bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time
Authors: Chen Lionel , Syn Nicholas L. , Goh Brian K. P. , Cheow Peng Chung , Raj Prema , Koh Yexin , Chung Alexander , Lee Ser Yee , Ooi London Lucien , Chan Chung Yip , Teo Jin Yao
Published: September 2020

Background

Resection of colorectal liver metastases (CLM) has been established as the standard of care. This study aims to compare the change in clinicopathological characteristics of patients who underwent curative resection of CLM across two time periods—2000 to 2010 (P1) and 2011 to 2016 (P2) and evaluate the prognostic impact of these characteristics on survival outcomes.

Methods

Patients who undergo liver resection for CLM at Singapore General Hospital from January 2000 to December 2016 were identified from a prospectively maintained database. The primary end point was overall survival.

Results

There were 183/318 (57.5%) patients and 135/318 (42.5%) patients in P1 and P2, respectively. There was a lower proportion of patients who had nodal metastases from primary colorectal cancer and clinical risk score (CRS) less than 3 in P2 when compared to P1. There was no difference in survival between both time periods. Independent predictors of survival for the cohort were CEA levels ≥ 200 ng/ml, primary tumour grade and lymph nodal status. Independent predictors of poor survival in P1 were poorly differentiated colorectal cancer and nodal metastases while in P2, independent predictors of poor survival were multiple liver metastases and nodal metastases.

Conclusion

Nodal metastases from primary colorectal cancer are an independent predictor of poor survival across time for resectable CLM. Although there is no difference in survival between the two time periods, patients with multiple liver metastases should be carefully considered prior to surgery as it is also an independent predictor of overall survival.
Capacity for health economics research and practice in Jordan, Lebanon, the occupied Palestinian territories and Turkey: needs assessment and options for development
Authors: Gheorghe Adrian , Gad Mohamed , Ismail Sharif A. , Chalkidou Kalipso
Published: September 2020

Background

Capacity for health economics analysis and research is indispensable for evidence-informed allocations of scarce health resources; however, little is known about the experience and capacity strengthening preferences of academics and practitioners in the Eastern Mediterranean region. This study aimed to assess the needs for strengthening health economics capacity in Jordan, Lebanon, the occupied Palestinian territories and Turkey as part of the Research for Health in Conflict in the Middle East and North Africa (R4HC) project.

Methods

We combined a bibliometric analysis of health economics outputs based on a literature search conducted across seven databases with an online survey of academic researchers and non-academic practitioners. The records included in the bibliometric analysis were original studies and reviews with an explicit economic outcome related to health, disease or disability, had at least one author in Jordan, Lebanon, Palestine or Turkey, and were published between January 2014 and December 2018. Two types of analyses were conducted using VOSviewer software, namely keyword co-occurrence and co-publication networks across countries and organisations. The online survey asked academic researchers, analysts and decision-makers – identified through the bibliometric analysis and regional professional networks – about previous exposure to and priorities for capacity development in health economics.

Results

Of 15,185 records returned by the literature search, 566 were included in the bibliometric analysis. Organisations in Turkey contributed more than 80% of records and had the broadest and most diverse network of collaborators, nationally and internationally. Only 1% (n = 7) of studies were collaborations between researchers in two or more different jurisdictions. Cost analysis, cost-effectiveness analysis and health system economics were the main health economics topics across the included studies. Economic evaluations, measuring the economic burden of disease and health equity, were reported by survey respondents (n = 80) as the most important areas to develop in. Short courses, learn-by-doing and mentoring from an experienced professional were, in aggregate, the most preferred learning styles.

Conclusions

Existing pockets of health economic expertise in the region can constitute the base of future capacity development efforts. Building confidence toward applying specific methods and trust toward stimulating cross-jurisdiction collaborations appear essential components for sustainably developing health economics capacity.
Lupeol inhibits osteosarcoma progression by up-regulation of HMGA2 via regulating miR-212-3p
Authors: Zhong Jinghua , He Chunlei , Xu Fangtian , Xu Xianyun , Liu Lulin , Xu Mingjun , Guo Zheng , Wang Yili , Liao Jiahua , Li Yonghong
Published: September 2020

Background

Osteosarcoma (OS) is a common severe illness globally. Lupeol has been reported to participate in the pathophysiologic properties of various cancers, including OS. This study aimed to explore the effects of lupeol on proliferation, invasion, and apoptosis on OS cells and the underlying mechanism.

Methods

The cell viability of OS cells was determined by 3-(4, 5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. The expression levels of miR-212-3p and high-mobility group AT-hook 2 (HMGA2) were detected by quantitative real-time polymerase chain reaction (qRT-PCR) in OS cells. The cell apoptosis and invasion were detected by flow cytometry and transwell invasion assays, respectively. The functional target of miR-212-3p was predicted by online software and confirmed by luciferase reporter assay. The protein level of HMGA2 was measured by western blot analysis.

Results

Lupeol suppressed cell viability and invasion, and promoted apoptosis by upregulating the expression of miR-212-3p in OS cells. Knockdown of miR-212-3p restored the anti-tumor effect of lupeol. Interestingly, miR-212-3p directly targeted HMGA2 and suppressed its expression. Moreover, HMGA2 reversed the inhibited impact on viability and invasion, and the promoted effect on apoptosis induced by upregulation of miR-212-3p. Also, lupeol administration exerts its anti-tumor effect by overexpression of miR-212-3p to suppress the expression of HMGA2 in OS cells.

