bluuebunny/crossref_metadata_2025 huggingface dataset:
Further cleaning of the name pool in the New World Commelina (Commelinaceae), and notes on the African C. aquatica

Authors: HASSEMER GUSTAVO
Published: March 2020

Study of the Commelina names published for the Americas and their original materials, in the context of a continental taxonomic revision of the genus, evidenced the need for typifications and synonymisations. In this work, 18 names are lectotypified (Athyrocarpus pseudomonosperma, C. aquatica, C. bravoa, C. diffusa var. cordispatha, C. dubia Redouté nom. illeg., C. erecta f. intercursa, C. formosa, C. glabra, C. nervosa, C. pallida, C. pallida var. parviflora, C. pilosula, C. quitensis var. mandonii, C. stricta, C. undulata Lodd. nom. illeg., C. virginica var. massonii, Nephralles parviflora and Phaeosphaerion efoveolaltum), one name neotypified (C. polygama), one name epitypified (C. longicaulis) and eight new synonymisations proposed. Evidence is presented that the African species C. aquatica, which is morphologically similar to the American C. longicaulis but has a different chromosome number, is most probably not conspecific with C. diffusa. Furthermore, the situation of seven Commelina names currently recognised in some sources, which however were never validly published, is discussed.
Nomenclatural notes and typification of names in Maranta (Marantaceae)

Authors: FRAGA FERNANDA RIBEIRO DE MELLO , BRAGA JOÃO MARCELO ALVARENGA
Published: March 2020

In the present study we designate lectotypes for 19 names, as well as a neotype for Maranta phrynioides. Furthermore, an illustration is recognized as the holotype of M. bicolor, based on historical data, and the unknown type of M. noctiflora is here located and its history is clarified. Finally, important taxonomic notes are provided, including the new synonyms Calathea stenostachys, M. longipes, M. longiscapa, M. pleiostachys and M. pycnostachys, all under M. phrynioides, as well as M. subterranea as a synonym of M. furcata.
Development and Evaluation of an Objective Tympanic Membrane Visualization Assessment Technique
Authors: Hakimi Amir A. , Lalehzarian Simon P. , Lalehzarian Aaron S. , Azhdam Ariel M. , Boodaie Benjamin D. , Walner David L.
Published: March 2020

Objectives:

To introduce an inexpensive method for objectively evaluating otoscopic visualization of the tympanic membrane wherein learners match what they visualize in standardized patients to tympanic membrane photographs.

Methods:

Two standardized patients had photographs taken of their tympanic membranes using a commercially-available digital otoscope. First- and third-year medical students were asked to perform an otoscopic examination on each patient using a conventional handheld otoscope and to match what they saw with the correct tympanic membrane image among distractor photographs belonging to other patients. The ability of students to match the standardized patients’ tympanic membrane to the correct photographs was assessed before and after a didactic training session. These measurements were compared between the two cohort groups for construct validity.

Results:

Fifty-one first-year medical students (with no previous otoscopy experience) and 44 third-year medical students (with otoscopy experience from completing pediatric and family medicine clinical clerkships) were recruited to voluntarily participate in this study. At baseline, a larger percentage of third-year students correctly matched both tympanic membranes compared to first-year students (27% vs 8%, P < .01). After otoscopy training, correct matching of both tympanic membranes significantly improved among both first-year students (8-31%, P < .01) and third-year students (27-54%, P < .01).

Conclusion:

The use of tympanic membrane photographs from standardized patients provides a novel technique for objectively assessing proficiency in otoscopic visualization of the middle ear. The concept is low cost, uses live patients, and can be easily implemented in pre-clinical instruction and beyond.
A wake-up call?
Authors: Loades Ann
Published: March 2020

This article argues that, in the twenty-first century, there has been a sharp decline in ‘religious literacy’. Evidence for this is drawn from a decline in A level and GCSE courses in religious studies and in changing patterns of Sunday worship.
Heating and controls use resulting from shared-cost charges in communal network social housing
Authors: Paine Sam , James Patrick , Bahaj AbuBakr , Waggott Andrew
Published: March 2020

In dwellings connected to district or communal heating schemes occupants are commonly charged based on actual heat consumption, providing a direct link between heat consumption and weekly heating cost. This article investigates how the use of fixed-rate, shared-cost charging without dwelling-level metering affects the heating and controls use in communal network social housing. Living room and radiator temperatures in 50 flats were monitored over a winter heating season and occupants surveyed at monitoring install and removal. The primary stated and observed heating strategy was to leave the heating always on and control through the radiator thermostatic radiator valves. Of people who used timer control, total heating hours reduced with increased frequency of manual intervention. Mean indoor temperatures up to 27.7°C were observed, implying many residents are adapted to higher indoor temperatures. Thus, the current model encourages wasteful behaviour and education on use of controls is key to transitioning residents to charging for actual heat use.

