bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of overweight and obesity in adverse cardiovascular disease mortality trends: an analysis of multiple cause of death data from Australia and the USA
Authors: Adair Tim , Lopez Alan D.
Published: August 2020

Background

In recent years, there have been adverse trends in premature cardiovascular disease (CVD) mortality rates (35–74 years) in the USA and Australia. Following long-term declines, rates in the USA are now increasing while falls in Australia have slowed rapidly. These two countries also have the highest adult obesity prevalence of high-income countries. This study investigates the role of overweight and obesity in their recent CVD mortality trends by using multiple cause of death (MCOD) data—direct individual-level evidence from death certificates—and linking the findings to cohort lifetime obesity prevalence.

Methods

We identified overweight- and obesity-related mortality as any CVD reported on the death certificate (CVD MCOD) with one or more of diabetes, chronic kidney disease, obesity, lipidemias or hypertensive heart disease (DKOLH-CVD), causes strongly associated with overweight and obesity. DKOLH-CVD comprises 50% of US and 40% of Australian CVD MCOD mortality. Trends in premature age-standardized death rates were compared between DKOLH-CVD and other CVD MCOD deaths (non-DKOLH-CVD). Deaths from 2000 to 2017 in the USA and 2006–2016 in Australia were analyzed. Trends in in age-specific DKOLH-CVD death rates were related to cohort relative lifetime obesity prevalence.

Results

Each country’s DKOLH-CVD mortality rate rose by 3% per annum in the most recent year, but previous declines had reversed more rapidly in Australia. Non-DKOLH-CVD mortality in the USA increased in 2017 after declining strongly in the early 2000s, but in Australia it has continued declining in stark contrast to DKOLH-CVD. There were larger increases in DKOLH-CVD mortality rates at successively younger ages, strongly related with higher relative lifetime obesity prevalence in younger cohorts.

Conclusions

The increase in DKOLH-CVD mortality in each country suggests that overweight and obesity has likely been a key driver of the recent slowdown or reversal of CVD mortality decline in both countries. The larger recent increases in DKOLH-CVD mortality and higher lifetime obesity prevalence in younger age groups are very concerning and are likely to adversely impact CVD mortality trends and hence life expectancy in future. MCOD data is a valuable but underutilized source of data to track important mortality trends.
LINC00441 promotes cervical cancer progression by modulating miR-450b-5p/RAB10 axis
Authors: Han Haiyan , Shao Qingchun , Liu Xuejie
Published: August 2020

Background

As one of the most common gynaecological malignant tumors, cervical cancer (CC) has become an important public health issue. Emerging evidence has revealed long non-coding RNAs (lncRNAs) are crucial regulators of biological functions in cancers, including CC. And the oncogenic role of LINC00441 has been verified in hepatocellular carcinoma (HCC). But the molecular mechanism and biological functions of LINC00441 in CC remain unknown.

Methods

qRT-PCR analysis detected the expression of genes in CC tissues or cells. CCK-8, colony formation, flow cytometry, transwell, western blot assays as well as animal studies were conducted to analyze the function of LINC00441 in CC. Luciferase reporter, RIP and RNA pull down assays were applied to verify the binding relations among the indicated genes.

Results

LINC00441 was upregulated in CC tissues and cells. Further, LINC00441 depletion repressed cell proliferation and motility in vitro as well as tumor growth in vivo. LINC00441 could sponge miR-450b-5p to upregulate RAB10 expression. Finally, miR-450b-5p inhibitor or RAB10 upregulation counteracted LINC00441 knockdown-mediated function on the development of CC.

Conclusions

LINC00441 drives CC progression by targeting miR-450b-5p/RAB10 axis, which might provide new idea for researching CC-related molecular mechanism.
Effects of particulate matter on atherosclerosis: a link via high-density lipoprotein (HDL) functionality?
Authors: Holme Siri A. N. , Sigsgaard Torben , Holme Jørn A. , Holst Gitte Juel
Published: August 2020

Background

Exposure to air pollution has been associated with adverse effects on human health, and ultimately increased morbidity and mortality. This is predominantly due to hazardous effects on the cardiovascular system. Exposure to particulate matter (PM) is considered to be responsible for the most severe effects.

Main body

Here we summarize current knowledge from existing epidemiological, clinical and animal studies on the influence of PM exposure on high-density lipoprotein (HDL) functionality and the potential initiation and progression of atherosclerosis. We highlight experimental studies that bring support to the causality and point to possible mechanistic links. Recent studies indicate that the functional properties of HDL are more important than the levels per se. Fine (PM2.5–0.1) and ultrafine (UFP) PM are composed of chemicals as well as biological elements that are redox-active and may trigger pro-inflammatory responses. Experimental studies indicate that these properties and responses may promote HDL dysfunction via oxidative pathways. By affecting protein and lipid components of the HDL particle, its anti-atherosclerotic characteristics including cholesterol efflux capacity, as well as other anti-oxidative and anti-inflammatory features might be impaired.

Conclusion

Current literature suggests that PM promotes HDL dysfunction via oxidative pathways. However, as relatively few studies so far have evaluated the impact of particulate air pollution on HDL functionality, more human epidemiological as well as experimental studies are needed to strengthen any possible causal relationship and determine any relevance to atherosclerosis.

