bluuebunny/crossref_metadata_2025 huggingface dataset:
We birth with others: Towards a Beauvoirian understanding of obstetric violence
Authors: Shabot Sara Cohen
Published: May 2020

Obstetric violence – psychological and physical violence by medical staff towards women giving birth – has been described as structural violence, specifically as gender violence. Many women are affected by obstetric violence, with awful consequences. The phenomenon has so far been mainly investigated by the health and social sciences, yet fundamental theoretical and conceptual questions have gone unnoticed. Until now, the phenomenon of obstetric violence has been understood as one impeding autonomy and individual agency and control over the body. In this article I will argue that the phenomenon of obstetric violence occurs in a specific state of embodied vulnerability and that might be destructive for subjectivity since it fails to recognize that state and instead disallows support and demolishes relationships (among women and their lived-bodies; among women and their others) and interdependence. This might introduce a conceptual shift and the phenomenon might be reconceptualized as a moment where vulnerability is misrecognized and ambiguity, relations and support (rather than autonomy) are banned. In this case violence is recognized as cutting the original links to our bodies and the world that constitute our phenomenological condition, instead of as hurting the autonomous subject. Obstetric violence, thus, calls to be reflected upon through de Beauvoir’s ideas on ambiguity, the embodied and situated subject and the subject as essentially construed in relations. I believe that de Beauvoir’s conception of the authentic embodied subject as necessarily ambiguous – immanent and transcendent at the same time and ineludibly linked to the world and its others – will be extremely useful for construing this new understanding of how obstetric violence happens and of what precisely constitutes its damage.
Women in the Profession: An Update on the Gendered Composition of the Discipline and Political Science Departments in the UK
Authors: Pflaeger Young Zoe , Amery Fran , Holden Bates Stephen , McKay Stephen , Miller Cherry , Billings Taylor , Hayton Rebecca , Holt Marianne , Khatri Jasmine , Marvin Molly , Ogunsanya Lola , Ramdehal Alice , Sullivan Rosie
Published: May 2020

We present data on the proportions and seniority of female and male political scientists working in the UK. Comparing the results with previous research from 2011, we find that progress has been made. However, progress has been incremental and we find no qualitative changes in the status of female political scientists: they continue to be outnumbered by their male counterparts; they are overrepresented in the least senior job groups and underrepresented in the most senior; and the average female political scientist occupies a less senior position than the average male counterpart. We also run regression analyses to explore the impact of broader contextual factors on the proportion of female political scientists within a unit and that unit’s ‘gender seniority gap’. We find evidence that gender equality kitemarks, university mission group membership, the gender of the Head of Unit and Vice-Chancellor and the proportion of female members of university governance bodies appear to matter for one or both of these measures but not always in the direction that might be expected. These results, then, raise questions about what strategies might be pursued by those who wish to improve the status of women in the profession.
The Relationship Between Campus Recreation Facility Use and Retention for First-Time Undergraduate Students
Authors: Zegre Sera J. , Hughes Rodney P. , Darling Andrew M. , Decker Craig R.
Published: May 2020

This study examines the relationship between campus recreation facility access and first-year retention of full-time, first-time undergraduate students at a public university for 2014–2015 through 2016–2017. Authors examine differences between facility users and nonusers by pairing facility swipe card data with student records. Statistical analysis includes logistic regression and matching approaches, controlling for student demographics, academic preparedness, academic goals, family characteristics, and various environmental factors. Results show a positive and significant relationship between recreation facility use and retention, including 7.1 to 8.4 percentage points higher retention for users versus nonusers, holding other variables constant. Subsample analysis suggests the relationship between recreation facility use and retention differs across student subgroups. Key study contributions include linking card swipe data on facility usage with extensive student records, clearly defining facility users and nonusers, and introducing a new robustness check based on assignment of students to residence halls different distances from recreation facilities.
Quality enhancement of VVC intra-frame coding for multimedia services over the Internet
Authors: Cho Seunghyun , Kim Dong-Wook , Jung Seung-Won
Published: May 2020

In this article, versatile video coding, the next-generation video coding standard, is combined with a deep convolutional neural network to achieve state-of-the-art image compression efficiency. The proposed hierarchical grouped residual dense network exhaustively exploits hierarchical features in each architectural level to maximize the image quality enhancement capability. The basic building block employed for hierarchical grouped residual dense network is residual dense block which exploits hierarchical features from internal convolutional layers. Residual dense blocks are then combined into a grouped residual dense block exploiting hierarchical features from residual dense blocks. Finally, grouped residual dense blocks are connected to comprise a hierarchical grouped residual dense block so that hierarchical features from grouped residual dense blocks can also be exploited for quality enhancement of versatile video coding intra-coded images. Various non-architectural and architectural aspects affecting the training efficiency and performance of hierarchical grouped residual dense network are explored. The proposed hierarchical grouped residual dense network respectively obtained 10.72% and 14.3% of Bjøntegaard-delta-rate gains against versatile video coding in the experiments conducted on two public image datasets with different characteristics to verify the image compression efficiency.
The novel role of IL-37 to enhance the anti-inflammatory response of regulatory T cells in patients with peripheral atherosclerosis
Authors: Lotfy Hassan , Moaaz Marwa , Moaaz Mai
Published: May 2020

Objectives

Regulatory T cells (Tregs) mediate immunomodulation and protect against atherosclerosis. It is considered that reducing the amount of pro-inflammatory mediators could be achieved by enhancing the anti-inflammatory response, and this may be considered one of the main targets for therapy development. The inhibitory cytokines secreted by Tregs mainly include interleukin-10 (IL-10) and transforming growth factor-beta (TGF-β). Based on its known immunosuppressive involvement with other inflammatory disorders, we hypothesized that the newly characterized cytokine interleukin-37 (IL-37) might be associated with the inhibitory functions of Treg in atherosclerosis. Immune regulatory functions of IL-37 have not been completely clarified. Accordingly, we speculated that IL-37 might play a regulatory role in the immunosuppression of Tregs in atherosclerotic disease.