Practical application: This article intends to inform the landlords of communal network social housing schemes on the impacts that shared-cost recovery methods of charging for heat has on heating and controls use. This charging method can impact the behaviour of the network occupants resulting in higher heat consumption, overall higher heating costs and subsequently higher carbon emissions from the site if occupants are not adequately trained in how to operate their heating effectively. Where similar charging methods are implemented, the article hopes to inform operators of the potential vulnerabilities of the network occupants to changes in the method of charging for heat.
What’s so new about New Municipalism?
Authors: Thompson Matthew
Published: March 2020

New municipalism is a nascent global social movement aiming to democratically transform the local state and economy – but what, precisely, is so new about it? I situate new municipalism in its geographical, political-economic and historical contexts, by comparison with earlier waves of municipal socialism and international municipalism, arguing that it re-politicises traditions of transnationalism, based not on post-political policy mobilities but on urban solidarities in contesting neoliberal austerity urbanism and platform capitalism. This article identifies three new municipalisms – platform, autonomist, managed – whose characteristics, contradictions, interconnections and potentials are explored in terms of state-space restructuring, urban-capitalist crisis and cycles of contention.
Optimal design methodology for sizing a fuel cell/battery hybrid power source
Authors: Ceschia Adriano , Azib Toufik , Bethoux Olivier , Alves Francisco
Published: March 2020

This paper presents an optimal design methodology enabling to exhibit the best parameters of a complex energy system combing several components and their related control parts. It is based on a particle swarm optimization technique for component sizing, combined with optimal control to consider energy management constraints. This approximate resolution is valuable since it allows to achieve a robust and effective optimal design using low computational resources: it enables to tackle large search spaces in engineering time constraints. The selected use case is a fuel cell/battery hybrid power source based on a power-split parallel architecture. Its performance index is defined as the fuel consumption. Regarding this objective, the drivetrain components size and the control parameters values are both strongly coupled and physically constrained. In this context, the methodology makes a tradeoff between component sizing and energy saving. Simulation results show the relevance and robustness of this approach regarding different driving cycles and operating conditions. It validates the replicability of this method to other optimization problems in the field of energy optimization. A comprehensive review of the simulation tests highlights the present limits of this optimization and provides new perspectives for future works.
Pressure capacity of sandwich pipe with cement-based core configuration under deep-water external pressure
Authors: Wan Feng , Guan Feng , Zhou Chuanxi , Liu Shaohu , Yang Ting
Published: March 2020

Sandwich pipe, consisting of two steel tubes and a polymeric or cement-based material core layer, has been considered as an attractive solution for oil and gas transporting in deep water. In this paper, the characteristic responses and pressure capacity of sandwich pipes having fiber-reinforced cementitious composites core configuration under external hydrostatic pressure were investigated. The interface adhesion behavior between the fiber-reinforced cementitious composite core and the surrounding steel pipes was modeled based on the inter-layer shear strength test experiments conducted on the sandwich pipe specimens. The parametric studies were carried out to evaluate the influence of geometry parameters and steel grade on the buckling response and ultimate pressure capacity. Furthermore, 768 FE models of sandwich pipes covering a wide range of practical design configurations were rapidly constructed and analyzed using FE software package ABAQUS with the help of programming language Python. Finally, a simplified equation for predicting the pressure capacity of sandwich pipes within the scope of this study was proposed using dimensional analysis combined with singular value decomposition methodology.
Dynamic failure of carbon fiber-reinforced plastics sandwich structures with polyvinyl chloride foam cores subjected to impact loading
Authors: Ren Peng , Yin Liangliang , Tao Qiangqiang , Guo Zitao , Zhang Wei
Published: March 2020

The dynamic failure of carbon/epoxy sandwich plates with polyvinyl chloride foam core subjected to foam projectile impact is experimentally analyzed in this research. The effects of intensity of impact impulse, cores density, core thickness on the impact resistance of the composite sandwich plates in terms of deflection of rear sheets are also assessed. The 3D- digital image correlation technique is applied to measure the dynamic deformation of the sandwich plates. The results show that the carbon/epoxy sandwich plates exhibit more excellent impact resistance than aluminum sandwich plates with polyvinyl chloride cores at the similar area mass. The carbon/epoxy sandwich plates experience an obvious spring back, and only a slight plastic deflection can be observed after test. The failure modes of the sandwich plates include plastic deformation, fiber breakage, delamination, matrix crack, debonding, and compression of cores. The damage of plates become more serious with core density and core thickness decreasing, and impact impulse increasing, respectively.
Why do evaluations of integrated care not produce the results we expect?
Authors: Kumpunen Stephanie , Edwards Nigel , Georghiou Theo , Hughes Gemma
Published: March 2020

