procedures including an anal swab for cytology, and high-resolution anoscopy with biopsy of any possibly HPV-related abnormality. Questionnaires were readministered 2 weeks and 3 months after participants were given cytology and histology results. Perceived test result served as the study factor.

Results
Participants with perceived abnormal results (n=232) reported poorer HR-QoL (mean difference=1.8; p=0.004) and lower utility-based QoL (mean difference=0.02; p=0.018) 2 weeks after screening than individuals with perceived normal results (n=268). These differences did not persist at 3-month follow-up. A greater proportion of participants who perceived their results as abnormal reported feeling worse than usual about their anal health and anal cancer fear (p’s<0.001), experienced more intrusive thoughts about their results (p’s≤0.006) and felt more likely to develop cancer than other gay men their age (p’s≤0.025) at both time points than those with perceived normal results.

Conclusions
Providing abnormal results may cause psychological distress and impact HR-QoL, with sustained intrusive thoughts, increased cancer worry and perceived cancer risk. The potential for psychological harm needs to be considered when implementing anal cancer screening programmes.
Incidence of syphilis among HIV-infected men in Singapore, 2006–2017: temporal trends and associated risk factors
Authors: Ang Li Wei , Wong Chen Seong , Ng Oon Tek , Leo Yee Sin 
Published: August 2019

ObjectiveThere have been recent reports globally on substantial increase in syphilis diagnoses particularly among high-risk men. The aim of this study was to assess temporal trends of incident syphilis and associated risk factors among HIV-infected men in Singapore.MethodsWe conducted retrospective cohort analysis using the clinical database maintained by the Clinical HIV Programme at the National Centre for Infectious Diseases, Singapore. HIV-infected men with a negative syphilis result at baseline who had undergone at least one subsequent test in 2006–2017 were included. Factors associated with incident syphilis were investigated using Cox proportional hazards regression analyses.ResultsA total of 1069 HIV-infected men were tested for syphilis at least once following their negative baseline test during the 12-year period, and they contributed 4284 person-years of follow-up (PYFU). There were 266 cases of incident syphilis, giving an overall incidence of 6.21 per 100 PYFU (95% CI 5.49–7.00). The incidence of syphilis per 100 PYFU increased from 1.21 (95% CI 0.33 to 3.10) in 2010 to 26.04 (95% CI 19.97 to 33.40) in 2017. In the multivariable model, risk factors for syphilis seroconversion were: age 15–24 years at HIV diagnosis (adjusted HR (aHR) 1.64, 95% CI 1.05 to 2.56) versus ≥45 years, being Chinese (aHR 1.82, 95% CI 1.01 to 3.29) versus Indian and other minority ethnic groups, men having sex with men (MSM) (aHR 3.29, 95% CI 2.22 to 4.87) versus heterosexuals, and HIV diagnosis in later periods of 2009–2011 (aHR 1.96, 95% CI 1.41 to 2.74), 2012–2014 (aHR 3.96, 95% CI 2.68 to 5.83) and 2015–2017 (aHR 7.94, 95% CI 4.52 to 13.95) versus 2006–2008.ConclusionThe annual incidence rate of syphilis in HIV-infected men was on the rise, and it was consistently higher among MSM than in heterosexual men. The findings supported regular screening for syphilis and enhanced behavioural interventions in Singapore.
PD-L1 Expression and Clinical Outcomes to Cabozantinib, Everolimus, and Sunitinib in Patients with Metastatic Renal Cell Carcinoma: Analysis of the Randomized Clinical Trials METEOR and CABOSUN
Authors: Flaifel Abdallah , Xie Wanling , Braun David A. , Ficial Miriam , Bakouny Ziad , Nassar Amin H. , Jennings Rebecca B. , Escudier Bernard , George Daniel J. , Motzer Robert J. , Morris Michael J. , Powles Thomas , Wang Evelyn , Huang Ying , Freeman Gordon J. , Choueiri Toni K. , Signoretti Sabina 
Published: August 2019

Abstract

Purpose:
Programmed death-ligand 1 (PD-L1) status by IHC is prognostic in metastatic renal cell carcinoma (mRCC), and its role as a potential predictive biomarker is under investigation. Using tumor tissue from the METEOR (NCT01865747) and CABOSUN (NCT01835158) clinical trials, we explored whether PD-L1 expression and the extent of the immune cell infiltrate can serve as prognostic and/or predictive biomarkers for cabozantinib and other targeted agents.