Graphical abstract
A knowledge-based intensity-modulated radiation therapy treatment planning technique for locally advanced nasopharyngeal carcinoma radiotherapy
Authors: Bai Penggang , Weng Xing , Quan Kerun , Chen Jihong , Dai Yitao , Xu Yuanji , Lin Fasheng , Zhong Jing , Wu Tianming , Chen Chuanben
Published: August 2020

Background

To investigate the feasibility of a knowledge-based automated intensity-modulated radiation therapy (IMRT) planning technique for locally advanced nasopharyngeal carcinoma (NPC) radiotherapy.

Methods

One hundred forty NPC patients treated with definitive radiation therapy with the step-and-shoot IMRT techniques were retrospectively selected and separated into a knowledge library (n = 115) and a test library (n = 25). For each patient in the knowledge library, the overlap volume histogram (OVH), target volume histogram (TVH) and dose objectives were extracted from the manually generated plan. 5-fold cross validation was performed to divide the patients in the knowledge library into 5 groups before validating one group by using the other 4 groups to train each neural network (NN) machine learning models. For patients in the test library, their OVH and TVH were then used by the trained models to predict a corresponding set of mean dose objectives, which were subsequently used to generate automated plans (APs) in Pinnacle planning system via an in-house developed automated scripting system. All APs were obtained after a single step of optimization. Manual plans (MPs) for the test patients were generated by an experienced medical physicist strictly following the established clinical protocols. The qualities of the APs and MPs were evaluated by an attending radiation oncologist. The dosimetric parameters for planning target volume (PTV) coverage and the organs-at-risk (OAR) sparing were also quantitatively measured and compared using Mann-Whitney U test and Bonferroni correction.

Results

APs and MPs had the same rating for more than 80% of the patients (19 out of 25) in the test group. Both AP and MP achieved PTV coverage criteria for no less than 80% of the patients. For each OAR, the number of APs achieving its criterion was similar to that in the MPs. The AP approach improved planning efficiency by greatly reducing the planning duration to about 17% of the MP (9.85 ± 1.13 min vs. 57.10 ± 6.35 min).

Conclusion

A robust and effective knowledge-based IMRT treatment planning technique for locally advanced NPC is developed. Patient specific dose objectives can be predicted by trained NN models based on the individual’s OVH and clinical TVH goals. The automated planning scripts can use these dose objectives to efficiently generate APs with largely shortened planning time. These APs had comparable dosimetric qualities when compared to our clinic’s manual plans.
Long-term outcomes of concomitant tricuspid valve repair in patients undergoing mitral valve surgery
Authors: Cetinkaya Ayse , Ganchewa Natalia , Hein Stefan , Bramlage Karin , Bramlage Peter , Schönburg Markus , Richter Manfred
Published: August 2020

Background

We aimed to find out how the concomitant performance of tricuspid valve repair (TVR) affects outcomes of patients undergoing mitral valve surgery (MVS).

Methods

Single-centre, retrospective analysis of 1357 patients who underwent MVS between January 2005 and December 2015, including 1165 patients with isolated MVS and 192 patients with MVS plus TVR. We used propensity scores to match patients for baseline characteristics other than valve related parameters and arrived at a matched sample of 182 patients per group.

Results

The overall procedure duration was longer in the MVS + TVR (224 min) versus the MVS group (176 min; p < 0.001), as were the duration of mechanical ventilation (13 vs. 11 h; p < 0.001), X-clamp (90.5 vs. 66 min; p < 0.001) and cardiopulmonary bypass time (136 vs. 95.5 min; p < 0.001). Rates of procedural complications were not different between groups with the exception of pacemaker rates which were 16.0% in the MVS + TVR group and 8.8% in the isolated MVS group (p = 0.037).

There was no difference in death rates within 30 days, stroke, myocardial infarction or repeat MVS. The long-term survival rate was 60.8% in the MVS + TVR vs. 57.5% in the isolated MVS group (HR 1.048; 95%CI 0.737–1.492; p = 0.794). The rate of grade III/IV tricuspid regurgitation (TR) remained low after MVS + TVR during long-term follow-up while the rate of grade ≥ II TR increased slightly in the isolated MVS group.

Conclusion

The data show that the concomitant performance of TVR in patients undergoing MVS is a safe and effective procedure with good long-term outcomes. Patients can undergo MVS + TVR with confidence as it improves their prognosis up to the level of patients undergoing isolated MVS.
A GPIU method for fractional diffusion equations
Authors: Shen Hai-Long , Li Yu-Han , Shao Xin-Hui
Published: August 2020

The fractional diffusion equations can be discretized by applying the implicit finite difference scheme and the unconditionally stable shifted Grünwald formula. Hence, the generating linear system has a real Toeplitz structure when the two diffusion coefficients are non-negative constants. Through a similarity transformation, the Toeplitz linear system can be converted to a generalized saddle point problem. We use the generalization of a parameterized inexact Uzawa (GPIU) method to solve such a kind of saddle point problem and give a new algorithm based on the GPIU method. Numerical results show the effectiveness and accuracy for the new algorithm.
Stability and bifurcation analysis of two-species competitive model with Michaelis–Menten type harvesting in the first species
Authors: Yu Xiangqin , Zhu Zhenliang , Li Zhong
Published: August 2020