Conclusion

Lupeol inhibited OS progression by modulating the miR-212-3p/HMGA2 axis in vitro.
A novel arthroscopically assisted reduction technique for three patterns of posterolateral tibial plateau fractures
Authors: Yang Yang , Zhou Xiaoxiao , Ji Houlin , Zhou Xiaobo , Ye Linchao , Zhang Mengqin
Published: September 2020

Background

Posterolateral tibial plateau fractures (PTPF) remain a challenge for orthopedics surgeons because the special anatomical structures of the posterolateral corner of knee joint including the fibular head, the lateral collateral ligament, and the peroneal nerve, which impedes the exposure of the fracture fragments and need irregular implants to get a stable fixation. The purpose of present study was to introduce a new articular fracture fragments restoration technique for three patterns of PTPF and investigate the relationship between associated soft injuries and fracture patterns.

Methods

From May 2016 to April 2018, 31 patients with PTPF who had undertaken arthroscopically assisted reduction and fixation (AARF) were enrolled in present study. Demographic data, pre-operation, and post-operation X plan films, three-dimensional computed tomography (CT) scans and magnetic resonance imaging (MRI) were reviewed. Present samples were divided into three patterns with lateral inclination (LI), posterior inclination (PI), and parallel compression (PC) according to the orientation of the articular fragment inclination. Rasmussen anatomical score was used to assess the radiological results. Rasmussen functional score, Hospital for Special Surgery knee-rating Score (HSS), and range of motion (ROM) of the knee joint at the final follow-up were measured to evaluate the clinical outcomes.

Results

In this series, the post-operation tibial plateau angle (TPA) was 9.7° ± 3.5°(range 4.0°–15.8°) and the Rasmussen anatomical score was 17.7 ± 0.7(range 16–18); clinical outcomes showed that the HSS score was 92.7 ± 21.8 (range 90–96) and the Rasmussen functional score was 27.9 ± 1.0 (range 26–30). Of all the patients, the anterior cruciate ligament (ACL) injuries including the ACL tibial attachment ruptures occurred in 16 patients (51.6%), meniscus lesions happened in 19 patients (61.3%), medial collateral ligament (MCL) injuries were founded in 13 patients (41.9%). The number of ACL injuries including the ACL tibial attachment ruptures in the PI fracture pattern (12 cases) is significantly higher than LI (2 cases) and PC (2 cases) fracture pattern (p < 0.05).

Conclusion

Profound understanding the different patterns of PTPF and using our reduction technique will facilitate to restore the main articular fracture fragments. The PI fracture patterns have a significant high incidence of the ACL ruptures.

Level of evidence

Therapeutic study, Level IV.
Fine-tuning sugar content in strawberry
Authors: Xing Sinian , Chen Kunling , Zhu Haocheng , Zhang Rui , Zhang Huawei , Li Bingbing , Gao Caixia
Published: September 2020

Fine-tuning quantitative traits for continuous subtle phenotypes is highly advantageous. We engineer the highly conserved upstream open reading frame (uORF) of FvebZIPs1.1 in strawberry (Fragaria vesca), using base editor A3A-PBE. Seven novel alleles are generated. Sugar content of the homozygous T1 mutant lines is 33.9–83.6% higher than that of the wild-type. We also recover a series of transgene-free mutants with 35 novel genotypes containing a continuum of sugar content. All the novel genotypes could be immediately fixed in subsequent generations by asexual reproduction. Genome editing coupled with asexual reproduction offers tremendous opportunities for quantitative trait improvement.
Toxicity evaluation of Aphidicidal crystalliferous toxins from Bacillus thuringiensis strains: a molecular study
Authors: Ramasamy Asokan , Suresh Meghana , Mallesh Mahadeva Swamy Hanchipura
Published: September 2020

Purpose

Aphis gossypii and A. punicae are the most damaging pests. The emergence of large populations has created concern among farmers because this pest complex is considered critical as it has a significant effect on major crops around the globe. The lack of new technologies for the control of A. gossypii and A. punicae is also worrying due to the indiscriminate use of chemical insecticides. Besides, this leads to the rapid development of resistance, which strangles their control in the field. Hence, there is a dire need to find the effective biocontrol agent for the management of Aphis gossypii and A. punicae.

Methods

The present investigation emphasizes the isolation and characterization of Aphidicidal Bacillus thuringiensis from the Andaman and Nicobar Islands, Karnataka, Assam, Arunachal Pradesh, and Sikkim soil samples. Phase contrast and scanning electron microscopy analysis used to characterize and identify the crystal morphology. Molecular profiling of Bt cry genes was determined by PCR using aphidicidal cry gene-specific primers, and molecular cloning and sequencing were carried out. Protein profiling by SDS–PAGE analysis was further studied. Finally, a qualitative bioassay of insecticidal activity was carried out against A. gossypii and A. punicae.