Experimental Design:
IHC double staining for PD-L1 and CD45/CD163 (immune cell markers) was performed on tumor tissue from METEOR (n = 306) and CABOSUN (n = 110) clinical trials. Immune cell density and MET expression levels were also analyzed. Our primary aim was to correlate progression-free survival (PFS) by independent central review with PD-L1 status in patients treated with cabozantinib, everolimus (METEOR), or sunitinib (CABOSUN). Overall survival (OS) was also interrogated.

Results:
Tumor cell (TC) PD-L1 expression (≥1% cutoff) was detected in 29% and 23% of tumors from patients in the METEOR and CABOSUN trials, respectively. On univariate analysis, patients with PD-L1–positive TC had poorer PFS and OS than patients with PD-L1–negative TC on both trials, independent of therapy. On multivariable analysis and when combining the two trials, the association between TC PD-L1 expression and OS was statistically significant for all patients (P = 0.034) and for patients treated with cabozantinib only (P = 0.038). Cabozantinib was associated with improved PFS (HR &lt; 0.70) and OS (HR &lt; 0.85) compared with everolimus and sunitinib irrespective of PD-L1 expression.

Conclusions:
Higher PD-L1 expression results in worse clinical outcomes in mRCC treated with targeted therapy. Furthermore, PD-L1 expression is not predictive of response to cabozantinib therapy.
Preferential Incorporation of Administered Eicosapentaenoic Acid Into Thin-Cap Atherosclerotic Plaques
Authors: Sato Tomohito , Horikawa Makoto , Takei Shiro , Yamazaki Fumiyoshi , Ito Takashi K. , Kondo Takeshi , Sakurai Takanobu , Kahyo Tomoaki , Ikegami Koji , Sato Shumpei , Sato Ryota , Jinno Yasutaka , Kawano Hiroyuki , Naoe Satoko , Arita Makoto , Kashiwagi Yukiyasu , Setou Mitsutoshi 
Published: August 2019

Objective:
n-3 polyunsaturated fatty acids, especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have beneficial effects on atherosclerosis. Although specific salutary actions have been reported, the detailed distribution of n-3 polyunsaturated fatty acids in plaque and their relevance in disease progression are unclear. Our aim was to assess the pharmacodynamics of EPA and DHA and their metabolites in atherosclerotic plaques.

Approach and Results:

Apolipoprotein E-deficient (Apoe
−/−
) mice were fed a Western diet supplemented with EPA (1%, w/w) or DHA (1%, w/w) for 3 weeks. Imaging mass spectrometry analyses were performed in the aortic root and arch of the Apoe
−/−
mice to evaluate the distribution of EPA, DHA, their metabolites and the lipids containing EPA or DHA in the plaques. Liquid chromatography-mass spectrometry and histological analysis were also performed. The intima-media thickness of atherosclerotic plaque decreased in plaques containing free EPA and EPAs attached with several lipids. EPA was distributed more densely in the thin-cap plaques than in the thick-cap plaques, while DHA was more evenly distributed. In the aortic root, the distribution of total EPA level and cholesteryl esters containing EPA followed a concentration gradient from the vascular endothelium to the media. In the aortic arch, free EPA and 12-hydroxy-EPA colocalized with M2 macrophage.

Conclusions:
Administered EPA tends to be incorporated from the vascular lumen side and preferentially taken into the thin-cap plaque.
Age and growth of the commercial spiny lobsters Panulirus argus (Latreille, 1804) and Panulirus laevicauda (Latreille, 1817) (Decapoda, Palinuridae) in Northeast Brazil: a review
Authors: Salazar Ivo S. Orellana , Cruz Raúl 
Published: August 2019

Abstract
The two spiny lobster fisheries targeting Panulirus argus (Latreille, 1804) and Panulirus laevicauda (Latreille, 1817) have made an important marine resource in Northeast Brazil since 1955. The Von Bertalanffy age and growth parameters of the spiny lobster started being studied in 1960 and the last assessment was performed over 20 years ago. The objective of this review is to analyse the type of input data and the methods historically used to assess age and growth of the spiny lobster stock in Northeast Brazil.
Our study reviews and updates the research on the subject and proposes relative values for the Von Bertalanffy growth parameters for P. argus and P. laevicauda as provisional reference. We recommend further age and growth research on spiny lobsters to create a new and updated growth function for commercial lobsters in Northeast Brazil.
A new record of the copepod Xanthocalanus agilis Giesbrecht, 1893 (Calanoida, Phaennidae) from the South China Sea
Authors: Feng Y. Z. , Liu Z. S. 
Published: August 2019