In this paper, a two-species competitive model with Michaelis–Menten type harvesting in the first species is studied. We have made a detailed mathematical analysis of the model to describe some important results that may be produced by the interaction of biological resources. The permanence, stability, and bifurcation (saddle-node bifurcation and transcritical bifurcation) of the model are investigated. The results show that with the change of parameters, two species could eventually coexist, become extinct or one species will be driven to extinction and the other species will coexist. Moreover, by constructing the Lyapunov function, sufficient conditions to ensure the global asymptotic stability of the positive equilibrium are given. Our study shows that compared with linear harvesting, nonlinear harvesting can exhibit more complex dynamic behavior. Numerical simulations are presented to illustrate the theoretical results.
Person-centered analysis of factors related to STEM students’ global awareness
Authors: Kulturel-Konak Sadan
Published: August 2020

Background

Twenty-first century communication has changed how we connect to the rest of the world. Therefore, it requires the preparation of undergraduate science, technology, engineering, and mathematics (STEM) students who are capable of coping with problems on a global scale and who can participate effectively in a global economic and civic environment. Breathtaking ability to send vast amounts of data instantly and at times globally often translates to graduates entering the workforce needing to be aware of the global community. Hence, in this study, factors related to engineering students’ global awareness have been explored so that higher education institutions may consider those factors when designing programs meant to influence this competence. The current study used a validated new instrument, based on a developmental model—the Model of Domain Learning (MDL)—to gauge engineering students’ growth in global awareness. The presented research is studying the following research question:What is the relation between students’ curricular and co-curricular experiences and levels of global awareness classified using MDL?

Results

Person-centered analyses were used to answer the research question. Four hundred twenty-five engineering students, who enrolled in 18 different engineering programs in a US land-grant university, participated in this study. The study found that engineering students’ engagement in extra-curricular activities was correlated with an increase of their knowledge, strategic processing, and interest in the domain of global awareness.

Conclusions

Based on the data analysis, students’ international experiences were positively related to not only their interest and knowledge but also their strategic processing predicted by the MDL. Moreover, engineering students’ international experience and high academic engagement are important variables related to their perception of increased global awareness and improved skills for international careers. Hence, higher education institutions should consider making pedagogical interventions in their programs to effectively embed international experience into students’ curriculum.
Effect of using different approximation models to the exact Mohr–Coulomb material model in the FE simulation of Anchor Foundations in sand
Authors: Riyad A. S. M. , Rokonuzzaman Md. , Sakai Toshinori
Published: August 2020

Singularities in the Mohr–Coulomb (MC) yield criterion create numerical difficulties when implemented in the finite element model (FEM). In this research, a two-dimensional (2D) and a three-dimensional (3D) elasto-plastic FEM coupled with isotropic strain hardening–softening or simple strain-softening law incorporating non-associated flow rule including shear band, is used to investigate the effect of singularities, embedment, shape, soil frictional as well as dilation angle on vertically uploaded shallow anchor foundations buried in Toyoura sand. Mohr–Coulomb–Drucker Prager (MC–DP) model provides a more appropriate solution than Drucker Prager–Drucker Prager (DP–DP) model. Besides, the peak resistance factor and the settlement at the ultimate capacity have been found as the functions of embedment, shape, and sand density. Also, the numerical model gives satisfactory agreement with the previous studies. In particular, a simple strain-softening model cannot capture the settlement behavior of anchor foundations in sand efficiently.
OCT changes of idiopathic epiretinal membrane after cataract surgery
Authors: Vallejo-Garcia Jose Luis , Romano Mary , Pagano Luca , Montericcio Alessio , Borgia Alfredo , Morenghi Emanuela , Vinciguerra Paolo
Published: August 2020

Background

We reviewed our experience in the management of cataract and idiopatic epiretinal membrane surgeries at the Humanitas Research Institute–Milan, Italy- over the past 3 years.

Methods

We conducted a single center retrospective observational case series of patients that underwent sequential cataract and idiopatic epiretinal membrane (ERM) surgeries from 2012–2015 in Humanitas Research Institute. Full data was obtained for 53 eyes of 57 patients. Patients with ERM secondary to uveitis or trauma or associated with simultaneous retinal detachment were excluded. Diabetic retinopathy, glaucoma, age-related macular degeneration, and myopia of more than 6 diopters were exclusion criteria as well.

Results

Cataract surgery was not associated with an ERM stage progression at one month follow up, but caused retinal inflammation that resulted in a significant increase in central macular thickness (CMT), macular volume (MV), central macular edema (CME), IS/OS disruption (IS/OS) and neurosensory detachment (NSD). However, there was no significant change in Best corrected visual acuity (BCVA).

Conclusion

We suggest that patients undergoing cataract surgery in the presence of epiretinal membranes need tight follow up to treat and control eventual macular inflammatory changes and eventual prompt vitrectomy if BCVA is threatened.
Prevalence of gram negative bacteria causing community acquired pneumonia among adults in Mwanza City, Tanzania
Authors: Kishimbo Peter , Sogone Nyambura Moremi , Kalokola Fredrick , Mshana Stephen E.
Published: August 2020

Background

Community acquired pneumonia (CAP) in adults is still a common and serious illness in the sub-Saharan Africa. Identification of the pathogens is crucial in the management of CAP. This study was done to determine the common bacterial pathogens, treatment outcomes and associated factors for microbiological confirmed CAP among adults attending the Bugando Medical Centre and Sekou Toure hospital in the city of Mwanza, Tanzania.

Methods

This was a hospital based cross sectional study involving patients with community acquired pneumonia attending Bugando Medical Centre and Sekou Toure regional Hospital. Demographic and other data were collected using standardized data collection tool. Sputum culture was done followed by identification of the isolates and antibiotics susceptibility testing.

