bluuebunny/crossref_metadata_2025 huggingface dataset:
The Driving Risk Analysis and Evaluation in Rightward Zone of Expressway Reconstruction and Extension Engineering
Authors: Zhang Chi , Wang Bo , Yang Shaoxiang , Zhang Min , Gong Quanli , Zhang Hong
Published: September 2020

In the expressway reconstruction and expansion engineering, the form of rightward zone is increasingly adopted, and its complicated traffic conditions can easily cause traffic accidents. In order to quickly and effectively grasp the traffic risk of the right diversion section, this study employs average speed, the coefficient of variation, the equivalent minimum safety distance, and the deceleration as evaluation indexes of driving risk, and then analyses the influence rules of traffic volume, the proportion of large vehicles, and the length of the transition section on each evaluation index by using Vissim simulation software. On the basis of this, we determine the weight of each evaluation index by the entropy method and establish the driving risk index evaluation model of the work zone with multiple linear regression. The results show that the partial regression coefficients of traffic volume, the proportion of large vehicles, and the length of the transition section to the driving risk index are 0.059, 0.317, and 0.15, respectively. Finally, in this paper, we analyze the traffic risk of example section based on the driving risk evaluation model. The results of evaluation are consistent with the number of measured conflicts. This study proposes a new method for predicting the traffic risk of the expressway reconstruction and extension engineering, which can provide a reference for the development of safety management measures in the rightward zone.
Numerical Solution of Sine-Gordon Equation with the Local Kriging Meshless Method
Authors: Guo Pengfei , Boldbaatar Ariunkhishig , Yi Dutao , Dai Pengxiang
Published: September 2020

This paper develops a local Kriging meshless solution to the nonlinear 2 + 1-dimensional sine-Gordon equation. The meshless shape function is constructed by Kriging interpolation method to have Kronecker delta function property for the two-dimensional field function, which leads to convenient implementation of imposing essential boundary conditions. Based on the local Petrov–Galerkin formulation and the center difference method for time discretization, a system of nonlinear discrete equations is obtained. The numerical examples are presented and the numerical solutions are found to be in good agreement with the results in the literature to validate the ability of the present meshless method to handle the 2 + 1-dimensional sine-Gordon equation related problems.
Prediction of Later‐Age Concrete Compressive Strength Using Feedforward Neural Network
Authors: Nguyen Thuy-Anh , Ly Hai-Bang , Mai Hai-Van Thi , Tran Van Quan
Published: September 2020

Accurate prediction of the concrete compressive strength is an important task that helps to avoid costly and time‐consuming experiments. Notably, the determination of the later‐age concrete compressive strength is more difficult due to the time required to perform experiments. Therefore, predicting the compressive strength of later‐age concrete is crucial in specific applications. In this investigation, an approach using a feedforward neural network (FNN) machine learning algorithm was proposed to predict the compressive strength of later‐age concrete. The proposed model was fully evaluated in terms of performance and prediction capability over statistical results of 1000 simulations under a random sampling effect. The results showed that the proposed algorithm was an excellent predictor and might be useful for engineers to avoid time‐consuming experiments with the statistical performance indicators, namely, the Pearson correlation coefficient (R), root‐mean‐squared error (RMSE), and mean squared error (MAE) for the training and testing parts of 0.9861, 2.1501, 1.5650 and 0.9792, 2.8510, 2.1361, respectively. The results also indicated that the FNN model was superior to classical machine learning algorithms such as random forest and Gaussian process regression, as well as empirical formulations proposed in the literature.
YAP and AP-1 Cooperate to Initiate Pancreatic Cancer Development from Ductal Cells in Mice
Authors: Park Jaeoh , Eisenbarth David , Choi Wonyoung , Kim Hail , Choi Chan , Lee Dahye , Lim Dae-Sik
Published: September 2020

The development of pancreatic cancer is heavily dependent upon the aberrant activation of KRAS signaling. Among the downstream targets of KRAS, the effectors of the Hippo pathway YAP and TAZ (YAP/TAZ) are crucial during cancer initiation and progression. However, little is known about the cell type-specific effects of YAP/TAZ on the development of pancreatic cancer. Here we clarify the unique consequences of YAP/TAZ activation in the ductal cell population of the pancreas by generating mice with pancreatic duct cell-specific, inducible knockouts of Lats1 and Lats2, the main kinases upstream of YAP/TAZ. Oncogenic activation of YAP by deletion of Lats1/2 in ductal cells led to the rapid transformation of the pancreas, which was accompanied by a robust increase in the expression of YAP and AP-1 target genes. Pharmacologic inhibition of AP-1 activity induced death in Lats1/2 knockout organoids and attenuated YAP-dependent transformation of the pancreas in vivo. Both YAP and AP-1 were activated during the development of KRAS-dependent cancer in mice and human patients with pancreatic ductal adenocarcinoma, suggesting that this signaling hub represents an important mediator of pancreatic cancer development and progression. Collectively, these data define a YAP-dependent mechanism of pancreatic cancer cell development and suggest that inhibition of AP-1 can suppress this development.