Methods

Real-time polymerase chain reaction and enzyme linked immunosorbent assay were used to test gene expression and protein levels of IL-37 in peripheral blood and localized freshly resected arterial tissues from 84 patients with peripheral arterial occlusive disease and 50 non-atherosclerotic subjects. Results were correlated to disease hallmarks. We also evaluated the ability of recombinant IL-37 to modulate Treg cytokine secretion and T cell inhibition in relation to atherosclerotic disorder in vitro. Results: Our results revealed that IL-37 was increased in patients with chronic lower limb atherosclerotic ischemia, compared to non-atherosclerotic controls. In addition, the expression levels of circulating IL-37 correlated with disease severity of chronic lower limb ischemia. Supplementation with rIL-37 augmented levels of released IL-10 and TGF-β in supernatants of T cells co-cultured with Tregs in the enrolled patients. Conclusions: Results suggest a role for IL-37 in mediating anti-inflammatory functions in the atherosclerotic process, potentially involving enhancement of Treg inhibitory function and anti-inflammatory cytokine secretion with a particularly marked direct response in severe disease.
Synthesis and characterization of novel coumarin-based terpyridine ligands and their Zn(II) complexes
Authors: Wang Xiaolong , Yue Xian , Deng Long
Published: May 2020

Two novel mononuclear Zn(II) complexes, [ZnL1Cl2] (1) (L1=( E)-3-(4-(2,2′:6′,2″-tripyridyl)-4′-styryl)-7-diethylaminocoumarin) and [ZnL2Cl2] (2) (L2=3-(4-(2,2′:6′,2″-tripyridyl)-4′-phenylimine)-7-diethylaminocoumarin), were obtained by the solvothermal method from ZnCl2 and coumarin-based terpyridine ligands. The complexes were characterized by spectroscopic methods and single-crystal X-ray diffraction. The Zn2+ in the complexes is coordinated by three nitrogen atoms of the terpyridine ligand and two chloride anions, forming a distorted trigonal bipyramidal environment. Moreover, the UV–Vis absorption and emission spectra of the ligands and complexes in diluted dichloromethane solutions were measured.
Class Dismissed? Explaining the Absence of Economic Injustice in the NLD’s Governing Agenda
Authors: McCarthy Gerard
Published: May 2020

Economic justice was the catch-cry of Burma’s independence struggle and a defining issue of postcolonial party politics. Yet, despite severe economic disparities and social vulnerability, class and inequality are now largely absent from the ideology and policy platform of Aung San Suu Kyi and her party, the National League for Democracy (NLD). What explains the absence of class inequality from contemporary Burmese politics? Drawing on historical research and extensive fieldwork in provincial Myanmar since 2013, this article focuses on how the junta’s post-1988 strategy of state-building shaped the political development of the NLD. It focuses specifically on how the military junta’s dissembling of Ne Win’s dysfunctional welfare state, control over market reform, and selective suppression of civil society privileged economic elites and religious philanthropic networks within the democracy movement while undermining labour activists and more overtly partisan groups. The resulting weakness of class-based interests within the democracy movement prior to 2011 has enabled commercial elites and market solutions to steer the organisational and ideological direction of Myanmar’s most prominent democratic political vehicle, the NLD, since liberalisation. Reflecting these social and institutional constraints, after taking office in 2016 the programmatic agenda of Suu Kyi’s NLD has plotted market liberalisation, foreign investment, and individual moral revival as the primary paths to a more “democratic” Myanmar, largely ignoring the dire inequality and economic injustices bequeathed by military dictatorship. If Myanmar’s democracy is to endure, the article concludes that structural reforms must be advanced, especially by the NLD, which encourage political representatives to address the precarity experienced by ordinary people.
Vietnam: Increasing influence in South East Asian affairs
Authors: Nguyen Thoi
Published: May 2020