Results

A total of 353 patients were enrolled in the study. Out of 353 sputum samples, 265(75%) were of good quality. Of 353 non-repetitive sputum cultures, 72/353 (20.4, 95% CI: 16.2–24.6) were positive for the bacterial pathogens with five patients having more than one pathogen. Good quality sputa had significantly higher yield of pathogenic bacteria than poor quality sputa (26.1% vs.3.4%, P = 0.001). The majority 64 (83.1%) of the isolates were gram negative bacteria. Common bacteria isolated were Klebsiella pneumoniae 23/77(29.9%), Streptococcus pyogenes 10/77 (13.0%), Pseudomonas aeruginosa 9/77 (11.7%) and Escherichia coli 7/77 (9.1%). Of 23 K. pneumoniae isolates, 20/23 (87.0%) were resistant to ceftriaxone. Resistance to ceftriaxone was found to be associated with prolongation of CAP symptoms (p = 0.009).

Conclusion

Gram negative bacteria resistant to ampicillin, amoxicillin/clavulanic acid and ceftriaxone were most frequently isolated bacteria among adults’ patients with CAP attending BMC and Sekou Toure hospital. Routine sputum culture should be performed to guide appropriate treatment of CAP among adults in developing countries.
The role of VEGF and BMP-2 in stimulation of bone healing with using hybrid bio-composite scaffolds coated implants in animal model
Authors: Rady Asmaa A. M. , Hamdy Soha M. , Abdel-Hamid Mohamed A. , Hegazy Marwa G. A. , Fathy Shadia A. , Mostafa Amany A.
Published: August 2020

Background

Osteogenesis and angiogenesis are two closely correlated processes during bone growth, development, remodeling, and repair. Vascular endothelial growth factor (VEGF) is an essential mediator during the process of angiogenesis. The bone morphogenetic protein (BMP-2) family of growth factors plays critical roles in bone formation. VEGF has the potential to enhance BMPs-induced bone formation.

Purpose

This study attempted to assess VEGF and BMP-2 reflecting the effect of hybrid bio-composite scaffold on bone healing in dogs and evaluate the quality of the healing process radiologically.

Methods

This study was conducted on 12 adult mongrel dogs. All dogs were divided into four equal groups (n = 3 each): chitosan non-medicated (CH) (NM), chitosan medicated (CH) (M), chitosan bioglass non-medicated (CH.BG) (NM), and Chitosan Bioglass Medicated (CH.BG) (M). VEGF and BMP-2 were evaluated during fracture healing.

Results

Results have showed a non-significant decrease in serum VEGF activity in the (CH.BG) (M) group when compared to other groups during 2, 3 weeks, followed by gradual decrease, then increase at 12 weeks of interval period. There was highly significant increase from pre-surgery to 12 weeks in serum BMP-2 levels in the (CH.BG) (M) group when compared to other groups.

Conclusion

Biochemical parameters along with clinical and radiographical provide sound knowledge on the degree of bone healing with the use of chitosan bio-glass medicated by risedronate sodium drug. The statistical analysis will include the Fisher exact test and T test with significance level P < 0.05 (AU).

Graphical abstract
Molecular Classification of the PORTEC-3 Trial for High-Risk Endometrial Cancer: Impact on Prognosis and Benefit From Adjuvant Therapy
Authors: León-Castillo Alicia , de Boer Stephanie M. , Powell Melanie E. , Mileshkin Linda R. , Mackay Helen J. , Leary Alexandra , Nijman Hans W. , Singh Naveena , Pollock Pamela M. , Bessette Paul , Fyles Anthony , Haie-Meder Christine , Smit Vincent T. H. B. M. , Edmondson Richard J. , Putter Hein , Kitchener Henry C. , Crosbie Emma J. , de Bruyn Marco , Nout Remi A. , Horeweg Nanda , Creutzberg Carien L. , Bosse Tjalling ,   on behalf of the TransPORTEC consortium
Published: August 2020

PURPOSE

The randomized Adjuvant Chemoradiotherapy Versus Radiotherapy Alone in Women With High-Risk Endometrial Cancer (PORTEC-3) trial investigated the benefit of combined adjuvant chemotherapy and radiotherapy (CTRT) versus radiotherapy alone (RT) for women with high-risk endometrial cancer (EC). Because The Cancer Genome Atlas defined an EC molecular classification with strong prognostic value, we investigated prognosis and impact of chemotherapy for each molecular subgroup using tissue samples from PORTEC-3 trial participants.

METHODS

Paraffin-embedded tissues of 423 consenting patients were collected. Immunohistochemistry for p53 and mismatch repair (MMR) proteins, and DNA sequencing for POLE exonuclease domain were done to classify tumors as p53 abnormal (p53abn), POLE-ultramutated ( POLEmut), MMR-deficient (MMRd), or no specific molecular profile (NSMP). The primary end point was recurrence-free survival (RFS). Kaplan-Meier method, log-rank test, and Cox model were used for analysis.