Significance:

A pancreatic ductal cell-specific knockout mouse model featuring constitutively active YAP allows for the study of YAP-dependent transformation of the pancreas and for screening pharmacologically active inhibitors.
AsiDNA Is a Radiosensitizer with no Added Toxicity in Medulloblastoma Pediatric Models
Authors: Ferreira Sofia , Foray Chloe , Gatto Alberto , Larcher Magalie , Heinrich Sophie , Lupu Mihaela , Mispelter Joel , Boussin François D. , Pouponnot Célio , Dutreix Marie
Published: September 2020

Purpose:

Medulloblastoma is an important cause of mortality and morbidity in pediatric oncology. Here, we investigated whether the DNA repair inhibitor, AsiDNA, could help address a significant unmet clinical need in medulloblastoma care, by improving radiotherapy efficacy without increasing radiation-associated toxicity.

Experimental Design:

To evaluate the brain permeability of AsiDNA upon systemic delivery, we intraperitoneally injected a fluorescence form of AsiDNA in models harboring brain tumors and in models still in development. Studies evaluated toxicity associated with combination of AsiDNA with radiation in the treatment of young developing animals at subacute levels, related to growth and development, and at chronic levels, related to brain organization and cognitive skills. Efficacy of the combination of AsiDNA with radiation was tested in two different preclinical xenografted models of high-risk medulloblastoma and in a panel of medulloblastoma cell lines from different molecular subgroups and TP53 status. Role of TP53 on the AsiDNA-mediated radiosensitization was analyzed by RNA-sequencing, DNA repair recruitment, and cell death assays.

Results:

Capable of penetrating young brain tissues, AsiDNA showed no added toxicity to radiation. Combination of AsiDNA with radiotherapy improved the survival of animal models more efficiently than increasing radiation doses. Medulloblastoma radiosensitization by AsiDNA was not restricted to a specific molecular group or status of TP53. Molecular mechanisms of AsiDNA, previously observed in adult malignancies, were conserved in pediatric models and resembled dose increase when combined with irradiation.

Conclusions:

Our results suggest that AsiDNA is an attractive candidate to improve radiotherapy in medulloblastoma, with no indication of additional toxicity in developing brain tissues.
Comparison of Surgical Resection and Stereotactic Radiosurgery in the Initial Treatment of Brain Metastasis
Authors: Liu Zhen , He Shuting , Li Liang
Published: September 2020

Background: Brain metastasis (BM) is the most common brain malignancy and a common cause of death in cancer patients. However, the relative outcome-related advantages and disadvantages of surgical resection (SR) and stereotactic radiosurgery (SRS) in the initial treatment of BM are controversial. Method: We systematically reviewed the English language literature up to March 2020 to compare the efficacy of SR and SRS in the initial treatment of BM. We identified cohort studies from the Cochrane Library, PubMed, and EMBASE databases and conducted a meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Twenty cohort studies involving 1,809 patients were included. Local control did not significantly differ between the SR and SRS groups overall (hazard ratio [HR] 1.02, 95% confidence interval (CI) 0.64–1.64, p = 0.92; I2 = 54%, p = 0.03) or in subgroup analyses of SR plus SRS vs. SRS alone, SR plus whole brain radiation therapy (WBRT) versus SRS plus WBRT, or SR plus WBRT versus SRS alone. Distant intracranial control did not significantly differ between the SR and SRS groups overall (HR 0.78, 95% CI 0.38–1.60, p = 0.49; I2 = 61%, p = 0.03) or in subgroup analyses of SR plus SRS versus SRS alone or SR plus WBRT versus SRS alone. In addition, overall survival (OS) did not significantly differ in the SR and SRS groups (HR 0.91, 95% CI 0.65–1.27, p = 0.57; I2 = 47%, p = 0.09) or in subgroup analyses of SR plus SRS versus SRS alone, SR plus WBRT versus SRS alone or SR plus WBRT versus SRS plus WBRT. Conclusion: Initial treatment of BM with SRS may offer comparable local and distant intracranial control to SR in patients with single or solitary BM. OS did not significantly differ between the SR and SRS groups in people with single or solitary BM.
Prediction of Large for Gestational Age by Ultrasound at 35 Weeks and Impact of Ultrasound-Delivery Interval: Comparison of 6 Standards
Authors: Savirón-Cornudella Ricardo , Esteban Luis M. , Aznar-Gimeno Rocío , Dieste Pérez Peña , Pérez-López Faustino R. , Castán-Larraz Berta , Sanz Gerardo , Tajada-Duaso Mauricio
Published: September 2020