Vietnam is an intriguing country. Its long history has been complicated by the rise and fall of different political formations and the vicissitudes of modern politics. After the Vietnam War ended in April 1975, the country was torn apart. The human, environmental and economic costs of the war had been overwhelming. Around 2.4 million people had died, mostly Vietnamese civilians, and thousands of Vietnamese had fled to new countries as refugees in search of a better life. The war caused a huge refugee crisis, with thousands of deaths at sea. Vietnam’s infrastructure – from roads to railways, buildings to bridges, and ports to power stations – was severely disrupted. However, Vietnam has changed significantly with the economic reform “Doi Moi” which was introduced in 1986. After the Soviet Union collapsed in December 1991, Vietnam lost its main supporter and the country faced a tough new challenge. Despite its difficulties, Vietnam has changed and grown as a political geographic centre in Asia, and its economy is growing significantly. Vietnam is a resilient country with over 97 million people, enjoying a rich cultural heritage. It has recently seen dramatic changes regarding climate change, the landscape, population, ruling powers, and politics. It is one of the countries in the world most vulnerable to climate change, and has adopted solutions to deal with this. This article will examine Vietnam’s foreign policy, and show how the country has played a key role in complex international events in Asia since its political and economic reforms. It will examine what has happened in Vietnam in recent years, how its climate attracts foreigners both as tourists and as investors, and the challenges and issues affecting the country.
The EMT modulator SNAI1 contributes to AML pathogenesis via its interaction with LSD1
Authors: Carmichael Catherine L. , Wang Jueqiong , Nguyen Thao , Kolawole Oluseyi , Benyoucef Aissa , De Mazière Charlotte , Milne Anna R. , Samuel Sona , Gillinder Kevin , Hediyeh-zadeh Soroor , Vo Anh N. Q. , Huang Yizhou , Knezevic Kathy , McInnes William R. L. , Shields Benjamin J. , Mitchell Helen , Ritchie Matthew E. , Lammens Tim , Lintermans Beatrice , Van Vlierberghe Pieter , Wong Nicholas C. , Haigh Katharina , Thoms Julie A. I. , Toulmin Emma , Curtis David J. , Oxley Ethan P. , Dickins Ross A. , Beck Dominik , Perkins Andrew , McCormack Matthew P. , Davis Melissa J. , Berx Geert , Zuber Johannes , Pimanda John E. , Kile Benjamin T. , Goossens Steven , Haigh Jody J.
Published: May 2020

Modulators of epithelial-to-mesenchymal transition (EMT) have recently emerged as novel players in the field of leukemia biology. The mechanisms by which EMT modulators contribute to leukemia pathogenesis, however, remain to be elucidated. Here we show that overexpression of SNAI1, a key modulator of EMT, is a pathologically relevant event in human acute myeloid leukemia (AML) that contributes to impaired differentiation, enhanced self-renewal, and proliferation of immature myeloid cells. We demonstrate that ectopic expression of Snai1 in hematopoietic cells predisposes mice to AML development. This effect is mediated by interaction with the histone demethylase KDM1A/LSD1. Our data shed new light on the role of SNAI1 in leukemia development and identify a novel mechanism of LSD1 corruption in cancer. This is particularly pertinent given the current interest surrounding the use of LSD1 inhibitors in the treatment of multiple different malignancies, including AML.
A hemophilia A mouse model for the in vivo assessment of emicizumab function
Authors: Ferrière Stephen , Peyron Ivan , Christophe Olivier D. , Kawecki Charlotte , Casari Caterina , Muczynski Vincent , Nathwani Amit , Kauskot Alexandre , Lenting Peter J. , Denis Cécile V.
Published: May 2020

The bispecific antibody emicizumab is increasingly used for hemophilia A treatment. However, its specificity for human factors IX and X (FIX and FX) has limited its in vivo functional analysis to primate models of acquired hemophilia. Here, we describe a novel mouse model that allows emicizumab function to be examined. Briefly, FVIII-deficient mice received IV emicizumab 24 hours before tail-clip bleeding was performed. A second infusion with human FIX and FX, administered 5 minutes before bleeding, generated consistent levels of emicizumab (0.7-19 mg/dL for 0.5-10 mg/kg doses) and of both FIX and FX (85 and 101 U/dL, respectively, after dosing at 100 U/kg). Plasma from these mice display FVIII-like activity in assays (diluted activated partial thromboplastin time and thrombin generation), similar to human samples containing emicizumab. Emicizumab doses of 1.5 mg/kg and higher significantly reduced blood loss in a tail-clip–bleeding model using FVIII-deficient mice. However, reduction was incomplete compared with mice treated with human FVIII concentrate, and no difference in efficacy between doses was observed. From this model, we deducted FVIII-like activity from emicizumab that corresponded to a dose of 4.5 U of FVIII per kilogram (ie, 9.0 U/dL). Interestingly, combined with a low FVIII dose (5 U/kg), emicizumab provided enough additive activity to allow complete bleeding arrest. This model could be useful for further in vivo analysis of emicizumab.
Risk stratification in pulmonary arterial hypertension using Bayesian analysis
Authors: Kanwar Manreet K. , Gomberg-Maitland Mardi , Hoeper Marius , Pausch Christine , Pittrow David , Strange Geoff , Anderson James J. , Zhao Carol , Scott Jacqueline V. , Druzdzel Marek J. , Kraisangka Jidapa , Lohmueller Lisa , Antaki James , Benza Raymond L.
Published: May 2020

Background

Current risk stratification tools in pulmonary arterial hypertension (PAH) are limited in their discriminatory abilities, partly due to the assumption that prognostic clinical variables have an independent and linear relationship to clinical outcomes. We sought to demonstrate the utility of Bayesian network-based machine learning in enhancing the predictive ability of an existing state-of-the-art risk stratification tool, REVEAL 2.0.

Methods

We derived a tree-augmented naïve Bayes model (titled PHORA) to predict 1-year survival in PAH patients included in the REVEAL registry, using the same variables and cut-points found in REVEAL 2.0. PHORA models were validated internally (within the REVEAL registry) and externally (in the COMPERA and PHSANZ registries). Patients were classified as low-, intermediate- and high-risk (<5%, 5–20% and >10% 12-month mortality, respectively) based on the 2015 European Society of Cardiology/European Respiratory Society guidelines.