RESULTS

Molecular analysis was successful in 410 high-risk EC (97%), identifying the 4 subgroups: p53abn EC (n = 93; 23%), POLEmut (n = 51; 12%), MMRd (n = 137; 33%), and NSMP (n = 129; 32%). Five-year RFS was 48% for patients with p53abn EC, 98% for POLEmut EC, 72% for MMRd EC, and 74% for NSMP EC ( P < .001). The 5-year RFS with CTRT versus RT for p53abn EC was 59% versus 36% ( P = .019); 100% versus 97% for patients with POLEmut EC ( P = .637); 68% versus 76% ( P = .428) for MMRd EC; and 80% versus 68% ( P = .243) for NSMP EC.

CONCLUSION

Molecular classification has strong prognostic value in high-risk EC, with significantly improved RFS with adjuvant CTRT for p53abn tumors, regardless of histologic type. Patients with POLEmut EC had an excellent RFS in both trial arms. EC molecular classification should be incorporated in the risk stratification of these patients as well as in future trials to target specific subgroups of patients.
Conducting Goals-of-Care Discussions Takes Less Time Than Imagined
Authors: Pintova Sofya , Leibrandt Ryan , Smith Cardinale B. , Adelson Kerin B. , Gonsky Jason , Egorova Natalia , Franco Rebeca , Bickell Nina A.
Published: August 2020

PURPOSE:

To describe the length of encounter during visits where goals-of-care (GoC) discussions were expected to take place.

METHODS:

Oncologists from community, academic, municipal, and rural hospitals were randomly assigned to receive a coaching model of communication skills to facilitate GoC discussions with patients with newly diagnosed advanced solid-tumor cancer with a prognosis of < 2 years. Patients were surveyed after the first restaging visit regarding the quality of the GoC discussion on a scale of 0-10 (0 = worst; 10 = best), with ≥ 8 indicating a high-quality GoC discussion. Visits were audiotaped, and total encounter time was measured.

RESULTS:

The median face-to-face time oncologists spent during a GoC discussion was 15 minutes (range, 10-20 minutes). Among the different hospital types, there was no significant difference in encounter time. There was no difference in the length of the encounter whether a high-quality GoC discussion took place or not (15 v 14 minutes; P = .9). If there was imaging evidence of cancer progression, the median encounter time was 18 minutes compared with 13 minutes for no progression ( P = .03). In a multivariate model, oncologist productivity, patient age, and Medicare coverage affected duration of the encounter.

CONCLUSION:

Oncologists can complete high-quality GoC discussions in 15 minutes. These data refute the common misperception that discussing such matters with patients with advanced cancer requires significant time.
Changes in Adrenal Androgens and Steroidogenic Enzyme Activities From Ages 2, 4, to 6 Years: A Prospective Cohort Study
Authors: Kim Jae Hyun , Lee Young Ah , Lim Youn-Hee , Lee Kyunghoon , Kim Bung-Nyun , Kim Johanna Inhyang , Hong Yun-Chul , Yang Sei Won , Song Junghan , Shin Choong Ho
Published: August 2020

Context

The levels of adrenal androgens are increased through the action of steroidogenic enzymes with morphological changes in the adrenal zona reticularis.

Objective

We investigated longitudinal changes in androgen levels and steroidogenic enzyme activities during early childhood.

Design and Participants

From a prospective children’s cohort, the Environment and Development of Children cohort, 114 boys and 86 girls with available blood samples from ages 2, 4, and 6 years were included.

Outcome Measurements

Serum concentrations of adrenal androgens using liquid chromatography-tandem mass spectrometry and steroidogenic enzyme activity calculated by the precursor/product ratio.

Results

During ages 2 to 4 years, 17,20-lyase and dehydroepiandrosterone (DHEA) sulfotransferase activities increased (P < 0.01 for both in boys). During ages 4 to 6 years, 17,20-lyase activity persistently increased, but 3β-hydroxysteroid dehydrogenase (HSD) and 17β-HSD activities decreased (P < 0.01 for all). Serum DHEA sulfate (DHEA-S) levels persistently increased from 2, 4, to 6 years, and DHEA, 17-hydroxyprogesterone, and androstenedione levels increased during ages 4 to 6 years (P < 0.01 for all). Serum DHEA-S levels during early childhood were associated with body mass index z-scores (P = 0.001 in only boys).

Conclusion

This study supports in vivo human evidence of increased 17,20-lyase and DHEA sulfotransferase activities and decreased 3β-HSD activity during early childhood.
Sino-European Differences in the Genetic Landscape and Clinical Presentation of Pheochromocytoma and Paraganglioma
Authors: Jiang Jingjing , Zhang Jing , Pang Yingxian , Bechmann Nicole , Li Minghao , Monteagudo Maria , Calsina Bruna , Gimenez-Roqueplo Anne-Paule , Nölting Svenja , Beuschlein Felix , Fassnacht Martin , Deutschbein Timo , Timmers Henri J L M , Åkerström Tobias , Crona Joakim , Quinkler Marcus , Fliedner Stephanie M J , Liu Yujun , Guo Jianming , Li Xiaomu , Guo Wei , Hou Yingyong , Wang Cikui , Zhang Liang , Xiao Qiao , Liu Longfei , Gao Xin , Burnichon Nelly , Robledo Mercedes , Eisenhofer Graeme
Published: August 2020

Context

Pheochromocytomas and paragangliomas (PPGLs) are characterized by distinct genotype-phenotype relationships according to studies largely restricted to Caucasian populations.

Objective

To assess for possible differences in genetic landscapes and genotype-phenotype relationships of PPGLs in Chinese versus European populations.

Design

Cross-sectional study.

Setting

2 tertiary-care centers in China and 9 in Europe.