Objective: The aim of the study was to assess the predictive ability of the ultrasound estimated percentile weight (EPW) at 35 weeks to predict large for gestational age (LGA) at term delivery according to 6 growth standards, including population, population-customized, and international references. The secondary objectives were to determine its predictive ability to detect adverse perinatal outcomes (APOs) and whether the ultrasound-delivery interval influences the detection rate of LGA newborns. Methods: This was a retrospective cohort study of 9,585 singleton pregnancies. Maternal clinical characteristics, fetal ultrasound data obtained at 35 weeks, and pregnancy and perinatal outcomes were used to calculate EPWs to predict LGAs at delivery according to the customized and the non-customized (NC) Miguel Servet University Hospital (MSUH), the customized Figueras, the NC Fetal Medicine Foundation (FMF), the NC INTERGROWTH-21st, and the NC World Health Organization (WHO) standards. Results: For a 10% false-positive rate, detection rates for total LGAs at delivery ranged from 31.2% with the WHO (area under the curve [AUC] 0.77; 95% confidence interval [CI], 0.76–0.79) to 56.5% with the FMF standard (AUC 0.85; 95% CI, 0.84–0.86). Detection rates and values of AUCs to predict LGAs by ultrasound-delivery interval (range 1–6 weeks) show higher detection rates as the interval decreases. APO detection rates ranged from 2.5% with the WHO to 12.6% with the Figueras standard. Conclusion: The predictive ability of ultrasound estimated fetal weight at 35 weeks to detect LGA infants is significantly greater for FMF and MSUH NC standards. In contrast, the APO detection rate is significantly greater for customized standards. The shorter ultrasound-delivery interval relates to better prediction rates.
Transition of a Large Tertiary Heart Failure Program in Response to the COVID-19 Pandemic
Authors: Sayer Gabriel , Horn Evelyn M. , Farr Maryjane A. , Axsom Kelly , Kleet Audrey , Gjerde Cecilie , Latif Farhana , Sobol Irina , Kelley Nancy , Lancet Erica , Halik Carolyn , Takeda Koji , Naka Yoshifumi , Yuzefpolskaya Melana , Kumaraiah Deepa , Colombo Paolo C. , Maurer Mathew S. , Uriel Nir
Published: September 2020

The coronavirus disease 2019 (COVID-19) pandemic imposed severe restrictions on traditional methods of patient care. During the pandemic, the heart failure program at New York-Presbyterian Hospital in New York, NY rapidly and comprehensively transitioned its care delivery model and administrative organization to conform to a new healthcare environment while still providing high-quality care to a large cohort of patients with heart failure, heart transplantation, and left ventricular assist device. In addition to the widespread adoption of telehealth, our program restructured outpatient care, initiating a shared clinic model and introducing a comprehensive remote monitoring program to manage patients with heart failure and heart transplant. All conferences, including administrative meetings, support groups, and educational seminars were converted to teleconferencing platforms. Following the peak of COVID-19, many of the new changes have been maintained, and the program structure will be permanently altered as a lasting effect of this pandemic. In this article, we review the details of our program’s transition in the face of COVID-19 and highlight the programmatic changes that will endure.
Altered Hemodynamics and End-Organ Damage in Heart Failure
Authors: Verbrugge Frederik H. , Guazzi Marco , Testani Jeffrey M. , Borlaug Barry A.
Published: September 2020

Heart failure is characterized by pathologic hemodynamic derangements, including elevated cardiac filling pressures (“backward” failure), which may or may not coexist with reduced cardiac output (“forward” failure). Even when normal during unstressed conditions such as rest, hemodynamics classically become abnormal during stressors such as exercise in patients with heart failure. This has important upstream and downstream effects on multiple organ systems, particularly with respect to the lungs and kidneys. Hemodynamic abnormalities in heart failure are affected by processes that extend well beyond the cardiac myocyte, including important roles for pericardial constraint, ventricular interaction, and altered venous capacity. Hemodynamic perturbations have widespread effects across multiple heart failure phenotypes, ranging from reduced to preserved ejection fraction, acute to chronic disease, and cardiogenic shock to preserved perfusion states. In the lung, hemodynamic derangements lead to the development of abnormalities in ventilatory control and efficiency, pulmonary congestion, capillary stress failure, and eventually pulmonary vascular disease. In the kidney, hemodynamic perturbations lead to sodium and water retention and worsening renal function. Improved understanding of the mechanisms by which altered hemodynamics in heart failure affect the lungs and kidneys is needed in order to design novel strategies to improve clinical outcomes.
Early and Supernormal Vascular Aging
Authors: Bruno Rosa Maria , Nilsson Peter M. , Engström Gunnar , Wadström Benjamin Nilsson , Empana Jean-Philippe , Boutouyrie Pierre , Laurent Stephane
Published: September 2020