Results

A total of 65 Bacillus-like colonies were screened; 15 putative Aphidicidal B. thuringiensis isolates were identified based on morphological as well as through microbiological studies. Spherical and amorphous crystal inclusion was predominantly present in 34.28% of the Bt isolates. Crystal protein profiling of Bt isolates by SDS–PAGE analysis showed the presence 130, 73, 34, 25, and 13 kDa bands, among which 50−66 kDa bands were present abundantly. The detection of the cry gene of these isolates was done by PCR analysis, which indicated that cry1, cry2A, cry3A, and cry11A were on plasmid DNA. All cry genes were 80–100% homologous when aligned on alignment tool NCBI-BLASTn and BLASTp. All isolates of Bt were tested for their insecticidal activity against aphids. Three of the 15 isolates are Aphidicidal toxin specific by PCR analysis which were observed to be toxic to Aphis gossypii and A. punicae at a concentration of 35 μg/mL. The observed physical changes were induced by B. thuringiensis infection; these strains had been re-isolated from the dead aphids, and the presented results fulfilled Koch’s postulates.

Conclusion

The present study brought promising Bt isolates, primarily capable of creating an efficient biocontrol agent for Aphis gossypii and A. punicae and various sucking pests soon.
Biosynthesis, characterization of PLGA coated folate-mediated multiple drug loaded copper oxide (CuO) nanoparticles and it’s cytotoxicity on nasopharyngeal cancer cell lines
Authors: Guo Long-Mei , Xu Xue-Mei , Zhao Dong , Cai Xun-Gong , Zhou Bin
Published: September 2020

Cytotoxicity of CuO nanoparticles (NPs) are an impediment in utilizing them as an effective nanocarriers of chemotherapeutic drugs for targeted drug delivery in nasopharyngeal cancer. In our current study, we have designed a two-step synthesis and coating of CuO NPs with different concentrations of PLGA (polylactide-co-glycolide) to reduce the cytotoxicity. This was further conjugated with folic acid to enhance targeting to specific tissue. The multiple drugs loaded in the NPs were two potent anticancer drugs doxorubicin and docetaxel. A complete characterization studies including micrographic analysis, zeta potential measurements, polydispersity index, Fourier transform infrared spectroscopy (FTIR), encapsulation and loading efficiencies, stability and in vitro release studies were done. Cytoxicity studies were done with MTT 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, acridine orange/ethidium bromide and DAPI (4, 6-diamidino-2-phenylindole, dihydrochloride) staining procedures. Impediametric studies were also carried out to reinforce the reduction in cytotoxicity. Finally the cellular uptake of the NPs was seen. It was evident from the results that the multiple drugs loaded CuO NPs formed with PLGA coating were uniform, non-agglomerated in size ranging from 180 to 195 nm. The FTIR revealed no major changes in drug peaks. Encapsulation and loading efficiencies showed sufficient amount of drug being loaded into the NPs. The drug loaded NPs showed no change in size or zeta potential even after a period of 30 days. The cytotoxicity studies revealed significant reduction in toxicity after coating the surface treated with PLGA as evident from the microscopic analysis of cells. Hence the current study may be prioritized and further in vivo/in vitro studies may be carried out.
Cultural adaptation of Internet- and mobile-based interventions for mental disorders: a systematic review protocol
Authors: Spanhel Kerstin , Balci Sumeyye , Baumeister Harald , Bengel Juergen , Sander Lasse B.
Published: September 2020

Background

Internet- and mobile-based interventions (IMI) are an effective and scalable low-threshold solution to reach people who are undersupplied by current healthcare. Adapting interventions to the cultural and ethnic background of the target group enhances their acceptance and effectiveness. However, no systematic approach to cultural adaptation of IMI has been established so far. Therefore, this review aims to summarise components and procedures commonly used in the cultural adaptation of IMI for mental disorders, as well as the current evidence base on whether such a cultural adaptation leads to an increased acceptance, adherence, and effectiveness of IMI for mental disorders.

Methods

A systematic literature search will be performed using the following databases: MEDLINE, Embase, PsycINFO, CENTRAL, and WoS. The search term will include keywords related to cultural adaptation, IMI, and mental disorders/disturbances. Two independent reviewers will evaluate studies against inclusion and exclusion criteria and extract study and intervention characteristics, details on the cultural adaptation approach, and outcome data. Quality of evidence will be assessed using the Quality Assessment Tool for Reviewing Studies with Diverse Designs, and results will be synthesised qualitatively.

Discussion

Providing adequate mental healthcare regardless of cultural backgrounds is a major global health challenge. The planned systematic review will lay the foundation for the further development of the cultural adaptation of IMI for mental disorders by summarising the current state and providing recommendations for future research.

Systematic review registration

PROSPERO CRD42019142320
Zolpidem reduces pain intensity postoperatively: a systematic review and meta-analysis of the effect of hypnotic medicines on post-operative pain intensity
Authors: O’Hagan Edel T. , Hübscher Markus , Miller Christopher B. , Gordon Christopher J. , Gustin Sylvia , Briggs Nancy , McAuley James H.
Published: September 2020

Background

This systematic review aimed to investigate whether the administration of hypnotic medicines, z-drugs, melatonin or benzodiazepines, reduced pain intensity postoperatively.