A number of evaluations of models of integrated care have not produced the expected result of reduced hospital admissions, and in some cases have even found people receiving integrated care services using hospitals more than matched controls. We tested three hypotheses for these surprising results with a group of 50 integrated care experts in a seminar: (1) problems with the model; (2) problems of implementation; and (3) problems of evaluation. Our group of experts did not rule out any of these hypotheses and came up with some advice as to manage these issues. For example, model designers should rigorously test the underlying logic; commissioners should seek out advice from experts and patients/professionals; and evaluators should choose outcomes wisely, use mixed methods approaches, and provide regular feedback loops to implementation sites. Evaluating integrated care is a skilled task that requires multiple approaches in terms of the design and implementation of the models. National research funders or other appropriate bodies might consider developing an advisory service to provide support to local systems planning evaluations.
Patient values and preferences regarding VTE disease: a systematic review to inform American Society of Hematology guidelines
Authors: Etxeandia-Ikobaltzeta Itziar , Zhang Yuan , Brundisini Francesca , Florez Ivan D. , Wiercioch Wojtek , Nieuwlaat Robby , Begum Housne , Cuello Carlos A. , Roldan Yetiani , Chen Ru , Ding Chengyi , Morgan Rebecca L. , Riva John J. , Zhang Yuqing , Charide Rana , Agarwal Arnav , Balduzzi Sara , Morgano Gian Paolo , Yepes-Nuñez Juan José , Rehman Yasir , Neumann Ignacio , Schwab Nicole , Baldeh Tejan , Braun Cody , Rodríguez María Francisca , Schünemann Holger J.
Published: March 2020

Values and preferences relate to the importance that patients place on health outcomes (eg, bleeding, having a deep venous thrombosis) and are essential when weighing benefits and harms in guideline recommendations. To inform the American Society of Hematology guidelines for management of venous thromboembolism (VTE) disease, we conducted a systematic review of patients’ values and preferences related to VTE. We searched Medline, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature from inception to April of 2018 (PROSPERO-CRD42018094003). We included quantitative and qualitative studies. We followed Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance for rating the certainty and presenting findings for quantitative research about the relative importance of health outcomes and a grounded theory approach for qualitative thematic synthesis. We identified 14 quantitative studies (2465 participants) describing the relative importance of VTE-related health states in a widely diverse population of patients, showing overall small to important impact on patients’ lives (certainty of the evidence from low to moderate). Additionally, evidence from 34 quantitative studies (6424 participants) and 15 qualitative studies (570 participants) revealed that patients put higher value on VTE risk reduction than on the potential harms of the treatment (certainty of evidence from low to moderate). Studies also suggested a clear preference for oral medication over subcutaneous medication (moderate certainty). The observed variability in health state values may be a result of differences in the approaches used to elicit them and the diversity of included populations rather than true variability in values. This finding highlights the necessity to explore the variability induced by different approaches to ascertain values.
Prevalence of latent tuberculosis among refugee children in Malaysia
Authors: Wong Yen Jun , Lee Shaun Wen Huey
Published: March 2020

Introduction

Tuberculosis remains one of the top 10 major causes of global mortality, imposing social–economic and medical challenges in Malaysia. Refugees sheltered in Malaysia are a high-risk population but basic health checks upon their arrival, including tuberculosis screening, are not practised. This study aimed to identify the prevalence and risk factors of tuberculosis and latent tuberculosis infection (LTBI) among refugee children in Malaysia.

Methods

A cross-sectional study was performed in three refugee schools in the Klang Valley, Malaysia, using tuberculin skin tests or interferon-γ release assays. Participants who tested positive were sent for further examination with chest radiography to confirm the tuberculosis diagnosis.

Results

From April 2018 to April 2019, we screened 430 refugee children with a median age of 13.0 years. Most of the children were born in Myanmar (n=274, 63.7%) and Pakistan (n=60, 14.0%). No children were diagnosed with active tuberculosis but 55 of the children (12.8%) were diagnosed with LTBI. Children with LTBI were generally older (OR 3.01, 95% CI 1.71–5.29; p<0.001) than those without LTBI infection. Sex, history of bacille Calmette–Guérin vaccination and country of birth were not associated with increased risk of LTBI.

Conclusion

The relatively high LTBI burden among refugee children in this study poses an indication of possible LTBI risk among this population nationwide, and thus would be an important group to target for preventive therapy. This provides a unique opportunity for researchers to further examine and implement well-structured preventive strategies in combating the endemic infectious disease in Malaysia.
ERS International Congress, Madrid, 2019: highlights from the Respiratory Intensive Care Assembly
Authors: Satici Celal , L�pez-Padilla Daniel , Schreiber Annia , Kharat Aileen , Swingwood Ema , Pisani Luigi , Patout Maxime , Bos Lieuwe D. , Scala Raffaele , Schultz Marcus J. , Heunks Leo
Published: March 2020

The Respiratory Intensive Care Assembly of the European Respiratory Society is delighted to present the highlights from the 2019 International Congress in Madrid, Spain. We have selected four sessions that discussed recent advances in a wide range of topics: from acute respiratory failure to cough augmentation in neuromuscular disorders and from extra-corporeal life support to difficult ventilator weaning. The subjects are summarised by early career members in close collaboration with the Assembly leadership. We aim to give the reader an update on the most important developments discussed at the conference. Each session is further summarised into a short list of take-home messages.
Value of clinical examination in the assessment of penetrating neck injuries: a retrospective study of diagnostic accuracy test
Authors: Isaza-Restrepo Andrés , Quintero-Contreras Julián Andrés , Escobar-DiazGranados Jorge , Ruiz-Sternberg Ángela María
Published: March 2020

Background

There are many high-volume trauma centers in limited resource environments where a thorough clinical examination of patients may contribute to a more economical, accurate, and widely applicable method of determining the proper management of patients with penetrating neck injuries. The purpose of this study was to validate thorough physical examination as a reliable diagnostic tool in these patients.