Pulse wave velocity is an established marker of early vascular aging but may also help identifying individuals with supernormal vascular aging. We tested the hypothesis that individuals with the largest difference (Δ-age) between chronological and vascular age show the lowest rate of cardiovascular events and may thus be defined as supernormal vascular aging. Vascular age was defined as the predicted age in the best fitting multivariable regression model including classical risk factors and treatment and pulse wave velocity, in a subset of the Reference Values for Arterial Stiffness Collaboration Database (n=3347). Δ-age was then calculated as chronological age minus vascular age, and the 10th and 90th percentiles were used to define early (Δ-age<−5.7 years), normal (Δ-age −5.7 to 6.8 years) and supernormal vascular aging (Δ-age>6.8 years). The risk for fatal and nonfatal cardiovascular events associated with vascular aging categories was investigated in the Malmö Diet and Cancer Study cohort (n=2642).

In the Malmö Diet and Cancer Study Cohort (6.6-year follow-up, 286 events), Δ-age was significantly (
P
<0.01) and inversely associated with cardiovascular events. Compared with normal vascular aging, supernormal vascular aging had lower risk (hazard ratio, 0.59 [95% CI, 0.41–0.85]), whereas early vascular aging had higher risk (hazard ratio, 2.70 [95% CI, 1.55–4.70]) of cardiovascular events, in particular coronary events. There was no significant association with all-cause mortality. This study represents the first validation of the clinical significance of the supernormal vascular aging concept, based on prospective data. Its further characterization may help discovering novel protective molecular pathways and providing preventive strategies for successful vascular aging.
Role of Endothelial G Protein-Coupled Receptor Kinase 2 in Angioedema
Authors: Gambardella Jessica , Sorriento Daniela , Bova Maria , Rusciano Mariarosaria , Loffredo Stefania , Wang Xujun , Petraroli Angelica , Carucci Laura , Mormile Ilaria , Oliveti Marco , Bruno Morelli Marco , Fiordelisi Antonella , Spadaro Giuseppe , Campiglia Pietro , Sala Marina , Trimarco Bruno , Iaccarino Guido , Santulli Gaetano , Ciccarelli Michele
Published: September 2020

Excessive BK (bradykinin) stimulation is responsible for the exaggerated permeabilization of the endothelium in angioedema. However, the molecular mechanisms underlying these responses have not been investigated. BK receptors are Gq-protein-coupled receptors phosphorylated by GRK2 (G protein-coupled receptor kinase 2) with a hitherto unknown biological and pathophysiological significance. In the present study, we sought to identify the functional role of GRK2 in angioedema through the regulation of BK signaling. We found that the accumulation of cytosolic Ca
2+
in endothelial cells induced by BK was sensitive to GRK2 activity, as it was significantly augmented by inhibiting the kinase. Accordingly, permeabilization and NO production induced by BK were enhanced, as well. In vivo, mice with reduced GRK2 levels in the endothelium (Tie2-CRE/GRK2
fl+/fl
−
) exhibited an increased response to BK in terms of vascular permeability and extravasation. Finally, patients with reduced GRK2 levels displayed a severe phenotype of angioedema. Taken together, these findings establish GRK2 as a novel pivotal regulator of BK signaling with an essential role in the pathophysiology of vascular permeability and angioedema.
Unique Transcriptome Signature Distinguishes Patients With Heart Failure With Myopathy
Authors: Caspi Talia , Straw Sam , Cheng Chew , Garnham Jack O , Scragg Jason L. , Smith Jessica , Koshy Aaron O. , Levelt Eylem , Sukumar Piruthivi , Gierula John , Beech David J. , Kearney Mark T. , Cubbon Richard M. , Wheatcroft Stephen B. , Witte Klaus K. , Roberts Lee D. , Bowen T. Scott
Published: September 2020

Background

People with chronic heart failure (CHF) experience severe skeletal muscle dysfunction, characterized by mitochondrial abnormalities, which exacerbates the primary symptom of exercise intolerance. However, the molecular triggers and characteristics underlying mitochondrial abnormalities caused by CHF remain poorly understood.