Methods

Medline, Embase, Cinahl, Psych info, Central and PubMed databases were searched, from inception to February 2020 to identify relevant trials. The search was extended, post hoc, to include meta-Register of Controlled Trials, the Web of Science and the conference booklets for the 14th, 15th, and 16th International Association for the Study of Pain conferences. Two independent reviewers screened titles and abstracts and cross-checked the extracted data.

Results

The search retrieved 5546 articles. After full-text screening, 15 trials were included, which had randomised 1252 participants. There is moderate-quality evidence that in the short-term [WMD − 1.06, CI − 1.48 to − 0.64,p≤ .01] and low-quality evidence that in the medium-term [WMD − 0.90, CI − 1.43 to − 0.37,p≤ .01] postoperative period oral zolpidem 5/10 mg with other analgesic medicines reduced pain intensity compared to the same analgesic medicines alone.

There is low-quality evidence that melatonin was not effective on postoperative pain intensity compared to placebo. The results of benzodiazepines on pain intensity were mixed. The authors reported no significant adverse events.

Conclusions

There is promising evidence that the hypnotic medicine zolpidem, adjuvant to other analgesics, is effective at achieving a minimally clinically important difference in pain intensity postoperatively. There is no consistent effect of melatonin or benzodiazepines on postoperative pain intensity. Readers should interpret these results with some caution due to the lack of data on safety, the small number of trials included in the pooled effects and their sample sizes.

Systematic review registration

The protocol for this systematic review was registered with PROSPERO ID=CRD42015025327.
Existence and data-dependence theorems for fractional impulsive integro-differential system
Authors: Khan Hasib , Khan Zareen A. , Tajadodi Haleh , Khan Aziz
Published: September 2020

In this article we have considered a fractional order impulsive integro-differential equation (IDE) in Caputo’s sense for the unique solution and data dependence results. We take help of the Banach fixed point theory and basic literature of fractional calculus. The results are examined with the help of an expressive numerical example for an application of the results.
What evidence exists on the impacts of chemicals arising from human activity on tropical reef-building corals? A systematic map protocol
Authors: Ouédraogo Dakis-Yaoba , Sordello Romain , Brugneaux Sophie , Burga Karen , Calvayrac Christophe , Castelin Magalie , Domart-Coulon Isabelle , Ferrier-Pagès Christine , Guillaume Mireille M. M. , Hédouin Laetitia , Joannot Pascale , Perceval Olivier , Reyjol Yorick
Published: September 2020

Background

Tropical coral reefs cover ca. 0.1% of the Earth’s surface but host an outstanding biodiversity and provide important ecosystem services to millions of people living nearby. However, they are currently threatened by both local (e.g. nutrient enrichment and chemical pollution of coastal reefs, arising from poor land management, agriculture and industry) and global stressors (mainly seawater warming and acidification, i.e. climate change). Global and local stressors interact together in different ways, but the presence of one stressor often reduces the tolerance to additional stress. While global stressors cannot be halted by local actions, local stressors can be reduced through ecosystem management, therefore minimizing the impact of climate change on reefs. To inform decision-makers, we propose here to systematically map the evidence of impacts of chemicals arising from anthropogenic activities on tropical reef-building corals, which are the main engineer species of reef ecosystems. We aim to identify the combinations of chemical and coral responses that have attracted the most attention and for which evidence can be further summarized in a systematic review that will give practical information to decision-makers.

Methods

The systematic map will follow the Collaboration for Environmental Evidence Guidelines and Standards for Evidence Synthesis in Environmental Management. We will search the relevant literature using English terms combined in a tested search string in two publication databases (Web Of Science Core Collection and Scopus). The search string will combine terms describing the population (tropical reef-building corals) and the exposure (chemicals). We will supplement this literature with some more obtained through search engines, specialist websites, and through a call to local stakeholders. Titles, abstracts, and full-texts will then be successively screened using pre-defined eligibility criteria. A list of pre-defined variables will then be extracted from full-texts. Finally, a database of all studies included in the map with coded metadata will be produced. The evidence will be described in a map report with text, figures and tables, and a matrix showing the distribution and frequency of included study into types of exposure and types of outcomes will be computed to identify potential knowledge gaps and knowledge clusters.
Regulation of metabolic reprogramming by tumor suppressor genes in pancreatic cancer
Authors: Liu Mengqi , Liu Wensheng , Qin Yi , Xu Xiaowu , Yu Xianjun , Zhuo Qifeng , Ji Shunrong
Published: September 2020

Background

Pancreatic cancer continues to be one of the most aggressive malignant tumors. Work in recent years in cancer molecular biology has revealed that metabolic reprogramming is an additional hallmark of cancer that is involved in the pathogenesis of cancers, and is intricately linked to gene mutations.

Main text

However, though oncogenes such asKRASandc-Mycplay important roles in the process, and have been extensively studied, no substantial improvements in the prognosis of pancreatic cancer have seen. Therefore, some scientists have tried to explain the mechanisms of abnormal cancer metabolism from the perspective of tumor suppressor genes. In this paper, we reviewed researches about how metabolic reprogramming was regulated by tumor suppressor genes in pancreatic cancer and their clinical implications.