Participants

Patients with pathologically confirmed diagnosis of PPGL, including 719 Chinese and 919 Europeans.

Main Outcome Measures

Next-generation sequencing performed in tumor specimens with mutations confirmed by Sanger sequencing and tested in peripheral blood if available. Frequencies of mutations were examined according to tumor location and catecholamine biochemical phenotypes.

Results

Among all patients, higher frequencies of HRAS, FGFR1, and EPAS1 mutations were observed in Chinese than Europeans, whereas the reverse was observed for NF1, VHL, RET, and SDHx. Among patients with apparently sporadic PPGLs, the most frequently mutated genes in Chinese were HRAS (16.5% [13.6-19.3] vs 9.8% [7.6-12.1]) and FGFR1 (9.8% [7.6-12.1] vs 2.2% [1.1-3.3]), whereas among Europeans the most frequently mutated genes were NF1 (15.9% [13.2-18.6] vs 6.6% [4.7-8.5]) and SDHx (10.7% [8.4–13.0] vs 4.2% [2.6–5.7]). Among Europeans, almost all paragangliomas lacked appreciable production of epinephrine and identified gene mutations were largely restricted to those leading to stabilization of hypoxia inducible factors. In contrast, among Chinese there was a larger proportion of epinephrine-producing paragangliomas, mostly due to HRAS and FGFR1 mutations.

Conclusions

This study establishes Sino-European differences in the genetic landscape and presentation of PPGLs, including ethnic differences in genotype-phenotype relationships indicating a paradigm shift in our understanding of the biology of these tumors.
Facts and Myths about Misperceptions
Authors: Nyhan Brendan
Published: August 2020

Misperceptions threaten to warp mass opinion and public policy on controversial issues in politics, science, and health. What explains the prevalence and persistence of these false and unsupported beliefs, which seem to be genuinely held by many people? Though limits on cognitive resources and attention play an important role, many of the most destructive misperceptions arise in domains where individuals have weak incentives to hold accurate beliefs and strong directional motivations to endorse beliefs that are consistent with a group identity such as partisanship. These tendencies are often exploited by elites who frequently create and amplify misperceptions to influence elections and public policy. Though evidence is lacking for claims of a “post-truth” era, changes in the speed with which false information travels and the extent to which it can find receptive audiences require new approaches to counter misinformation. Reducing the propagation and influence of false claims will require further efforts to inoculate people in advance of exposure (for example, media literacy), debunk false claims that are already salient or widespread (for example, fact-checking), reduce the prevalence of low-quality information (for example, changing social media algorithms), and discourage elites from promoting false information (for example, strengthening reputational sanctions).
The Economics of Urban Density
Authors: Duranton Gilles , Puga Diego
Published: August 2020

Density boosts productivity and innovation, improves access to goods and services, reduces typical travel distances, encourages energy efficient construction and transport, and allows broader sharing of scarce urban amenities. However, density is also synonymous with crowding and makes living and moving in cities more costly. We explore the appropriate measurement of density and describe how it is both a cause and a consequence of the evolution of cities. We then discuss whether and how policy should target density and why, in practice, the tradeoff between its pros and cons is unhappily resolved by both market and political forces.
Using Place-Based Jobs Policies to Help Distressed Communities
Authors: Bartik Timothy J.
Published: August 2020

Place-based jobs policies seek to create jobs in particular local labor markets. Such policies include business incentives provided by state and local governments, which cost almost $50 billion annually. The most persuasive rationale for these policies is that they can advance equity and efficiency by increasing long-term employment rates in distressed local labor markets. However, current incentives are not targeted at distressed areas. Furthermore, incentives have high costs per job created. Lower costs can be achieved by public services to business, such as manufacturing extension, customized job training, and infrastructure. Reforms to place-based jobs policies should focus on greater targeting of distressed areas and using more cost-effective policies. Such reforms could be achieved by state and local governments acting in their residents’ interests or could be encouraged by federal interventions to cap incentives and provide aid to distressed areas.
Principles of mRNA control by human PUM proteins elucidated from multimodal experiments and integrative data analysis
Authors: Wolfe Michael B. , Schagat Trista L. , Paulsen Michelle T. , Magnuson Brian , Ljungman Mats , Park Daeyoon , Zhang Chi , Campbell Zachary T. , Goldstrohm Aaron C. , Freddolino Peter L.
Published: August 2020

The human PUF-family proteins, PUM1 and PUM2, posttranscriptionally regulate gene expression by binding to a PUM recognition element (PRE) in the 3′-UTR of target mRNAs. Hundreds of PUM1/2 targets have been identified from changes in steady-state RNA levels; however, prior studies could not differentiate between the contributions of changes in transcription and RNA decay rates. We applied metabolic labeling to measure changes in RNA turnover in response to depletion of PUM1/2, showing that human PUM proteins regulate expression almost exclusively by changing RNA stability. We also applied an in vitro selection workflow to precisely identify the binding preferences of PUM1 and PUM2. By integrating our results with prior knowledge, we developed a “rulebook” of key contextual features that differentiate functional versus nonfunctional PREs, allowing us to train machine learning models that accurately predict the functional regulation of RNA targets by the human PUM proteins.
Protocol for a mixed-methods exploratory investigation into the role of health information technology for the provision of cancer care in Indonesia
Authors: Espressivo Aufia , Puspitaningtyas Herindita , Hutajulu Susanna H. , Fuad Anis , Allsop Matthew J.
Published: August 2020

Background: Cancer and its management can incur high costs, high risks and high demand. In Indonesia, there remains gap in the availability of national cancer data despite the establishment of a National Committee for Cancer Control. Multiple pilot projects have been developed by the Ministry of Health to improve the delivery of care, including interventions utilising digital health approaches and integrated referral information systems. However, it is not yet clear to what extent these approaches influence patient management or the experience of cancer patients themselves. This research aims to explore the current role of health information technology (HIT) in the provision of services and treatments for patients with cancer from primary to tertiary healthcare centres in Yogyakarta, Indonesia.