Methods and Results

We recruited 28 patients with CHF caused by reduced ejection fraction and 9 controls. We simultaneously biopsied skeletal muscle from the pectoralis major in the upper limb and from the vastus lateralis in the lower limb. We phenotyped mitochondrial function in permeabilized myofibers from both sites and followed this by complete RNA sequencing to identify novel molecular abnormalities in CHF skeletal muscle. Patients with CHF presented with upper and lower limb skeletal muscle impairments to mitochondrial function that were of a similar deficit and indicative of a myopathy. Mitochondrial abnormalities were strongly correlated to symptoms. Further RNA sequencing revealed a unique transcriptome signature in CHF skeletal muscle characterized by a novel triad of differentially expressed genes related to deficits in energy metabolism including adenosine monophosphate deaminase 3, pyridine nucleotide‐disulphide oxidoreductase domain 2, and lactate dehydrogenase C.

Conclusions

Our data suggest an upper and lower limb metabolic myopathy that is characterized by a unique transcriptome signature in skeletal muscle of humans with CHF.
Urban Schooling and Social Integration of Ethnic Migrant Students in China
Authors: Wang Tao
Published: September 2020

A great migration from rural to urban areas is happening in China and dramatically changing China society. This qualitative study examines the educational experience and social integration of ethnic migrant students in urban China. Contextualized within the huge rural-urban divide, findings indicate challenges in urban schooling and study adaption, including language barriers, achievement gaps, incompatibility of teaching and learning, and high-stakes tests. This study also interprets their negotiation with host and home places and cultures, and cultivation of cultural capital and cross-cultural competence. The unification and competitiveness in urban schooling and the need for culturally responsive teaching are discussed.
Book review: A. S. Panneerselvan (Ed.), Uncertain Journeys: Labour Migration from South Asia
Authors: Alha Akhil
Published: September 2020

A. S. Panneerselvan (Ed.), Uncertain Journeys: Labour Migration from South Asia. Speaking Tiger, New Delhi 2018, 188 pp, ₹399, ISBN 978-93-88326-71-1
Risk and Value in Benefit-sharing with Displaced People: Looking Back 40 Years, Anticipating the Future
Authors: Price Susanna , Van Wicklin Warren A. , Koenig Dolores , Owen John , Wet Chris de , Kabra Asmita
Published: September 2020

The right to compensation and rehabilitation for those displaced by projects is a generally recognised principle of multilateral development institutions and, increasingly, of national governments. There is no such consensus of the concept of benefit-sharing—neither its definition nor realisation. This paper advances this discussion: reviewing past performance of benefit-sharing and anticipating its future rationale, timing and delivery. Drawing upon country laws and project reviews for hydropower, it also briefly examines prospects for another revenue generating sector: mining and non-revenue generating urban projects. It addresses the question: should benefit-sharing be limited to monetary benefits derived only from projects generating revenue during the project operations phase or should a broader concept of benefit-sharing prevail? The authors compare both financial and resettlement logics of each form. In anticipating an uncertain future, they conclude that centralising partnerships and negotiated consent with the resource losers can lead to workable, durable, ethical and effective benefit-sharing.
Parental Knowledge of Children’s Screen Time: The Role of Parent-Child Relationship and Communication
Authors: Marciano Laura , Petrocchi Serena , Camerini Anne-Linda
Published: September 2020

The ubiquity of media in children’s lives makes it increasingly difficult for parents to keep track of their children’s screen time, leading to considerable discrepancies in parent- and child-report. In the present study, we aimed to examine if and how these discrepancies can be explained by parent-child communication, in terms of children’s self-disclosure, secrecy, and parental solicitation, and to what extend the quality of the parent-child relationship can influence these communication patterns. We tested two structural equation models to investigate the absolute discrepancy between parent and child estimates of children’s screen time and parental underestimation, using dyadic data from 854 11-year-olds and their parents, in Switzerland. Our results showed that children’s self-disclosure and secrecy behaviors were significantly associated with parental knowledge, where the relationship between self-disclosure and parental knowledge of children’s screen time was the stronger among the two. Moreover, a good parent-child relationship, especially parents’ ability in perspective taking, was significantly related to increased self-disclosure and decreased secrecy behaviors by children.
Evidence‐Based Medicine in Otolaryngology Part XII: Assessing Patient Preferences
Authors: Naunheim Matthew R. , Randolph Gregory W. , Shin Jennifer J.
Published: September 2020

Objective

To provide a contemporary resource to update clinicians and researchers on the current state of assessment of patient preferences.

Data Sources

Published studies and literature regarding patient preferences, evidence‐based practice, and patient‐centered management in otolaryngology.

Review Methods

Patients make choices based on both physician input and their own preferences. These preferences are informed by personal values and attitudes, and they ideally result from a deliberative evaluation of the risks, benefits, and other outcomes pertaining to medical care. To date, rigorous evaluation of patient preferences for otolaryngologic conditions has not been integrated into clinical practice or research. This installment of the “Evidence‐Based Medicine in Otolaryngology” series focuses on formal assessment of patient preferences and the optimal methods to determine them.