Conclusion

Abnormal metabolism and genetic mutations are mutually causal and complementary in tumor initiation and development. A clear understanding of how metabolic reprogramming is regulated by the mutated genes would provide important insights into the pathogenesis and ultimately treatment of pancreatic cancer.
Earlier diagnosis in anorexia nervosa: better watch growth charts!
Authors: Marion Morgane , Lacroix Sylvie , Caquard Marylène , Dreno Laurence , Scherdel Pauline , Guen Christèle Gras Le , Caldagues Emmanuelle , Launay Elise
Published: September 2020

Background

A better understanding of the healthcare pathway of children and adolescents with anorexia nervosa (AN) may contribute to earlier detection and better disease management. Here we measured and compared the symptomatic time to diagnosis (TTD) (time between the first symptoms, as reported by parents, and the diagnosis) and the auxological TTD (time between the deviation in the weight growth curve and the diagnosis).

Methods

We performed a monocentric retrospective study including all patients age 9 years to 16 years who were hospitalized in Nantes University Hospital for AN between 2013 and 2016. We analysed the two TTDs by medical record review and growth curve investigation. TTDs were described by medians and Kaplan-Meier curves. Two profiles of patients were compared according to the kinetics of growth deviation and the occurrence of symptoms.

Results

Among the 137 patients included, the median symptomatic and auxological TTDs was 7.0 months (IQR: 4.0–12.0) and 7.2 months (IQR: 2.0–18.0). TTDs were significantly different but clinically similar. For 48% of the patients, a deviation in the growth curve could have been noted at a median of 9.7 months (IQR: 3.0–18.0) before the first symptoms were reported by parents. Those patients showed significantly slower weight loss than did patients with first symptoms reported before growth deviation (weight loss rate 0.41% vs 1.90% per month, p < 0.0001).

Conclusions

Careful study of growth curves remains an essential step in detecting eating disorders, possibly allowing for earlier detection of the disease in nearly half of these patients.
A protein interaction map identifies existing drugs targeting SARS-CoV-2
Authors: Cava Claudia , Bertoli Gloria , Castiglioni Isabella
Published: September 2020

Background

Severe acute respiratory syndrome coronavirus (SARS-CoV-2), an emerging Betacoronavirus, is the causative agent of COVID-19. Angiotensin converting enzyme 2 (ACE2), being the main cell receptor of SARS-CoV-2, plays a role in the entry of the virus into the cell. Currently, there are neither specific antiviral drugs for the treatment or preventive drugs such as vaccines.

Methods

We proposed a bioinformatics analysis to test in silico existing drugs as a fast way to identify an efficient therapy. We performed a differential expression analysis in order to identify differentially expressed genes in COVID-19 patients correlated with ACE-2 and we explored their direct relations with a network approach integrating also drug-gene interactions. The drugs with a central role in the network were also investigated with a molecular docking analysis.

Results

We found 825 differentially expressed genes correlated with ACE2. The protein-protein interactions among differentially expressed genes identified a network of 474 genes and 1130 interactions.

Conclusions

The integration of drug-gene interactions in the network and molecular docking analysis allows us to obtain several drugs with antiviral activity that, alone or in combination with other treatment options, could be considered as therapeutic approaches against COVID-19.
The burden and correlates of childhood undernutrition in Tanzania according to composite index of anthropometric failure
Authors: Khamis Ahmed Gharib , Mwanri Akwilina Wendelin , Kreppel Katharina , Kwesigabo Gideon
Published: September 2020

Background

Undernutrition is a public health problem worldwide. Tanzania has made significant achievements in the reduction of childhood undernutrition over the past two decades. However, the exact burden of undernutrition was under-estimated when using conventional indices of stunting, wasting and underweight. The objective of this study was to determine the overall prevalence of undernutrition, describe the trends and examine the correlates associated with undernutrition among children under-five years using the composite index of anthropometric failure (CIAF). This study aims to understand the real burden and drivers of undernutrition to improve design, implementation and monitoring of appropriate interventions to ameliorate all form of childhood undernutrition in the country.

Methods

About 37,205 mother-child pairs were retrieved and analyzed from the Tanzania Demographic and Health Surveys (TDHS) conducted in various years from 1991, 1996, 1999, 2004–05, 2009–10, to 2015–16. The anthropometric data of children under-five years were used to determine the overall burden and trends of undernutrition using CIAF. The recent TDHS surveys from 2005 to 2015 were used to examine the correlates of CIAF. To determine the correlates, multivariate analysis was conducted to estimate the prevalence ratios (PR) with 95% confidence intervals (CI) using Poisson regression with robust variance.

Results

The prevalence of CIAF declined significantly from 50% in 1991 to 38.2% in 2015 (p < 0.001). The correlates of CIAF vary across surveys. The multivariate analysis of recent 2015 survey revealed that the prevalence of CIAF was significantly higher for older children (p < 0.001), children living in rural areas (p = 0.028), and those born with non-educated (p = 0.009) or single mothers (p = 0.008). The prevalence of CIAF was significantly lower for girls (p < 0.001), being born with overweight/obese mothers (p < 0.001), living with older head of the household (p < 0.001) or living in richest household (p < 0.001). Moreover, children who were born with low birth weight (p < 0.001), or having fever (p = 0.044) were most likely to have anthropometric failure. However, consumption of diversified diet was not found to be associated with anthropometric failure (p > 0.05).