Results

PHORA had an area under the curve (AUC) of 0.80 for predicting 1-year survival, which was an improvement over REVEAL 2.0 (AUC 0.76). When validated in the COMPERA and PHSANZ registries, PHORA demonstrated an AUC of 0.74 and 0.80, respectively. 1-year survival rates predicted by PHORA were greater for patients with lower risk scores and poorer for those with higher risk scores (p<0.001), with excellent separation between low-, intermediate- and high-risk groups in all three registries.

Conclusion

Our Bayesian network-derived risk prediction model, PHORA, demonstrated an improvement in discrimination over existing models. This is reflective of the ability of Bayesian network-based models to account for the interrelationships between clinical variables on outcome, and tolerance to missing data elements when calculating predictions.
Early childhood respiratory morbidity and antibiotic use in ex-preterm infants: a primary care population-based cohort study
Authors: Tan Shin , Szatkowski Lisa , Moreton William , Fiaschi Linda , McKeever Tricia , Gibson Jack , Sharkey Don
Published: May 2020

Background

Globally, bronchopulmonary dysplasia (BPD) continues to increase in preterm infants. Recent studies exploring subsequent early childhood respiratory morbidity have been small or focused on hospital admissions.

Aims

To examine early childhood rates of primary care consultations for respiratory tract infections (RTI), lower respiratory tract infections (LRTI), wheeze and antibiotic prescriptions in ex-preterm and term children. A secondary aim was to examine differences between preterm infants discharged home with or without oxygen.

Methods

Retrospective cohort study using linked electronic primary care and hospital databases of children born between 1997 and 2014. We included 253 277 eligible children, with 1666 born preterm at <32 weeks' gestation, followed-up from primary care registration to age 5 years. Adjusted incidence rate ratios (aIRRs) were calculated.

Results

Ex-preterm infants had higher rates of morbidity across all respiratory outcomes. After adjusting for confounders, aIRRs for RTI (1.37, 95% CI 1.33–1.42), LRTI (2.79, 95% CI 2.59–3.01), wheeze (3.05, 95% CI 2.64–3.52) and antibiotic prescriptions (1.49, 95% CI 1.44–1.55) were higher for ex-preterm infants. Ex-preterm infants discharged home on oxygen had significantly greater morbidity across all respiratory diagnoses and antibiotic prescriptions compared to those without home oxygen. The highest rates of respiratory morbidity were observed in children from the most deprived socioeconomic groups.

Conclusion

Ex-preterm infants, particularly those with BPD requiring home oxygen, have significant respiratory morbidity and antibiotic prescriptions in early childhood. With the increasing prevalence of BPD, further research should focus on strategies to reduce the burden of respiratory morbidity in these high-risk infants after hospital discharge.
Comparison of personal and shared frameshift neoantigen vaccines in a mouse mammary cancer model
Authors: Peterson Milene , Murphy Sierra Nicole , Lainson John , Zhang Jian , Shen Luhui , Diehnelt Chris W. , Johnston Stephen Albert
Published: May 2020

Background

It is widely hoped that personal cancer vaccines will extend the number of patients benefiting from checkpoint and other immunotherapies. However, it is clear creating such vaccines will be challenging. It requires obtaining and sequencing tumor DNA/RNA, predicting potentially immunogenic neoepitopes and manufacturing a one-use vaccine. This process takes time and considerable cost. Importantly, most mutations will not produce an immunogenic peptide and many patient’s tumors do not contain enough DNA mutations to make a vaccine. We have discovered that frameshift peptides (FSP) created from errors in the production of RNA rather than from DNA mutations are potentially a rich source of neoantigens for cancer vaccines. These errors are predictable, enabling the production of a FSP microarray. Previously we found that these microarrays can identify both personal and shared neoantigens. Here, we compared the performance of personal cancer vaccines (PCVs) with that of a shared antigen vaccine, termed Frameshift Antigen Shared Therapeutic (FAST) vaccine, using the 4 T1 breast cancer model. Sera from 4 T1-tumor bearing mice were assayed on the peptide microarray containing 200 Fs neoantigens, for the PCV, the top 10 candidates were select and personal vaccines constructed and administrated to the respective mice. For the FAST, we selected the top 10 candidates with higher prevalence among all the mice challenged. Seven to 12 days challenged mice were immunized, combined or not with immune checkpoint inhibitor (ICI) (αPD-L1 and αCTLA-4). Primary and secondary tumor clearance and growth were evaluated as well as cellular and humoral immune response against the vaccine targets by IFN-γ ELISPOT and ELISA. Lastly, we analyzed the immune response of the FAST-vaccinated mice by flow cytometry in comparison to the control group.

Results

We found that PCVs and FAST vaccines both reduced primary tumor incidence and growth as well as lung metastases when delivered as monotherapies or in combination with ICI. Additionally, the FAST vaccine induces a robust and effective T-cell response.