Conclusions

Methods have been developed to optimize our understanding of patient preferences.

Implications for Practice

Understanding these patient preferences may help promote an evidence‐based approach to the care of individual patients.
An exploration of the multiple motivations for spending less time at work
Authors: Balderson Ursula , Burchell Brendan , Kamerāde Daiga , Wang Senhu , Coutts Adam
Published: September 2020

This article makes a significant empirical contribution to our understanding of why people in the United Kingdom without childcare responsibilities actively reduce or limit the amount of time they spend in paid employment. We show how the negative aspects of employment (push factors) and the desire to spend time in more varied and enjoyable ways (pull factors) interact to produce decisions to enact working time reductions (WTRs). The push factors include excessive workloads and difficult or tedious tasks which can result in stress and mental exhaustion. For people working non-standard schedules, their lack of control over hours can make it difficult to enjoy the free time that is available. The pull factors we have identified include traumatic experiences such as illness or the early death of a loved one which can lead to an increased awareness of the salience of time. Also important was the desire to develop skills and subjectivities unrelated to work-time identities. An overarching theme in the interviews was the idea that full-time work leads to a loss of autonomy, and a reduction in hours is a route to greater freedom. These motivations are contrasted with understandings of WTRs present in the empirical and predominantly quantitative literature which highlight the structural constraints that often force women in particular into part-time work as a result of childcare responsibilities. An exploration of the motivations of short-hour workers is pertinent, given increasing concern that long hours of work exacerbate multiple social, economic and environmental problems. We suggest that a deeper understanding of why individuals want to work less could help facilitate ‘priming’ campaigns aimed at increasing demand for WTRs more generally.
Communicating Oncologic Prognosis With Empathy: A Pilot Study of a Novel Communication Guide
Authors: Lippe Megan , Farya Phillips , Jennifer McCulloch , Stanley Alexandra , Barbara Jones , Boone Goodgame
Published: September 2020

Background:

Clear communication between patients, families, and health-care providers is imperative to maximize patient outcomes, particularly for patients diagnosed with incurable cancer who require prompt engagement in decision-making. In response to the need to engage in quality patient-centered communication, an interprofessional team, representing medicine, nursing, social work, spiritual care, and clinical psychology, explored extant literature and developed a simple, single-page communication guide that summarizes the prognosis for patients with incurable cancers. The tool was specifically designed to enhance communication for patients, families, and across all members of the treatment and patient support team.

Purpose:

The purpose of this pilot study was to evaluate the impact of the communication guide on patient’s accurate understanding of prognosis and the feasibility and acceptability of the intervention.

Methods:

The study employed a sequential explanatory mixed-method design. Using pre- and post-tests, participants completed a prognosis and treatment perception survey and were randomized into control or intervention groups based on preference for prognostic information. The oncologist utilized the communication guide with the participants in the intervention group. Finally, 6-week post-test surveys were completed, followed by an exit interview.

Results:

Key findings revealed participants prefer receiving detailed information about prognosis and have differing perceptions compared to the oncologists. Understandings of prognosis for patients and oncologists became more congruent following use of the communication guide. Participants found the tool useful and helpful.

Conclusions:

The communication tool serves as a promising mechanism to enhance patient-centered communication about prognosis for patients with incurable cancer.
Evaluating the Factor Structure of the Posttraumatic Cognitions Inventory
Authors: Whiteman Sarah E. , Kramer Lindsay B. , Silverstein Madison W. , Witte Tracy K. , Weathers Frank W.
Published: September 2020

The Posttraumatic Cognitions Inventory (PTCI) is one of the most widely used measure of posttraumatic cognitions. The original factor analysis of the PTCI provided evidence for a three-factor model of negative cognitions about self, world, and self-blame. However, subsequent research has failed to replicate this factor structure without removing multiple items. Given these inconsistent findings, we examined the PTCI factor structure in a sample of trauma-exposed undergraduates ( n = 868). First, we conducted a series of four confirmatory factor analyses (CFAs) based on previously published models of the PTCI and a modified model based on previously removed items, all which indicated poor fit. Next, we conducted a CFA of the recently published three-factor PTCI-9, which approached adequate fit. We then replicated the CFA of the PTCI-9 in a second independent sample ( n = 971), finding a similar pattern of near adequate fit. These findings highlight the need to revise the PTCI. In addition, results indicate the promising nature of the PTCI-9 as an alternative measure of posttraumatic cognitions.
Can You Hear Out the Melody? Testing Musical Scene Perception in Young Normal-Hearing and Older Hearing-Impaired Listeners
Authors: Siedenburg Kai , Röttges Saskia , Wagener Kirsten C. , Hohmann Volker
Published: September 2020