Conclusion

About one in every three under-five years children are suffering from either one or multiple forms of anthropometric failure in Tanzania. There is a significant decline trends in overall burden of undernutrition in Tanzania from the past 25 years, as measured by CIAF. Multiple factors including those related to mothers, children and household socio-economic characteristics have the potential to influence childhood undernutrition. Efforts to reduce the burden of undernutrition should mainly focus on reducing poverty and raising people’s living standards.
Immunotherapy with heat shock protein 96 to treat gliomas
Authors: Li Chunzhao , Du Yifei , Zhang Yang , Ji Nan
Published: September 2020

Heat shock protein 96 (gp96) is a highly conserved protein in the endoplasmic reticulum. The functions of gp96 include promoting the oncogenesis and progression of glioma. In addition, tumor-derived gp96 can activate anti-tumor immune. Therefore, this protein was used to generate an anti-tumor vaccine and widely applied to glioma therapy. This review summarizes the mechanisms of gp96 in glioma oncogenesis and clinical trials of the gp96 tumor vaccine in glioma treatment.
Does coronavirus pose a challenge to the diagnoses of anxiety and depression? A view from psychiatry
Authors: Drummond Lynne M.
Published: September 2020

Some authors have suggested that the emergence of the novel coronavirus, SARS-CoV-2, and the subsequent pandemic has meant that the constructs of pathological anxiety and depression are meaningless owing to widespread anxiety and depressive symptoms. This paper examines what is required to make a diagnosis of a depressive or anxiety disorder and how this may differ from fleeting symptomatology in response to specific situations or stimuli. All people experience the emotions of both anxiety and depression, but far fewer have a persistent anxiety or depressive syndrome which interferes with their quality of life and functioning. The pandemic and its issues are then discussed, and existing studies examining the reactions of people living through the pandemic are presented. Finally, the paper examines possible ways to cope at times of increased stress and how we can try to protect ourselves from long-term mental health sequelae of chronic stress.
Post-traumatic stress disorder risk and witnessing team members in acute psychological stress during combat
Authors: Adler Amy B. , Svetlitzky Vlad , Gutierrez Ian A.
Published: September 2020

Background

Occupational groups operating in dangerous environments may witness the development of acute stress reaction (ASR) in team members. Witnessing ASR in team members may increase the risk of developing subsequent post-traumatic stress disorder (PTSD) symptoms.

Aims

To describe ASR symptoms that individuals witness, assess the relationship between witnessing a team member exhibiting ASR symptoms and an individual's own PTSD symptoms, and describe common intervention responses by peers.

Method

Cross-sectional, anonymous surveys were conducted with US soldiers who were previously deployed (sample 1; n = 176) and currently deployed sample 2; n = 497). Surveys assessed combat experiences, PTSD (PTSD Checklist-5), ASR exposure and intervention responses. Analyses included frequencies and binary logistic regression.

Results

Witnessing at least one ASR symptom during a combat-related event was reported by 51.7% in sample 1 and 42.4% in sample 2; the most commonly observed symptoms were being unable to function or being detached. Controlling for combat experiences, high levels of witnessing a team member exhibit ASR symptoms was associated with increased risk of subthreshold PTSD or PTSD in sample 1 (odds ratio (OR) = 8.69, 95% CI 2.29–42.60) and approached significance in sample 2 (OR = 1.67, 95% CI 0.98–2.81). Common intervention responses included providing a directive or yelling; many also reported being unsure how to respond.

Conclusions

Witnessing team members who exhibit ASR symptoms appears to be associated with screening positive for subthreshold PTSD or PTSD. Results suggest the need for further research into how to prepare individuals to manage ASR in team members and to examine ASR in other high-risk occupations.
Variation in clinical care associated with weekend admission and discharge in psychiatric in-patient units: retrospective case-note review
Authors: Williams Ryan , Farquharson Lorna , Rhodes Ellen , Dang Mary , Lindsay Natasha , Quirk Alan , Baldwin David S. , Crawford Mike J.
Published: September 2020

Background

Questions have been raised regarding differences in the standards of care that patients receive when they are admitted to or discharged from in-patient units at weekends.

Aims

To compare the quality of care received by patients with anxiety and depressive disorders who were admitted to or discharged from psychiatric hospital at weekends with those admitted or discharged during the ‘working week’.

Method

Retrospective case-note review of 3795 admissions to in-patient psychiatric wards in England. Quality of care received by people with depressive or anxiety disorders was compared using multivariable regression analyses.

Results

In total, 795 (20.9%) patients were admitted at weekends and 157 (4.8%) were discharged at weekends. There were minimal differences in quality of care between those admitted at weekends and those admitted during the week. Patients discharged at weekends were less likely to be given sufficient notification (48 h) in advance of being discharged (OR = 0.55, 95% CI 0.39–0.78), to have a crisis plan in place (OR = 0.65, 95% CI 0.46–0.92) or to be given medication to take home (OR = 0.45, 95% CI 0.30–0.66). They were also less likely to have been assessed using a validated outcome measure (OR = 0.70, 95% CI 0.50–0.97).