Methods: The study will adopt an observational mixed-methods single case study design of health facilities involved in the delivery of cancer services in a sub-national health system. We will collect data through face-to-face interviews with a range of health professionals involved in the delivery of cancer care. Patients will be interviewed to share their views and experiences of the existing cancer referral system and communication with health facilities. Alongside interviews, we will undertake an analysis of routine data from participating health facilities to assess gaps in existing information systems. Data analysis will include framework analysis for qualitative data alongside descriptive analyses of quantitative data. Findings will be used to inform conceptual maps to be presented as part of Theory of Change workshops focused on understanding how the existing cancer referral system works, why and for whom, with a focus on future refinement and intervention development. 

Conclusion: Our findings will inform critical thinking around the design, implementation, adaptation, and evaluation of existing systems. Through early engagement and participation of key stakeholders and project partners, we intend that findings will have immediate utility.
A Scale for Measuring Sustainable Manufacturing Practices and Sustainability Performance: Validity and Reliability
Authors: Ibrahim Yousif M. , Hami Norsiah , Abdulameer Susan S.
Published: August 2020

Purpose: In quantitative studies, providing a valid and reliable instrument is necessary to ensure accurate results when measuring sustainable manufacturing practices (SMPs) and sustainability performance (SP). Therefore, this study aims to evaluate the validity and reliability of the measurements of SMPs and SP.Methodology/Approach: The population of this study is top managers who have experience in the oil and gas industry (O&GI) in Iraq. Two tests were carried out in the present study: the pre-test and the pilot test.Findings: In the pre-test, the comments made by six academician experts and three practitioners were used to rephrase the measurements items and modify them according to the requirements of the O&GI by the Iraqi context. Moreover, in the pilot test was all the items were reliable and were sufficiently correlated with their constructs.Research Limitation/implication: There are some limitations to the current study. First, due to the small size of the study population, the pilot test sample in the current study was only 12 respondents. Future researchers can increase the sample size for the pilot test when they have a large population. Second, the validity and reliability of the measurements were tested in the current study in the oil and gas industry only. Future studies can test these measurements in other industries or small and Small and medium-sized enterprises (SMEs).Originality/Value of paper: Theoretically, there are four contributions to the body of knowledge: first, introduce measures for SMPs according to the product life cycle view, it is limited in the literature. Second, these measures can be used by researchers to study the extent of SMPs and the SP of companies using descriptive statistics. Third, these measures can be used to investigate the impact of SMPs on SP by regression testing or structural equation modelling. Fourth, measures can be modified into open-ended questions for use in qualitative or mixed studies. Practically, there are two practical implications which explain in the conclusion.
Are the ‘Illnesses’ of Traditional Likert Scales Treatable?
Authors: Tóth Zsuzsanna E. , Árva Gábor , Dénes Rita V.
Published: August 2020

Purpose: The main aim of this paper is to introduce the development and the application of a fuzzy rating scale in measuring customer satisfaction which are to be demonstrated through a healthcare example in order to illustrate how the proposed methodology is able to enhance the reliability of traditional Likert scale-based evaluations.Methodology/Approach: The proposed methodology is built on fuzzy sets the membership function of which is composed of two sigmoid functions by applying Dombi’s conjunction operator. The possible ‘values’ of the linguistic variable expressing customer satisfaction are to be expressed by these functions which can also be linked to the level of organizational performance allowing the illustration of the mainly nonlinear relationship between the provided and perceived service performance.Findings: The application of the proposed fuzzy rating scale confirms its ability to reflect the unambiguity of human ratings as well as the context-dependency of ratings resulting in a more precise representation of human judgements.Research Limitation/implication: The presented methodology may be viewed as a viable approach in any kind of service quality evaluations where Likert-type scales are traditionally applied to handle its weaknesses.Originality/Value of paper: The proposed methodology is not only able to reflect the satisfaction of customers and the organizational performance simultaneously, but the expectations of customers related to the desired level of performance can also be incorporated into the establishment of the scale yielding to more reliably supported managerial decisions.
Collusion or collision? The war on drugs in the Philippines
Authors: Lara, Jr Francisco J. , De la Rosa Nikki Philline C.
Published: August 2020

The spiral of State-led violence against the illegal drug trade in Southeast Asia did not end nor disrupt this shadow economy and its complex links to state and non-state actors as well as the newly emerging violent extremism. The evidence in fact shows that the violent response to the problem has only fuelled more economic, political, and security concerns. The case is the same in the Philippines where an indiscriminate and violent war on drugs has not lived up to its promises. Yet why is there continued public support for the anti-drug war despite its failures, and from among those that are often victimized by its violence? This paper takes an economic sociology approach to the problem of illegal drugs and turns the spotlight on the threats to embedded social networks posed by this deadly enterprise. Using quantitative and qualitative evidence and case studies of a province and city recognized as a hotbed in the government’s anti-drug war, the study will show how collusion and collision are alternate realities and means of adapting to an illicit enterprise that is bound to many social and economic arrangements, including those brought about by violent extremism.
A Switch in Time Saves the Dime: A Model to Reduce Rental Cost in Cloud Computing
Authors: Hosseini Leila , Tang Shaojie , Mookerjee Vijay , Sriskandarajah Chelliah
Published: August 2020