It is well known that hearing loss compromises auditory scene analysis abilities, as is usually manifested in difficulties of understanding speech in noise. Remarkably little is known about auditory scene analysis of hearing-impaired (HI) listeners when it comes to musical sounds. Specifically, it is unclear to which extent HI listeners are able to hear out a melody or an instrument from a musical mixture. Here, we tested a group of younger normal-hearing (yNH) and older HI (oHI) listeners with moderate hearing loss in their ability to match short melodies and instruments presented as part of mixtures. Four-tone sequences were used in conjunction with a simple musical accompaniment that acted as a masker (cello/piano dyads or spectrally matched noise). In each trial, a signal-masker mixture was presented, followed by two different versions of the signal alone. Listeners indicated which signal version was part of the mixture. Signal versions differed either in terms of the sequential order of the pitch sequence or in terms of timbre (flute vs. trumpet). Signal-to-masker thresholds were measured by varying the signal presentation level in an adaptive two-down/one-up procedure. We observed that thresholds of oHI listeners were elevated by on average 10 dB compared with that of yNH listeners. In contrast to yNH listeners, oHI listeners did not show evidence of listening in dips of the masker. Musical training of participants was associated with a lowering of thresholds. These results may indicate detrimental effects of hearing loss on central aspects of musical scene perception.
Fluid therapy in mechanically ventilated critically ill children: the sodium, chloride and water burden of fluid creep
Authors: Langer Thomas , D’Oria Veronica , Spolidoro Giulia C. I. , Chidini Giovanna , Scalia Catenacci Stefano , Marchesi Tiziana , Guerrini Marta , Cislaghi Andrea , Agostoni Carlo , Pesenti Antonio , Calderini Edoardo
Published: September 2020

Background

Fluid therapy is a cornerstone of pediatric intensive care medicine. We aimed at quantifying the load of water, sodium and chloride due to different fluid indications in our pediatric intensive care unit (PICU). We were particularly interested in the role of fluid creep, i.e. fluid administered mainly as the vehicle for drugs, and the association between sodium load and water balance.

Methods

Critically ill children aged ≤3 years and invasively ventilated for ≥48 h between 2016 and 2019 in a single tertiary center PICU were retrospectively enrolled. Need for renal replacement therapy, plasmapheresis or parenteral nutrition constituted exclusion criteria. Quantity, quality and indication of fluids administered intravenously or enterally, urinary output and fluid balance were recorded for the first 48 h following intubation. Concentrations of sodium and chloride provided by the manufacturers were used to compute the electrolyte load.

Results

Forty-three patients (median 7 months (IQR 3–15)) were enrolled. Patients received 1004 ± 284 ml of water daily (153 ± 36 ml/kg/day), mainly due to enteral (39%), creep (34%) and maintenance (24%) fluids. Patients received 14.4 ± 4.8 mEq/kg/day of sodium and 13.6 ± 4.7 mEq/kg/day of chloride, respectively. The majority of sodium and chloride derived from fluid creep (56 and 58%). Daily fluid balance was 417 ± 221 ml (64 ± 30 ml/kg/day) and was associated with total sodium intake (r2 = 0.49, p < 0.001).

Conclusions

Critically ill children are exposed, especially in the acute phase, to extremely high loads of water, sodium and chloride, possibly contributing to edema development. Fluid creep is quantitatively the most relevant fluid in the PICU and future research efforts should address this topic in order to reduce the inadvertent water and electrolyte burden and improve the quality of care of critically ill children.
An exploration of the experiences of GP registrar supervisors in small rural communities: a qualitative study
Authors: Couch Danielle , O’Sullivan Belinda , Russell Deborah , McGrail Matthew , Wallace Glen , Bentley Michael
Published: September 2020

Background

In Australia registrar training to become a general practitioner (GP) involves three to four years of supervised learning with at least 50% of GP registrars training wholly in rural areas. In particular rural over regional GP placements are important for developing future GPs with broader skills because the rural scope of practice is wider. Having enough GP supervisors in smaller rural communities is essential such training. We aimed to explore what makes rural GPs’ based outside of major regional centres, participate in supervising or not, their experiences of supervising, and impact of their practice context.

Methods

Semi-structured interviews were undertaken with 25 GPs based in rural Tasmania (outside of major regions - Hobart and Launceston), in towns of < 25,000 population, to explore the GPs’ professional backgrounds, their experiences of supervising GP registrars, their practice context and their decisions about supervising GP registrars or not. Thematic analysis was undertaken; key ideas, concepts and experiences were identified and then reviewed and further refined to core themes.