Conclusions

There is no evidence of a ‘weekend effect’ for patients admitted to psychiatric hospital at weekends, but the quality of care offered to those who were discharged at weekends was relatively poor, highlighting the need for improvement in this area.
Refugee mental health research: challenges and policy implications
Authors: Chaplin Lucia , Ng Lauren , Katona Cornelius
Published: September 2020

Mental illness is common among forced migrant populations, and ongoing mental illness can hinder refugees’ ability to negotiate the asylum process. This editorial rehearses the challenges of undertaking research among forced migrant populations, exploring how they could be addressed in future research, and outlines differences between forced migrant groups. It points to the growing body of evidence that can be called on in advocating for systemic change in government policy and mental health services, with significant support for a sensitive and objective inquisitorial approach to gathering evidence in support of asylum claims.
Fluid Restriction Therapy for Chronic SIAD; Results of a Prospective Randomized Controlled Trial
Authors: Garrahy Aoife , Galloway Iona , Hannon Anne Marie , Dineen Rosemary , O’Kelly Patrick , Tormey William P , O’Reilly Michael W , Williams David J , Sherlock Mark , Thompson Chris J
Published: September 2020

Context

Fluid restriction (FR) is the recommended first-line treatment for syndrome of inappropriate antidiuresis (SIAD), despite the lack of prospective data to support its efficacy.

Design

A prospective nonblinded randomized controlled trial of FR versus no treatment in chronic SIAD.

Interventions and Outcome

A total of 46 patients with chronic asymptomatic SIAD were randomized to either FR (1 liter/day) or no specific hyponatremia treatment (NoTx) for 1 month. The primary endpoints were change in plasma sodium concentration (pNa) at days 4 and 30.

Results

Median baseline pNa was similar in the 2 groups [127 mmol/L (interquartile range [IQR] 126-129) FR and 128 mmol/L (IQR 126–129) NoTx, P = 0.36]. PNa rose by 3 mmol/L (IQR 2-4) after 3 days FR, compared with 1 mmol/L (IQR 0-3) NoTx, P = 0.005. There was minimal additional rise in pNa by day 30; median pNa increased from baseline by 4 mmol/L (IQR 2-6) in FR, compared with 1 mmol/L (IQR 0-1) NoTx, P = 0.04. After 3 days, 17% of FR had a rise in pNa of ≥5 mmol/L, compared with 4% NoTx, RR 4.0 (95% CI 0.66-25.69), P = 0.35. After 3 days, 61% of FR corrected pNa to ≥130 mmol/L, compared with 39% of NoTx, RR 1.56 (95% CI 0.87-2.94), P = 0.24.

Conclusion

FR induces a modest early rise in pNa in patients with chronic SIAD, with minimal additional rise thereafter, and it is well-tolerated. More than one-third of patients fail to reach a pNa ≥130 mmol/L after 3 days of FR, emphasizing the clinical need for additional therapies for SIAD in some patients.
Systemic Corticosteroids and Mortality in Severe and Critical COVID-19 Patients in Wuhan, China
Authors: Wu Jianfeng , Huang Jianqiang , Zhu Guochao , Liu Yihao , Xiao Han , Zhou Qian , Si Xiang , Yi Hui , Wang Cuiping , Yang Daya , Chen Shuling , Liu Xin , Liu Zelong , Wang Qiongya , Lv Qingquan , Huang Ying , Yu Yang , Guan Xiangdong , Li Yanbing , Nirantharakumar Krishnarajah , Cheng KarKeung , Peng Sui , Xiao Haipeng
Published: September 2020

Background

Systemic corticosteroids are now recommended in many treatment guidelines, although supporting evidence is limited to 1 randomized controlled clinical trial (RECOVERY).

Objective

To identify whether corticosteroids were beneficial to COVID-19 patients.

Methods

A total of 1514 severe and 249 critical hospitalized COVID-19 patients from 2 medical centers in Wuhan, China. Multivariable Cox models, Cox model with time-varying exposure and propensity score analysis (inverse-probability-of-treatment-weighting [IPTW] and propensity score matching [PSM]) were used to estimate the association of corticosteroid use with risk of in-hospital mortality in severe and critical cases.

Results

Corticosteroids were administered in 531 (35.1%) severe and 159 (63.9%) critical patients. Compared to the non-corticosteroid group, systemic corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality in either severe cases (HR = 1.77; 95% CI, 1.08-2.89; P = 0.023), or critical cases (HR = 2.07; 95% CI, 1.08–3.98; P = 0.028). Findings were similar in time-varying Cox analysis. For patients with severe COVID-19 at admission, corticosteroid use was not associated with improved or harmful outcome in either PSM or IPTW analysis. For critical COVID-19 patients at admission, results were consistent with multivariable Cox model analysis.