With the rapid growth of cloud computing, firms face a dizzying array of choices and pricing structures for performing their computing tasks on the cloud. Unlike captive computing resources, cloud computing occurs as a pay-as-you-go contract, similar to the provision of electricity. We develop a method to reduce the rental cost of completing a given computing task with a certain deadline. The current practice is to use a single computing resource that can get the task done in the cheapest possible manner. Instead, costs can be significantly reduced if the task is switched between multiple resources, some more powerful and others less powerful. We apply our method to a real computing task at Cidewalk and show that costs can be significantly reduced.
Evaluation of patient satisfaction with the quality of maternal and child services of health facilities in Ile-Ife, Osun State
Authors: Oyeniran Yemisi Adebola , Adeyeye Olajumoke , Sowunmi Christiana Olanrewaju
Published: August 2020

Background/Aims

An evaluation of patient satisfaction of the quality of healthcare facilities and services provides feedback to enhance improved service delivery. Patient satisfaction with care has been identified as one of the essential elements of quality care, which can be used to determine the quality of care being rendered in health centres. This study aimed to assess patient satisfaction with maternal and child services in health facilities in Ile-Ife, Osun State, Nigeria.

Methods

A quantitative cross-sectional study was carried out in Ile-Ife, Osun State, in all seven secondary health facilities and 45 selected primary healthcare centres. A total of 330 nursing mothers with babies aged 0–1 years old were selected through simple random sampling. A self-developed, structured, pre-tested satisfaction survey based on Donabedian and Linder-Pelz satisfaction model was used to explore nursing mothers' satisfaction with maternal and child healthcare services and the determinants of satisfaction. Data were analysed using descriptive statistics and t-tests at a significance level of 0.05. Ordered logistic regression was used to establish the significance of association between sociodemographic characteristics and satisfaction.

Results

The majority of clients were satisfied with maternal and child services in primary (76.7%) and secondary (55.1%) healthcare facilities, respectively. There was a significant difference between satisfaction at primary and secondary healthcare centres (P=0.012). The marital status and number of pregnancies of participants were significant determinants of clients' satisfaction with secondary healthcare facilities (P=0.035 and P=0.013, respectively).

Conclusions

There is high patient satisfaction with maternal and child healthcare services in both primary and secondary healthcare facilities in Ile-Ife. The majority of the health facilities have inadequate personnel for maternal and child healthcare services, which is one of the major factors contributing to high maternal and infant morbidity and mortality in Nigeria. However, many of the respondents may not have ever experienced high-quality services. Stakeholders in maternal and child services should improve on areas where poor satisfaction was reported.
ECG of the month
Authors: Bloe Charlie
Published: August 2020

In this issue's ECG of the month, Charles Bloe presents the case of a smoker who self-presented at the emergency department.
A new species of the genus Xylodromus Heer, 1839 (Coleoptera: Staphylinidae: Omaliinae: Omaliini) from Jiangxi, China

Authors: SHAVRIN ALEXEY V.
Published: August 2020

A new species, Xylodromus schweiki sp. nov. (Staphylinidae: Omaliinae: Omaliini), is described and illustrated based on a male collected in Jiangxi, China. Key words: Coleoptera, Staphylinidae: Omaliinae: Xylodromus, taxonomy, new species, China, Palaearctic Region
Initial angular deformity and its recovery of the proximal tibial metaphyseal fracture according to the cause: Trampoline-related injury versus other injuries
Authors: Bae Kunhyung , Jeon Ji Young , Park Soo-Sung , Park Jinhee , Kang Michael Seungcheol
Published: August 2020

Purpose

This study investigated the initial angular deformity of proximal tibial metaphyseal fracture in children and its recovery during follow-up according to the cause of injury.

Methods

Prospective data about the patients with a proximal tibial metaphyseal fracture at the age less than six years and available follow-up data at two years post-trauma were retrospectively reviewed. They were grouped into trampoline-related injuries (TRI) and non-TRI groups based on the cause of injury. Proximal tibial valgus and recurvatum angles were measured to assess angular deformity on the coronal and sagittal planes, respectively.

Results

A total of 47 patients (33 TRI and 14 non-TRI) were included. Initially, the valgus angles were -1.5° in TRI and 1.6° in non-TRI groups (p < 0.001) and the recurvatum angles were 7.8° in TRI and 4.1° in non-TRI groups (p = 0.048). After two-year follow-up, the valgus angles were 0.2° in TRI and 0.9° in non-TRI groups (p = 0.070), and the recurvatum angles were 6.5° in TRI and 2.3° in non-TRI groups (p = 0.001).

Conclusion

For children with a proximal tibial metaphyseal fracture, the initial coronal deformity was different according to the injury cause (varus in TRI whereas valgus in non-TRI). Although there was a near complete recovery after approximately two years of follow-up in the coronal deformities, the sagittal deformity (genu recurvatum) seems to recover incompletely or tardily, especially for those caused by TRI.

Level of Evidence

III