Methods

We performed an observational retrospective study of a diagnostic accuracy test where we compared clinical findings (symptoms and soft signs on admission of the patient) with the definitive findings according to the gold standard test for each particular situation (selective studies, clinical observation and surgical exploration). The study was conducted at Hospital Occidente Kennedy (HOK) between August 2009 and June 2010.

Results

The sample consisted of the clinical records of 207 (n = 207) patients who went to the emergency room for penetrating neck wounds at Hospital Occidente Kennedy (HOK). Of the total sample, 36.2% (n = 75) of patients were considered “asymptomatic” as they didn’t present with any soft signs of injury. Vascular soft signs were present in 57% (n = 118) of the patients, soft signs of the airway and the upper gastrointestinal tract were present in 15.9% (n = 33) and 21.3% (n = 44) of the patients respectively. The sensitivity and negative predictive value (NPV) of any soft sign to determine injuries which require surgical repair was 97.4% [CI] [86.5–99.5%] and 98.7% [CI] [92.8–99.8%] respectively, with a range of confidence [CI] of 95%.

Conclusions

Our study’s main findings suggest that patients with neck injuries and no vascular, airway, or gastrointestinal soft sign can be safely managed with a conservative approach. It is important to emphasize the value of the clinical examination since there are many contexts in the modern world where a considerable amount of the population is afflicted by neck trauma and treated under conditions where technological resources are limited.
Genetic diversity of Bacillus anthracis Ames lineage strains in China
Authors: Zhang Enmin , Zhang Huijuan , He Jinrong , Li Wei , Wei Jianchun
Published: March 2020

Background

Anthrax is an endemic disease that persists in the rural regions of China. The global genetic population structure of B.anthracis has also been defined by the canonical single-nucleotide polymorphisms (canSNP) and multiple-locus variable-number tandem repeat analysis (MLVA). Five canSNP lineages were found in China, and the A.Br.Ames lineage has been the second predominant group in recent years in China. The objective of this study was to reveal genetic diversity of the Ames lineage strains by MLVA.

Methods

Two molecular typing methods, canSNP and MLVA with 15markers were used to study the genetic relationship among the Ames lineage strains. The outbreak information associated with these strains was also collected and investigated.

Results

From 2007 to 2018, a total of 21 human anthrax infection outbreaks (68 patients) associated with B. anthracis Ames lineage strains were reported in China. Ames lineage strain-associated human anthrax is mainly distributed in the northern part of China, including the provinces of Inner Mongolia, Liaoning, Gansu, and Xinjiang. In the study, a total of 30 Ames lineage strains were included and 10 MLVA15 genotypes were identified. These strains were mainly found in northeast China, Inner Mongolia and Liaoning. In recent years, the Ames lineage strains were isolated in the two provinces every year. The 18 Ames lineage strains isolated from Inner Mongolia were divided into eight MLVA15 genotypes. From 2010 to 2015, there were continuous reports of outbreaks in Keyouzhongqi County, Inner Mongolia, and the strains that were isolated annually in succession belonged to the MLVA15–30 genotype.

Conclusions

The Ames lineage strains are widely distributed in northern China. Their genetic diversity can be illustrated by the results of the MLVA. The genetic characteristics of the Ames lineage strains from outbreaks in different provinces varied. In some areas, human anthrax outbreaks occurred annually in succession, and these related strains grouped together. These observations indicate that the local environment was persistently contaminated with B. anthracis spores, vaccination of livestock should become the fundamental control measure in the areas.
Epigenetic loss of heterozygosity of Apc and an inflammation-associated mutational signature detected in Lrig1+/−-driven murine colonic adenomas
Authors: Preston Jessica L. , Stiffler Nicholas
Published: March 2020

Background

The loss of a single copy of adenomatous polyposis coli (Apc)in leucine-rich repeats and immunoglobulin-like domains 1 (Lrig1)-expressing colonic progenitor cells induces rapid growth of adenomas in mice with high penetrance and multiplicity. The tumors lack functional APC, and a genetic loss of heterozygosity ofApcwas previously observed.

Methods

To identify genomic features of early tumorigenesis, and to profile intertumoral genetic heterogeneity, tumor exome DNA (n = 9 tumors) and mRNA (n = 5 tumors) sequences were compared with matched nontumoral colon tissue. Putative somatic mutations were called after stringent variant filtering. Somatic signatures of mutational processes were determined and splicing patterns were observed.

Results

The adenomas were found to be genetically heterogeneous and unexpectedly hypermutated, displaying a strong bias toward G:C > A:T mutations. A genetic loss of heterozygosity ofApcwas not observed, however, an epigenetic loss of heterozygosity was apparent in the tumor transcriptomes. Complex splicing patterns characterized by a loss of intron retention were observed uniformly across tumors.