Conclusions

These results suggest that FSPs produced from RNA-based errors are potent neoantigens that could enable production of off-the-shelf shared antigen vaccines for solid tumors with efficacy comparable to that of PCVs.
Evaluating the effects of a risk-adapted screening program for familial colorectal cancer in individuals between 25 and 50 years of age: study protocol for the prospective population-based intervention study FARKOR
Authors: Hoffmann Sabine , Crispin Alexander , Lindoerfer Doris , Sroczynski Gaby , Siebert Uwe , Mansmann Ulrich , Consortium FARKOR
Published: May 2020

Background

Colorectal cancer (CRC) is the second most common malignant disease and the second most common cause of cancer death in Germany. Official CRC screening starts at age 50. As there is evidence that individuals with a family history of CRC have an increased risk of developing CRC before age 50, there are recommendations to start screening for this group earlier. This study aims to evaluate the clinical and economic effects of a risk-adapted screening program for CRC in individuals between 25 and 50 years of age with potentially increased familial CRC risk.

Methods

FARKOR (Familiäres Risiko für das Kolorektale Karzinom) is a population-based prospective intervention study. All members of cooperating statutory health insurance companies between 25 and 50 years of age living in a model region in Germany (federal state of Bavaria, 3.5 million inhabitants in this age group) can participate in the program between October 2018 and March 2020. Recruitment takes place through physicians and through a public campaign. Additionally, insurances contact recently diagnosed CRC patients in order to encourage their relatives to participate in the program. Physicians assess a participant’s familial history of CRC using a short questionnaire. All participants with a family history of CRC are invited to a shared decision making process to decide on further screening options consisting of either undergoing an immunological test for fecal occult blood or colonoscopy. Comprehensive data collection based on self-reported lifestyle information, medical documentation and health administrative databases accompanies the screening program. Longterm benefits, harms and the cost-effectiveness of the risk-adapted CRC screening program will be assessed by decision analytic modeling.

Discussion

The data collected in this study will add important pieces of information that are still missing in the evaluation of the effects and the cost-effectiveness of a risk-adapted CRC screening strategy for individuals under 50 years of age.

Trial registration

German Clinical Trials Register, DRKS-IDDRKS00015097.
Feasibility of using an led-probe in third-space endoscopy: a clinical study
Authors: Hernández Mondragón Oscar Víctor , Zamarripa Mottú Raúl , Solórzano Pineda Omar , Gutierrez Aguilar Raúl Alberto , García Contreras Luís Fernando
Published: May 2020

Background

Third-space endoscopy is a novel, safe, and effective method for treating different gastrointestinal conditions. However, several failed endoscopic procedures are attributed to incomplete myotomy. Lighting devices are used to prevent organic injuries. We aimed to investigate the feasibility of using a hand-made LED-probe (LP) in third-space procedures.

Methods

This prospective study was conducted in a tertiary-care center in Mexico between December 2016 and January 2019. We included peroral endoscopic myotomy (POEM) and gastric peroral endoscopic myotomy(G-POEM) procedures. Pseudoachalasia, peptic ulcer, normal gastric emptying scintigraphy (GES) and prepyloric tumors were excluded. LP was used to guide or confirm procedures. Clinical and procedural characteristics were recorded and analyzed.

Results

Seventy third-space procedures were included (42POEM,28G-POEM), with an average patient age of 46.7 ± 14.3 and 43.7 ± 10.1 years, respectively. For the POEM and G-POEM groups, respectively, 18/42(42.9%) and 13/28(46.7%) patients were males; median procedure times were 50 (interquartile range [IQR]: 38–71) and 60(IQR: 48–77) min, median LP placement times were 5(IQR: 4-6) and 6(IQR: 5-7) min, mild adverse events occurred in 4(9.4%) and 4(14.2%) of cases, and clinical success at 6 months occurred in 100 and 85.7% of cases. Integrated relaxation pressure (IRP) improved from 27.3 ± 10.8 to 9.5 ± 4.1 mmHg (p < 0.001); retention percentage at 4 h also improved. LP was successfully placed and adequate myotomy confirmed including 14.2 and 17.8% of POEM and G-POEM difficult patients.

Conclusions

Using an LP is promising and allows guiding during third-space procedures either for submucosal tunnel creation or myotomy confirmation, with excellent safety and efficacy in clinical practice.
Frailty Index and functional level upon admission predict hospital outcomes: an interRAI-based cohort study of older patients in post-acute care hospitals
Authors: Kerminen Hanna , Huhtala Heini , Jäntti Pirkko , Valvanne Jaakko , Jämsen Esa
Published: May 2020

Background

Geriatric assessment upon admission may reveal factors that contribute to adverse outcomes in hospitalized older patients. The purposes of this study were to derive a Frailty Index (FI-PAC) from the interRAI Post-Acute Care instrument (interRAI-PAC) and to analyse the predictive ability of the FI-PAC and interRAI scales for hospital outcomes.

Methods

This retrospective cohort study was conducted by combining patient data from interRAI-PAC with discharge records from two post-acute care hospitals. The FI-PAC was derived from 57 variables that fulfilled the Frailty Index criteria. Associations of the FI-PAC and interRAI-PAC scales (ADLH for activities of daily living, CPS for cognition, DRS for mood, and CHESS for stability of health status) with hospital outcomes (prolonged hospital stay ≥90 days, emergency department admission during the stay, and in-hospital mortality) were analysed using logistic regression and ROC curves.