Abstract
The genus Xanthocalanus inhabits the intermediate and deep waters of the world ocean. The present study records and describes the first female individual of Xanthocalanus agilis Giesbrecht, 1893, collected in the South China Sea (13°0.21′N 113°0.21′E) at depths of 500-800 m. This species was identified by the following morphological characteristics: (i) rostrum with 2 slender filaments; (ii) posterolateral corners of fifth thoracic somite protuberant and triangular, reaching the posterior margin of genital somite; (iii) first segment of fifth pereiopod (P5) with a list of inner marginal spinules, distal segment short with 3 robust terminal spines. This finding expands the known global and vertical distribution of X. agilis.
Somānanda on the Meaningfulness of Language
Authors: Nemec John 
Published: August 2019

Abstract
The present article examines Somānanda’s understanding of the denotative capacity of speech (śabda) as presented in his Śivadṛṣṭi, āhnika four. Somānanda argues that this denotative capacity is innate in words because based in a real sāmānya or universal; that a permanent connection links śabda and its object (artha), not convention (saṃketa); and that the referent of speech is an object innately imbued with linguistic capacity in the form of an ever-present, innate sāmānya. Each of these positions is also supported by the Mīmāṃsā, and Somānanda, citing both Śabara and Kumārila, assents to their positions on these points on the understanding that they may only be accepted as philosophically sound if one presumes the existence of a Śaiva non-duality of all as Śiva-as-consciousness. These positions, in turn, are all deployed as arguments against those of the Buddhist Pramāṇa Theorists, whose views in each of these three areas Somānanda contests.
Securities and Capital Markets Regulation in South Africa
Authors: Chanetsa C. King 
Published: August 2019

AbstractAn effective securities and capital markets industry has existed in South Africa for over 120 years. The regulatory authorities have been alive to globally competitive pressures for inward investment and have endeavoured to implement a conducive environment therefore in compliance with international standards. As recently as 2015, South Africa was considered the best regulator of securities in the world. The effects of the global financial crisis (GFC) were keenly observed. The fall out from the GFC contained lessons for all markets, but not to the same extent. Commentators may therefore regard aspects of the South African reform agenda as replicative of initiatives in other jurisdictions and, consequently, uncritical in parts. In light of the fall to forty sixth place in the world in securities regulation ranking and some uncertainty in respect of the extent and shape of the reform process, this opus reviews activities in South Africa along the busy securities and capital markets value chain, and considers the continuing and emerging regulatory and supervisory framework.
Ecological Water Stress under Projected Climate Change across Hydroclimate Gradients in the North-Central United States
Authors: Adhikari Arjun , Hansen Andrew J. , Rangwala Imtiaz 
Published: August 2019

AbstractWater balance influences the distribution, abundance, and diversity of plant species across Earth’s terrestrial system. In this study, we examine changes in the water balance and, consequently, the dryland extent across eight ecoregions of the north-central United States by quantifying changes in the growing season (May–September) moisture index (MI) by 2071–99, relative to 1980–2005, under three high-resolution (~4 km) downscaled climate projections (CNRM-CM5, CCSM4, and IPSL-CM5A-MR) of high-emission scenarios (RCP8.5). We find that all ecoregions are projected to become drier as based on significant decreases in MI, except four ecoregions under CNRM-CM5, which projects relatively more moderate warming and much greater increases in precipitation relative to the other two projections. The mean projected MI across the entire study area changes by from +4% to −33%. The proportion of dryland (MI < 0.65) is projected to increase under all projections, but more significantly under the warmer and drier projections represented by CCSM4 and IPSL-CM5A-MR; these two projections also show the largest spatial increases in the arid (33%–53%) and hyperarid (135%–180%) dryland classes and the greatest decrease in the dry subhumid (from −56% to −88%) dryland class. Among the ecoregions, those in the semiarid class have the highest increase in potential evapotranspiration, those in the nondryland and dry subhumid class have the largest decrease in MI, and those in the dry subhumid class have the greatest increase in dryland extent. These changes are expected to have important implications for agriculture, ecological function, biodiversity, vegetation dynamics, and hydrological budget.