Conclusion

This study demonstrates that early tumors originating from intestinal stem cells with reducedLrig1andApcexpression are highly mutated and genetically heterogeneous, with an inflammation-associated mutational signature and complex splicing patterns that are uniform across tumors.
Community canteen services for the rural elderly: determining impacts on general mental health, nutritional status, satisfaction with life, and social capital
Authors: Wang Xiaolei , Liu Minhui , Li Yuchen , Guo Chanyuan , Yeh Chao Hsing
Published: March 2020

Background

The Chinese government is piloting canteen services for older adults, but few studies have explored the influence of canteen services on the health of these older adults. This study aimed to investigate the impact of canteen services on older adults’ general mental health, nutritional status, satisfaction with life, and social capital in rural areas.

Methods

This study used a cross-sectional design. We selected 14 villages in Jinhua City, Zhejiang Province, China, including seven villages with canteen services and seven villages without canteen services. Participants were 284 senior older adults (aged 75~98), including 140 residing in villages with canteen services (Canteen Group [CG]) and 144 residing in villages without canteen services (Non-Canteen Group [NCG]). We also divided the CG into two sub-groups according to the funding sources (one receiving government support only, the other receiving government support plus enterprise donations). We used a self-designed questionnaire, including sociodemographics, diet-related items (e.g., satisfaction with the meals, diet expenditure, self-evaluation of meal nutrition), and the four scales including the Chinese version of the 12-item General Health Questionnaire (GHQ-12), the Chinese version of the Mini Nutritional Assessment Short-Form (MNA-SF), the Satisfaction with Life Scale (SWLS), and the Social Capital Questionnaire (SCQ).

Results

The overall mental health, satisfaction with life, and social capital of the CG were better than the NCG (P <  0.05). The nutritional status of these two groups did not show a significant difference. Participants in the CG with financial support from local government and donations from an enterprise with a better dietary diversity exhibited a better nutritional status (P <  0.05); the average satisfaction with diet and self-evaluation of food nutrition of the CG were higher than the NCG (P < 0.05); the ratio of having a diet on time in the CG was higher than that of the NCG (P < 0.05).

Conclusion

The free canteen services provided by the government can improve older adults’ satisfaction with life and diet, and mental health status and also enrich their social capital, but this still needs to be future evidenced. More financial support for canteen services is an essential component in promoting successful aging in China.
Development, validation and application of a 3D printed model depicting adenoid hypertrophy in comparison to a Nasoendoscopy
Authors: Thereza-Bussolaro Claudine , Lagravère Manuel , Pacheco-Pereira Camila , Flores-Mir Carlos
Published: March 2020

Background

The exploration of tridimensional (3D) technology of computational tomography and the development of valid 3D printed models may improve the assessment of adenoid obstruction. The identification of an enlarged adenoid in childhood would streamline the referral of appropriately selected cases to an otolaryngologist, leading to early treatment of affected children when indicated. The objective of this study is to validate the use of a 3D printed model depicting adenoid hypertrophy based on the pediatric otolaryngologist, head and neck surgeon (OHNS) participants assessment.

Methods

A cross-sectional study was performed to develop and validate 3D depictions, including print-outs, of the nasopharynx including different degrees of Adenoidal Hypertrophy (AH). The print-outs were obtained from 14 Cone-beam computed tomography (CBCT) scans of 14 children (12 boys, 2 girls; mean age of 10.61 years) representing grades 1, 2, 3, and 4 nasopharyngeal adenoidal obstructions, according to a previously Nasoendoscopy-graded (NE) classification by a licensed OHNS. The prevalence of AH in this study was 36%. Two OHNS were recruited to assess the print-outs representing two different representations of the nasopharyngeal airway, the lumen (LU) and adenoid mass (AD). LU and AD were visualized in 2D - pictures- and in 3D – printed prototypes. Intraclass correlation was used to assess intra- and inter-reliability. The validity of our depictions was analyzed through comparison (accuracy and correlation) to the reference standard (NE). The data were clustered to calculate the sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV). Cross-tab and Pearson’s T-test were performed.

Results

Overall, the 3D depiction tools showed different diagnostic capabilities. AD representations showed strong (AD 2D, 75%) to almost perfect (AD 3D, 88%) accuracy compared to NE. Excellent sensitivity and specificity were observed for the AD 3D (100, 70%), as well as adequate PPV and NPV (66 and 97% respectively), with only 5% of false-negative cases.

Conclusion

The use of Dolphin software for the acquisition of a 3D printed prototype of the nasopharyngeal adenoidal region seems promising. These prototypes may be a practical and readily available alternative for the assessment of the nasopharyngeal obstructed area. CBCT in children must be taken under strong solid indications. Early referral to an OHNS for a full assessment remains the main objective in children with unclear symptoms.
Correction to: Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙ
Authors: Chen Jian , Ma Jian-xiong , Wang Ying , Bai Hao-hao , Sun Lei , Wang Yan , Lu Bin , Dong Ben-chao , Tian Ai-xian , Ma Xin-long
Published: March 2020

In the original publication of this article [1], Chinese text of the Figs. 3, 4, 5 has not been converted to English.
Do farm-level technical efficiency and welfare complement each other? Insight from Ghana’s cocoa industry
Authors: Danso-Abbeam Gideon , Baiyegunhi Lloyd J. S.
Published: March 2020