Results

The cohort included 2188 patients (mean age (SD) 84.7 (6.3) years) who were hospitalized in two post-acute care hospitals. Most patients (n = 1691, 77%) were discharged and sent home. Their median length of stay was 35 days (interquartile range 18–87 days), and 409 patients (24%) had a prolonged hospital stay. During their stay, 204 patients (9%) were admitted to the emergency department and 231 patients (11%) died. The FI-PAC was normally distributed (mean (SD) 0.34 (0.15)). Each increase of 0.1 point in the FI-PAC increased the likelihood of prolonged hospital stay (odds ratio [95% CI] 1.91 [1.73─2.09]), emergency admission (1.24 [1.11─1.37]), and in-hospital death (1.82 [1.63─2.03]). The best instruments for predicting prolonged hospital stay and in-hospital mortality were the FI-PAC and the ADLH scale (AUC 0.75 vs 0.72 and 0.73 vs 0.73, respectively). There were no differences in the predictive abilities of interRAI scales and the FI-PAC for emergency department admission.

Conclusions

The Frailty Index derived from interRAI-PAC predicts adverse hospital outcomes. Its predictive ability was similar to that of the ADLH scale, whereas other interRAI-PAC scales had less predictive value. In clinical practice, assessment of functional ability is a simple way to assess a patient’s prognosis.
MiR-18a and miR-18b are expressed in the stroma of oestrogen receptor alpha negative breast cancers
Authors: Egeland Nina Gran , Jonsdottir Kristin , Aure Miriam Ragle , Sahlberg Kristine , Kristensen Vessela N. , Cronin-Fenton Deirdre , Skaland Ivar , Gudlaugsson Einar , Baak Jan P. A. , Janssen Emiel A. M.
Published: May 2020

Background

Previously, we have shown that miR-18a and miR-18b gene expression strongly correlates with high proliferation, oestrogen receptor -negativity (ER−), cytokeratin 5/6 positivity and basal-like features of breast cancer.

Methods

We investigated the expression and localization of miR-18a and -18b in formalin fixed paraffin embedded (FFPE) tissue from lymph node negative breast cancers (n = 40), by chromogenic in situ hybridization (CISH). The expression level and in situ localization of miR-18a and -18b was assessed with respect to the presence of tumour infiltrating lymphocytes (TILs) and immunohistochemical markers for ER, CD4, CD8, CD20, CD68, CD138, PAX5 and actin. Furthermore, in two independent breast cancer cohorts (94 and 377 patients) the correlation between miR-18a and -18b expression and the relative quantification of 22 immune cell types obtained from the CIBERSORT tool was assessed.

Results

CISH demonstrated distinct and specific cytoplasmic staining for both miR-18a and miR-18b, particularly in the intratumoural stroma and the stroma surrounding the tumour margin. Staining by immunohistochemistry revealed some degree of overlap of miR-18a and -18b with CD68 (monocytes/macrophages), CD138 (plasma cells) and the presence of high percentages of TILs. CIBERSORT analysis showed a strong correlation between M1-macrophages and CD4+ memory activated T-cells with mir-18a and -18b.

Conclusions

Our study demonstrates that miR-18a and miR-18b expression is associated with ER- breast tumours that display a high degree of inflammation. This expression is potentially associated specifically with macrophages. These results suggest that miR-18a and miR-18b may play a role in the systemic immunological response in ER− tumours.
Influential factors on sexual function in infertile women with endometriosis: a path analysis
Authors: Youseflu Samaneh , Jahanian Sadatmahalleh Shahideh , Bahri Khomami Mahnaz , Nasiri Malihe
Published: May 2020

Background

Endometriosis have a negative influence on women’s sexual life. The aim of the current study was to test a conceptual model considering the interrelated role of anxiety, depression, sleep quality, physical activity, BMI, stage of endometriosis, the intensity of dyspareunia and pelvic pain on sexual function (SF) in infertile women with endometriosis. Also test the mediating role of sleep quality, anxiety, and depression.

Method

In the present cross-sectional study, 220 infertile women with a laparoscopically confirmed endometriosis were recruited. Data were collected using a socio-demographic checklist, Female Sexual Function Index (FSFI), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Visual Analog Scale (VAS).

Results

We found that anxiety, depression, sleep quality, BMI, level of education, stage of endometriosis, and dyspareunia have a direct effect on women’s SF. In our study, sleep quality, anxiety, pelvic pain, and depression were the four major mediators that the higher scores lead to a decrease in the SF of endometriosis patients. The intensity of pelvic pain with an effect on sleep quality (SQ) and dyspareunia change women’s SF. The lower level of physical activity, and higher BMI with indirect effect thorough anxiety, and SQ can worsen SF. Also, a higher level of anxiety leads to poor SQ and depression. Anxiety with both direct and indirect effect impress women’s SF.

Conclusion

It seems that the main risk factors for sexual dysfunction in women with endometriosis are higher rates of anxiety, depression, poor sleep quality, pelvic pain, and dyspareunia. In the care of women with endometriosis, not only laparoscopy and medical treatment should be performed but also psychotherapeutic and psychosexual help should be offered.
Does the chronically ill population in the Netherlands switch their health insurer as often as the general population? Empirical evidence from a nationwide survey study
Authors: van der Schors Wouter , Brabers Anne E. M. , De Jong Judith D.
Published: May 2020

Background

Consumer mobility is an important aspect of a health insurance system based on managed competition. Both the general population and insured with a chronic illness should enjoy an equal opportunity to switch their insurer every year. We studied possible differences in the rates of switching between these two groups in the Netherlands.