Conclusion

Corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality for severe or critical cases in Wuhan. Absence of the beneficial effect in our study in contrast to that observed in the RECOVERY clinical trial may be due to biases in observational data, in particular prescription by indication bias, differences in clinical characteristics of patients, choice of corticosteroid used, timing of initiation of treatment, and duration of treatment.
Shotgun Weddings in Control Engineering and Postwar Economics, 1940–72
Authors: Klein Judy L.
Published: September 2020

During World War II there was a “shotgun wedding” forged in the processes of designing feedback mechanisms used to control gunfire targeting fast-moving enemy aircraft. Hendrik Bode perceived the shotgun marriage as a union of the classic regulator approach and long-distance telephone communications engineering. Norbert Weiner took the wedding description a step further by nesting communication engineering into a statistical mechanics framework in which the information engineer had to filter the useful signal from the useless noise. A main goal in designing weapon-fire control systems was to use negative feedback loops to ensure the stability of a system that was always in a transient mode. In the 1950s, control engineers such as Arnold Tustin, Bill Phillips, and Charles Holt offered their new analytic tools of block diagrams of systems with feedback loops, stability criteria, and physical analogues to model the economy, realize the promise of stability of employment and prices, and avoid another depression similar to that of the 1930s. By the early 1970s Paul Samuelson and the rational expectations theorists were primed to be receptive to a second, Cold War shotgun wedding in control engineering. Richard Bellman described it as a marriage of classical optimization theory and the probabilistic theory of stochastic processes.
Realities of Formalization
Authors: Boldyrev Ivan
Published: September 2020

In the postwar USSR, there were a few scattered research groups engaged in research most closely resembling “Western” mainstream economics. Inspired by the new sciences of the artificial, these groups were able to make important contributions to various fields of economic theory. This article focuses on the story of one group created by the control engineer Mark Aizerman at the Institute of Control Sciences in Moscow. It discusses the origins and the outstanding diversity and dynamics of the group’s research agenda, reconstructs the factors that made Aizerman turn from the cybernetics of mechanical or biological systems to the abstract theory of choice and rationality, and demonstrates how the group was related to—and communicated with—the scholars doing work in social choice, mechanism design, and formal political theory. It also speculates on one missed research opportunity of doing experimental economics—something that, given the ideological and intellectual constraints Aizerman was facing, was hardly possible in the Soviet context, but could have been a synthesis of economics and engineering. The article also discusses a research culture Aizerman created and nurtured in his lab by encouraging research collaboration, sharing ideas, and freely moving across various disciplines.
Acceleration of Environmental Electrostatic Potential Using Cholesky Decomposition with Adaptive Metric (CDAM) for Fragment Molecular Orbital (FMO) Method
Authors: Okiyama Yoshio , Nakano Tatsuya , Watanabe Chiduru , Fukuzawa Kaori , Komeiji Yuto , Segawa Katsunori , Mochizuki Yuji
Published: September 2020

The calculation speed of the ab initio fragment molecular orbital (FMO) method can and must be increased by applying approximations to the environmental electrostatic potential (ESP) and the dimer electrostatic potential (dimer-es). These approximations were previously implemented by introducing the Cholesky decomposition with adaptive metric (CDAM) method to the FMO (Okiyama et al., Chem. Phys. Lett.2010, 490, 84). In this study, a distributed memory algorithm of CDAM was introduced to reduce the necessary memory size. The improved version of CDAM was applied to the ESP approximation and was shown to give sufficiently precise energy values while halving the calculation time.
Fórum GIGAPP
Authors: Dias Thiago Ferreira
Published: September 2020

Nesta edição, temos o prazer de compartilhar trabalhos que trazem autores iberoamericanos, dentro do processo de internacionalização da Cadernos Gestão Pública e Cidadania. E o embrião deste trabalho iniciou no fim de 2019, quando fui convidado (ou convocado) pela nossa querida editora-chefe, professora Andréa Leite Rodrigues, para organizar um Fórum Especial GIGAPP, dada a minha participação como membro, coordenador de grupo de trabalho e frequentador assíduo de seus congressos desde o ano de 2014.
Fiscal Governance in the Eurozone: From Maastricht to crisis and back again?*
Authors: Katsikas Dimitris
Published: September 2020

Determining the optimal level and instruments of fiscal governance in a monetary union of sovereign states is not an easy task. A monetary union needs to have in place a comprehensive framework of fiscal governance, which allows enough flexibility to deal with asymmetric shocks in different member states; discourage fiscal mismanagement, and minimize spillover effects when it happens; provide the means for effective fi scal management over the business cycle; and build the necessary mechanisms to deal with a common external shock. The fiscal governance designed at Maastricht was imbalanced and incomplete. It instituted a decentralized ‘individual responsibility’ approach, with no effective compliance mechanism and no support facilities for times of economic turbulence. Its weaknesses, revealed by the global financial crisis, contributed to Eurozone’s deterioration into a second, debt crisis and a double dip recession. The lack of institutional provisions for dealing with the crisis, turned its handling into a de facto political, and therefore, intergovernmental process where creditor countries, enjoying a highly asymmetrical negotiating advantage, dictated both the terms of the bailout agreements and the provisions of the new fiscal governance. Being essentially a reinforced version of the precrisis framework, the ‘reformed’ fiscal governance has tried to balance conflicting objectives with little success; it is simultaneously more constraining and more prone to political maneuvering, increasingly complex while leaving more room for variable interpretations, and ultimately it is not more effective than its predecessor. As a result, a short few years after its implementation, the calls for a new reform are multiplying.