Technical inefficiency persists in Ghana’s cocoa farms. Farm-level guidelines from empirical studies are essential to inform programmes dealing with this challenge and subsequently improves farmers’ welfare. This study evaluates the two-way effects of technical efficiency and welfare using Data Envelopment Analysis (DEA) and Conditional Mixed-process (CMP). The study reveals that, with no additional inputs, farmers have the potential of increasing their output by an average of 56% (overall technical efficiency) with mean pure technical and scale efficiencies estimated at 76% and 58%, respectively. Observed inefficiency in the Ghanaian cocoa farms is due to both inefficient utilization of inputs and farmers’ inability to operate at the most productive scale size. Furthermore, findings from the study indicated that improved technical efficiency and welfare of smallholder cocoa farmers are crucial for the sustainable growth of Ghana’s cocoa sector as farmers’ efficiency and welfare significantly complement each other. In other words, improved welfare enhances technical efficiency, and higher technical efficiency score translates into better welfare. Hence, farm-level policies such as inputs subsidy programmes, training farmers on the proper application of agrochemicals, among others to enhance farm efficiency should be strengthened since efficiency is tied to household welfare. Moreover, investment in education targeted at farmers to improve their managerial and technical capacities will enhance their ability to optimize the operational size of the cocoa production system, and subsequently improve their welfare.
Coronavirus disease-2019: is fever an adequate screening for the returning travelers?
Authors: Bwire George M. , Paulo Linda S.
Published: March 2020

On Thursday, 30 January 2020, World Health Organization declared Coronavirus disease-2019 (COVID-2019) a Public Health Emergency of International Concern. Since its identification in late December 2019 in Wuhan, Hubei Province, People’s Republic of China, the number of cases imported into other countries is increasing, and the epidemiological map is changing rapidly. On the other hand, body temperature screening (fever) is the major test performed at points of entry, i.e., airports, in the returning travelers in most of the countries with limited resources. However, the recent report on asymptomatic contact transmission of COVID-19 and travelers who passed the symptoms-based screening and tested positive for COVID-19 using reverse transcription polymerase chain reaction (RT-PCR) challenges this approach as body temperature screening may miss travelers incubating the disease or travelers concealing fever during travel. On this note, travel restrictions to and from high risk areas and/or 14 days quarantine of travelers coming from high risk areas are recommended to prevent possible importation of COVID-19. Currently, RT-PCR is a reliable test in detecting both symptomatic and asymptomatic COVID-19.
University teachers' perception of barriers to the use of digital technologies: the importance of the academic discipline
Authors: Mercader Cristina , Gairín Joaquín
Published: March 2020

Digital technologies are currently one of the most used resources among students for developing their personalized learning environment. However, recent studies continue to demonstrate a lack of usage on the part of teaching staff for developing their teaching practices, especially at the university level. Through the identification of personal, professional, institutional, and contextual barriers, this study seeks to reveal the reasons why teachers in institutions of higher education do not use digital technologies for teaching purposes and whether the academic discipline influences this perception. The results suggest that professional barriers are the most prevalent and that the discipline of arts and humanities is where the most obstacles are perceived. In conclusion, there is a need for better professional development for teachers and more institutional involvement through strategic plans.
Evaluation of the clinical value of circulating miR-101, miR-187 and miR-21 in neonatal sepsis diagnosis and prognosis
Authors: Salim Rabab F. , Sobeih Ahmed A. , Abd El Kareem Heba M.
Published: March 2020

Background

Neonatal sepsis is considered as a complicated syndrome, which requires urgent intervention to avoid the unfavorable outcome. Thus, biomarkers that can either distinguish sepsis early or predict sepsis outcome are of critical need. Therefore, the aim of the current study was to investigate the clinical value of miR-187, miR-101, and miR-21 on neonatal sepsis diagnosis and prediction of prognosis. Fifty neonates with sepsis, 30 neonates with SIRS, and 20 healthy neonates were selected. Relative expression levels of the selected miRNAs were quantified by qRT-PCR. Serum CRP and PCT were analyzed.

Results

miR-101 and miR-187 expression levels were elevated in septic neonates compared with SIRS neonates and normal controls. The AUC of miR-101, miR-187, and PCT to predict sepsis diagnosis were 0.908, 789, and 0.856, respectively. miR-21 expression levels in non-survivors were significantly higher than in survivors. The AUC of miR-21, a score of neonatal acute physiology (SNAP-II), and PCT to detect the predictive mortality value were 0.793, 0.781, and 0.635, respectively. Survival analysis revealed that high miR-21 expression levels were related to low survival rates. miR-21 and SNAP II were independent risk factors for sepsis mortality, and the AUC of the two combined variables’ predictive probabilities was 0.926 and yielded a specificity of 91.2% and a sensitivity of 81.3%, which was higher than that of either miR-21 or SNAP II.