Methods

A structured questionnaire was sent to 1500 members of Nivel’s Dutch Health Care Consumer Panel (response rate: 47%) and to 1911 chronically ill members of the National Panel of the Chronically ill and Disabled (response rate: 84%) in February 2016. Associations between switching and background characteristics were estimated using logistic regression analyses with interaction effects.

Results

In general, we did not find significant differences in switching rates between the general population and chronically ill population. However, a combination of the population and background characteristics demonstrated that young insured with a chronic illness switched significantly less often than young insured from the general population (1% versus 17%).

Conclusions

Our results demonstrated that the group of young people with a chronic illness is less inclined to switch insurer. This observation suggests that this group might either face difficulties or barriers which prevents them from switching, or that they experience a high level of satisfaction with their current insurer. Further research should therefore focus on unravelling the mechanisms which explain the differences in switching rates.
Fasting to enhance Cancer treatment in models: the next steps
Authors: Zhang Jing , Deng Yanlin , Khoo Bee Luan
Published: May 2020

Short-term fasting (STF) is a technique to reduce nutrient intake for a specific period. Since metabolism plays a pivotal role in tumor progression, it can be hypothesized that STF can improve the efficacy of chemotherapy. Recent studies have demonstrated the efficacy of STF in cell and animal tumor models. However, large-scale clinical trials must be conducted to verify the safety and effectiveness of these diets. In this review, we re-examine the concept of how metabolism affects pathophysiological pathways. Next, we provided a comprehensive discussion of the specific mechanisms of STF on tumor progression, derived through studies carried out with tumor models. There are currently at least four active clinical trials on fasting and cancer treatment. Based on these studies, we highlight the potential caveats of fasting in clinical applications, including the onset of metabolic syndrome and other metabolic complications during chemotherapy, with a particular focus on the regulation of the epithelial to mesenchymal pathway and cancer heterogeneity. We further discuss the advantages and disadvantages of the current state-of-art tumor models for assessing the impact of STF on cancer treatment. Finally, we explored upcoming fasting strategies that could complement existing chemotherapy and immunotherapy strategies to enable personalized medicine. Overall, these studies have the potential for breakthroughs in cancer management.
SARS-CoV-2 RNA polymerase as target for antiviral therapy
Authors: Buonaguro Luigi , Tagliamonte Maria , Tornesello Maria Lina , Buonaguro Franco M.
Published: May 2020

A new human coronavirus named SARS-CoV-2 was identified in several cases of acute respiratory syndrome in Wuhan, China in December 2019. On March 11 2020, WHO declared the SARS-CoV-2 infection to be a pandemic, based on the involvement of 169 nations. Specific drugs for SARS-CoV-2 are obviously not available. Currently, drugs originally developed for other viruses or parasites are currently in clinical trials based on empiric data. In the quest of an effective antiviral drug, the most specific target for an RNA virus is the RNA-dependent RNA-polymerase (RdRp) which shows significant differences between positive-sense and negative-sense RNA viruses. An accurate evaluation of RdRps from different viruses may guide the development of new drugs or the repositioning of already approved antiviral drugs as treatment of SARS-CoV-2. This can accelerate the containment of the SARS-CoV-2 pandemic and, hopefully, of future pandemics due to other emerging zoonotic RNA viruses.
Oncolytic Newcastle disease virus delivered by Mesenchymal stem cells-engineered system enhances the therapeutic effects altering tumor microenvironment
Authors: Keshavarz Mohsen , Ebrahimzadeh Mir Saeed , Miri Seyed Mohammad , Dianat-Moghadam Hassan , Ghorbanhosseini Seyedeh Sara , Mohebbi Seyed Reza , Keyvani Hossein , Ghaemi Amir
Published: May 2020

Background

Human papillomavirus (HPV)-associated malignancy remain a main cause of cancer in men and women. Cancer immunotherapy has represented great potential as a new promising cancer therapeutic approach. Here, we report Mesenchymal stem cells (MSCs) as a carrier for the delivery of oncolytic Newcastle disease virus (NDV) for the treatment of HPV-associated tumor.

Methods

For this purpose, MSCs obtained from the bone marrow of C57BL mice, then cultured and characterized subsequently by the flow cytometry analysis for the presence of cell surface markers. In this study, we sought out to determine the impacts of MSCs loaded with oncolytic NDV on splenic T cell and cytokine immune responses, caspase-3 and -9 expression, and myeloid and myeloid-derived suppressor cells (MDSCs) by histological and immunohistochemical studies in the tumor microenvironment (TME).

Results

Our findings proved that MSCs possess both migratory capacity and tumor tropism toward transplanted tumor tissue after peritumoral administration. Tumor therapy experiments indicated that oncolytic NDV delivered by MSCs-engineered system significantly reduces tumor growth, which is associated with the enhancement of E7-specific lymphocyte proliferation, CD8+ T cell cytolysis responses, and splenic IFN-γ, IL-4 and IL-12 responses compared with control groups. Moreover, the treatment upregulated the concentration of apoptotic proteins (caspase 9) and increased infiltration of tumor microenvironment with CD11b + myeloid and Gr1 + MDSCs cells.