Conclusion

miR-101 might function as a hopeful diagnostic biomarker for neonatal sepsis. Additionally, miR-21 gained attention to be a valuable predictor for sepsis prognosis especially if combined with SNAP II.
The incidence of BRCA1 and BRCA2 variants of unknown significance varies in different ethnic populations
Authors: Opatt D. M. , Morrow M. , Daly M.
Published: March 2020

10002

Background: BRCA1 and BRCA2 mutations in the general population are rare. Women with these mutations have a significantly increased risk of invasive breast and ovarian cancer (65–85% and 15–65% cumulative lifetime risk, respectively). Variants of unknown significance (VUS), which are of uncertain clinical importance, account for up to 50% of all identified BRCA1 and BRCA2 sequence alterations1. Methods: Pooled data from all patients presenting to Fox Chase Cancer Center for genetic counseling was examined. Patients underwent genetic testing after detailed genetic counseling. Clinical data, including gender, ethnic background, and personal history of cancer, and total number of patients tested were collected. Results: A total of 1,765 women and 236 men underwent genetic testing. The distribution of ethnicity was: <1% Asian, 2.7% African American, <1% Hispanic, 2.4% other or of more than one ethnicity, 83% White, and 11% unknown. Mutations of BRCA1 and BRCA2 were seen in 13% of the women and 2.7% of the men. VUS were seen in 6.2% of the women and .15% of the men. Of the women positive for a VUS, 2.4% were Asian, 18.1% were African American, 5.5% were Hispanic, 4.7% were more than one ethnicity, 66.9% were White, and 2.4% were Unknown ethnicity. Only .15% of the men tested were positive for a VUS, all of whom were White. Of the 51 African American women tested, 45.1% were positive for a VUS while only 5.5% of the 1,503 White women tested were positive (p<0.0001). Of the females testing positive for a VUS, a personal history of breast cancer was seen in 66.7% of Asians, 78.3% of African Americans, 100% of Hispanics, 83.3% of those more than one race, 61% of Whites, and none of the people of unknown ethnic origin. One of three men testing positive for a VUS reported a history of breast cancer. Conclusions: Identification of VUS occurred disproportionately in African Americans, occurring ten times more often in African American women than White women in our study. Studies to improve classification of VUS as deleterious or neutral are needed to enhance the utility of genetic testing for women at risk, particularly those of African American ethnicity. 1Goldman, DE et al. Am. J. Hum. Genet., 2004.

No significant financial relationships to disclose.
Effects of tumor stroma interaction on global gene expression in breast cancer
Authors: Buess M. , Nuyten D. , Hastie T. , Brown P. O.
Published: March 2020

10006

Background: Perturbations in cell-cell interaction are a key feature of cancer. However, the systematic effects of cell-cell interaction on global gene expression in cancer are largely unexplored. We hypothesized that gene expression signatures induced by cell-cell interaction might be of clinical relevance. Methods: We simulated tumor-stroma interaction in vitro by systematically co-cultivating each of 7 different breast cancer cell lines with stromal fibroblasts from 3 different sites, and determined associated gene expression changes with cDNA microarrays. A dataset of pretreatment gene expression profiles from 295 early stage breast cancers (stage 1 and 2) with a median follow up of 12.6 years allowed us to evaluate the prognostic significance of the gene expression signatures of specific cell-cell interactions derived from our ex vivo models. Results: The most prominent response to epithelial-mesenchymal interaction was an induction of interferon-response genes (IRG), observed in 4 of the 7 breast cancer cell lines in co-culture with fibroblasts, but not in normal mammary epithelial cells. In response to close contact with these breast cancer cells, the fibroblasts secreted type I interferons, which, in turn, induced expression of the IRG in the tumor cells. Immunohistochemical analysis of human breast cancer tissues showed that Stat1, the key transcriptional activator of the IRG, and itself an IRG, was expressed in a subset of the cancers, with a striking pattern of elevated expression in the cancer cells in contact with, or close proximity to, the tumor stroma - paralleling the response seen in our ex vivo model. In vivo, expression of the IRGs was remarkably coherent, providing a basis for segregation of the 295 early-stage breast cancers into two groups by unsupervised hierarchical clustering with the IRG. Tumors with high expression levels (n=161) of IRG were associated with significantly shorter overall survival; 59% at 10 years versus 80% at 10 years for tumors with low expression levels (n=134) (log-rank p=0.001). Conclusions: Our results suggest that an interaction between some breast cancer cells and stromal fibroblasts can induce an interferon response, and that this response may be associated with a greater propensity for tumor progression.

No significant financial relationships to disclose.
Prognostic value of thymidylate synthase (TS) expression on failure-free survival of fluorouracil-treated metastatic colorectal cancer patients
Authors: Richman S. , Braun M. S. , Adlard J. W. , Daly C. , Turner F. , Barrett J. , Meade A. , Parmar M. , Quirke P. , Seymour M. T.
Published: March 2020