Conclusions

Our data suggest MSCs carrying oncolytic NDV as a potentially effective strategy for cancer immunotherapy through inducing splenic Th1 immune responses and apoptosis in the tumor microenvironment.
Maternal health services utilisation among primigravidas in Uganda: what did the MDGs deliver?
Authors: Atuoye Kilian Nasung , Barnes Ethel , Lee Melissa , Zhang Lily Ziyue
Published: May 2020

Background

Achieving maternal health outcomes in the SDGs requires the implementation of more targeted policies and strategies. While the MDGs may have deepened our understanding in this regard, we know little about the trends in maternal health services utilisation among primigravidas, and how age and geographical regions could have influenced these trends. In this study, we examined utilisation of antenatal and skilled delivery services among primigravidas in Uganda, a country with one of the highest maternal mortality ratios, and where early childbearing and its attendant challenges are common.

Methods

Guided by Andersen’s Behavioural Model, we fitted multivariate regression models to a pooled dataset of the 2006, 2011 and 2016 Ugandan Demographic and Health Survey (n = 3477) to understand the dynamics in Antenatal Care (ANC) and Skilled Birth Attendance (SBAs) utilisation among primigravidas. Post-estimation margins were employed to further highlight the effect of age and geographical regions.

Results

The analyses show an improvement in access to maternal health services among primigravidas from 2006 to 2016. Compared to 2006, primigravidas in 2016 were 48%, 24% and 2.98 times more likely to have early ANC, four or more ANC visits, and SBAs, respectively. Altogether, a primigravida in 2016 relative to 2006 was 42% more likely to meet all three maternal health service indicators. Post-estimation margins analyses on age and geographical disparities revealed that younger primigravidas have lower probability, while primigravidas in Eastern Region, one of the most deprived in the country, have the lowest probability of accessing maternal health services. Also, the study found education, wealth, women’s household decision-making power, place of residence as important determinants of ANC visits and SBAs.

Conclusions

Based on our findings, it is important to address the vulnerabilities of primigravidas, particularly younger individuals, in accessing early ANC. Uganda should scale-up decentralisation and integration of maternal health delivery in local communities as a strategy of addressing lingering geographical disparities, and ultimately improve maternal health outcomes in the SDGs period.
Soliton and lump-soliton solutions in the Grammian form for the Bogoyavlenskii–Kadomtsev–Petviashvili equation
Authors: Rui Wenjuan , Zhang Yufeng
Published: May 2020

This paper investigates the Bogoyavlenskii–Kadomtsev–Petviashvili (BKP) equation by using Hirota’s direct method and the Kadomtsev–Petviashvili (KP) hierarchy reduction method. Soliton solutions in the Grammian determinant form for the BKP-II equation are obtained and soliton collisions are shown graphically. Lump-soliton solutions for the BKP-I equation are presented in terms of the Grammian determinants. Various evolution processes of the lump-soliton solutions are demonstrated graphically through the study of three kinds of lump-soliton solutions. The fusion of lumps and kink solitons into kink solitons and the fission of kink solitons into lumps and kink solitons are observed in the interactions of lumps and solitons.
Stability switches in a ring-structured predator–prey metapopulation model with dispersal delay
Authors: Sun Guowei , Mai Ali
Published: May 2020

In this paper, we consider a predator–prey metapopulation model with a ring-structured configuration of an arbitrary and finite number of patches. The prey are assumed to disperse between the connected patches with a constant dispersal delay. We show that the dispersal delay can induce stability switches exhibiting both stabilizing and destabilizing roles in the stability of the symmetric coexistence equilibrium. Numerical simulations are presented to further illustrate the effects of the dispersal delay, the dispersal rate, the fraction of dispersal due to predation avoidance and the network topology on the number of stability switches.
Current review of Excimer laser Trabeculostomy
Authors: Durr Georges M. , Töteberg-Harms Marc , Lewis Richard , Fea Antonio , Marolo Paola , Ahmed Iqbal Ike K.
Published: May 2020

Background

Excimer laser trabeculostomy (ELT) is a microinvasive glaucoma surgery (MIGS) that creates multiple laser channels through the trabecular meshwork using a cold laser system, which minimizes tissue fibrosis and aids in bypassing the main area of resistance to aqueous outflow. The purpose of this review is to evaluate the current body of evidence surrounding ELT in terms of efficacy and review the safety profile of the procedure.

Main text

Studies screened had to show clear inclusion and exclusion criteria as well as well-defined outcome measures. PubMed, MEDLINE, EMBASE and the Cochrane Controlled Trial Database were searched. Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines were used to assess for study quality and for any bias. Sixty-four articles were initially identified with 18 meeting preliminary screening criteria. Ultimately, 8 studies met inclusion criteria and 2 additional non-referenced publications were also included: 1 randomized control trial, 4 prospective case series and 5 retrospective studies. Overall studies showed moderate intraocular pressure (IOP) lowering of between 20% and 40% from baseline without medication washout and mostly a decrease in glaucoma medications with few complications.

Conclusion

Current literature shows a significant IOP-lowering effect of ELT with a favorable safety-profile in standalone cases or combined with cataract surgery. Limitations to these studies are the lack of controls and washout IOP. Overall, ELT is an attractive MIGS option that does not require any residual device remaining in the angle.
Correction to: Delineating forest stands from grid data
Authors: Pukkala Timo
Published: May 2020

In the original publication of this article Pukkala, 2020 the Fig. 6 is not correct, the correct figure is as below. The error in this Correction and low quality Fig. 4 and Fig. 5 have been updated in the original article and the caption of Fig. 5 was modified.