10011

Background: We previously presented (ASCO 04 #9506) an exploratory analysis of 13 molecular markers in relation to clinical outcomes in 846 patients treated with fluorouracil (FU), or FU+irinotecan, or FU+oxaliplatin in a large UK-based randomized controlled trial (FOCUS - ASCO ’05 #3518). High TS IHC expression and tumor grade were highly significantly associated with reduced failure-free survival (FFS) in a multivariable model. We now present data from an independent validation set of 449 FOCUS patients and on the combined test and validation sets. Methods: Formalin-fixed, paraffin embedded blocks were retrieved from consenting patients and tissue microarrays made for IHC assessment. Factors assessed for the effect on FFS of first-line therapy were: liver metastases; ALP; grade; mucoid status; age; and IHC for dUTPase and TS. Log-rank univariate analyses and Cox Model multivariable analysis was performed. Results: Univariate analysis of the validation set failed to confirm evidence of the previously observed association between high TS expression and FFS (p=0.2); however high dUTPase IHC (p=0.01), ALP (p<0.0001) and grade (p=0.001) showed significant associations. Table 1 illustrates the results of univariate and multivariable analysis of the combined test and validation sets. In the Cox Model, high TS IHC expression, tumor grade and baseline serum ALP were highly significant predictors of reduced FFS. Conclusions: We failed to confirm a significant association between high TS expression and reduced FFS in an independent validation set. However, in an exploratory analysis of the combined validation and test sets (n>1000), TS IHC expression remained a highly significant predictor of FFS. Overall, our results cannot be taken to demonstrate a powerful and clinically useful influence of TS on treatment efficacy, but are consistent with a moderate effect.

[Table: see text]

No significant financial relationships to disclose.
Ductal carcinoma in situ and BRCA mutations: Association and risk factors
Authors: Smith K. L. , Adank M. , Kauff N. , Lafaro K. , Boyd J. , Lee J. , Hudis C. , Offit K. , Robson M.
Published: March 2020

10016

Introduction: Ductal carcinoma in situ (DCIS) has been associated with BRCA mutations. Factors associated with the presence of mutations are not well defined. Methods: BRCA founder mutation status was determined in 3 groups of women with DCIS: 1) a prevalent convenience sample of Ashkenazi Jewish (AJ) women (Sukumvanich SSO 2005), 2) an incident cohort of AJ women ascertained before breast surgery and 3) a clinical ascertainment of probands (P) with DCIS (53 AJ and 38 non-AJ) presenting to a cancer risk assessment service. For women in groups 1 and 2, BRCA founder mutation status was also determined in age-matched controls with invasive breast cancer (BC). Results: Within the prevalent ascertainment, 3/62 (4.8%) women with DCIS and 15/130 (11.5%) controls with invasive BC had BRCA mutations. In the incident cohort, 0/58 (0%) women with DCIS and 6/116 (5.2%) controls with invasive BC had BRCA mutations (combined OR 3.6, 95% CI 1.1–12.5, p 0.04). In the clinical ascertainment of AJ women with DCIS, mutations were identified in 4/35 (11.4%) P ≤ 50 yrs at dx and in 2/18 (11.1%) P > 50 yrs. The proportion of AJ P with mutations based on family history (FH) of BC and ovarian cancer (OC) is shown in the table. In AJ P with DCIS, FH of OC is strongly associated with BRCA mutations (adjusted OR 10.0, 95% CI 1.1–89.3, p 0.04). Among non-AJ P, no mutations were identified without a FH of OC or BC ≤ 50 yrs at dx. Conclusions: DCIS is associated with BRCA mutations in AJ women, but the prevalence is lower than in women with invasive cancer. FH of OC is a strong risk factor.

[Table: see text]

No significant financial relationships to disclose.
Telomere maintenance predicts progression and survival in pediatric intracranial ependymoma
Authors: Tabori U. , Bouffet E. , Bartels U. , Malkin D. , Hawkins C.
Published: March 2020

10020

Background: Ependymoma is the third most common pediatric brain tumor. Despite the importance of surgical resection and pathology, its clinical course is highly unpredictable and the biological behavior is largely unknown. As part of ongoing studies to identify potential biological and therapeutic markers for the disease, we analyzed the role of telomere maintenance, which is required for cancers to sustain growth and evade senescence. Methods: We analyzed 111 primary and recurrent ependymomas that were resected at the Hospital for Sick Children in Toronto between 1986 and 2004. A tissue array was constructed. hTERT and γH2AX expression were evaluated. Thirty-one frozen samples were additionally analyzed for telomere length (TRF) and telomerase activity (TRAP assay). Results: Of the 111 samples, 40 tumors were hTERT(-) with progression-free survival (PFS) of 83±15% and 71 were hTERT(+) with PFS of 21±9% (p<0.0001). Of the 65 patients with primary ependymomas, five-yr overall survival (OS) were 84±7% and 41±7% for hTERT(-) and hTERT(+) tumors, respectively (p=0.001). There was good correlation between telomerase activity and hTERT expression (κ=0.637). Multivariate analysis revealed hTERT expression to be the single most important predictor of survival of all known pathological, clinical and treatment factors (HR 60.4 (CI 6.4–561)). TRF measurement revealed lack of alternative lengthening of telomeres (ALT) and heterogenous telomere length in pediatric ependymomas. We observed a trend for better prognosis with telomere dysfunction manifested by shorter telomeres and positive γH2AX. Conclusions: This study suggest that telomere maintenance represents the first known biologic prognostic factor for intracranial ependymomas. Telomerase activity highlights the importance of senescence in carcinogenesis and a possible target for novel treatment approaches for the disease.

No significant financial relationships to disclose.