Results

Supervising was perceived to positively impact on quality of clinical care, reduce busy-ness and improve patient access to primary care. It was energising for GPs working in rural contexts. Rural GPs noted business factors impacted the decision to participate in supervision and the experience of participating: including uncertainty and discontinuity of registrar supply (rotational training systems), registrar competence and generating income.

Conclusions

Supervising is strongly positive for rural GPs and related to job satisfaction but increasing supervision capacity in rural areas may depend on better policies to assure continuity of rural registrars as well as policies and systems that enable viable supervision models tailored to the context.
Correction to: What has been the progress in addressing financial risk in Uganda? Analysis of catastrophe and impoverishment due to health payments
Authors: Kwesiga Brendan , Aliti Tom , Nabukhonzo Pamela , Najuko Susan , Byawaka Peter , Hsu Justine , Ataguba John E. , Kabaniha Grace
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
Macrophage accumulation within coronary arterial wall in diabetic patients with acute coronary syndrome: a study with in-vivo intravascular imaging modalities
Authors: Kogo Takaaki , Hiro Takafumi , Kitano Daisuke , Takayama Tadateru , Fukamachi Daisuke , Morikawa Tomoyuki , Sudo Mitsumasa , Okumura Yasuo
Published: September 2020

Background and aims

Macrophage accumulation in arteriosclerotic plaque of coronary arteries is involved in plaque destabilization. Atherosclerosis has been known to be progressive in patients with type 2 diabetes mellitus (DM). This study compared the features of 3-dimensional (3D) spatial distribution of macrophage accumulation within coronary artery wall between acute coronary syndrome (ACS) patients with DM (n = 20) and those without (non-DM, n = 20) by using intravascular ultrasound (IVUS) and optical coherence tomography (OCT).

Methods

The OCT-derived macrophage accumulation was measured within the proximal left anterior-descending artery. This measurement was performed for the whole vessel segment of interest, higher shear stress region (flow divider side) and lower shear stress region (the opposite side).

Results

Normalized macrophage accumulation per unit length of the whole segment of interest was significantly larger in ACS patients with DM than without. In non-DM patients, macrophage density per IVUS-derived plaque volume was significantly higher in high shear stress region compared to low shear stress region, however, there was no significant difference between the two regions in DM patients. The macrophage density in the low shear stress region was significantly higher in the DM group than in the non-DM group. A multivariate analysis showed that the presence of DM was a major determinant for macrophage distribution.

Conclusions

Macrophage accumulation was more abundant and homogeneous within coronary arterial wall in DM patients with ACS compared to non-DM patients, suggesting that plaque destabilization may occur more widely throughout coronary wall in DM patients.
Establishment and characterization of a new gastric cancer cell line, XGC-1
Authors: Peng Jigui , Xu Hao , Cai Jianchun
Published: September 2020

Background

To establish a primary human gastric cancer cell line.

Methods

Fresh gastric cancer tissue samples were separated into a cell suspension, and DMEM/F12 medium containing 10% foetal bovine serum was used for primary culture and subculture. The morphology of the cells was observed under a light microscope, and the cell growth curve was plotted. A soft agar colony formation assay was used to detect the colony formation ability of the cell line. Immunohistochemical methods were used to detect cytokeratin, vimentin and Ki-67, the chromosome G banding method was used to analyse the karyotype of the cells, and the tumourigenic ability of the cells was detected by subcutaneous inoculation of BALB/C nude mice.

Results

We established a gastric cancer cell line from a 68-year-old male patient. This gastric cancer cell line was named XGC-1 and had a doubling time of approximately 48 h. The cell line displayed strong colony formation ability and tumourigenicity in BALB/C nude mice and had complicated chromosomal abnormalities. When nutrients were insufficient, the cells shed and floated in the medium, but adherent growth was observed in nutrient-rich conditions.

Conclusions

The XGC-1 cell line will be useful for future studies of gastric cancer development, progression, metastasis and therapy.
Pathways leading to prevention of fatal and non-fatal cardiovascular disease: An interaction model on 15 years population-based cohort study
Authors: Shakibaei Najmeh , Hassannejad Razieh , Mohammadifard Noushin , Marateb Hamid Reza , Mansourian Marjan , Mañanas Miguel Angel , Sarrafzadegan Nizal
Published: September 2020

Background

A comprehensive study on the interaction of cardiovascular disease (CVD) risk factors is critical to prevent cardiovascular events. The main focus of this study is thus to understand direct and indirect relationships between different CVD risk factors.

Methods

A longitudinal data on adults aged ≥35 years, who were free of CVD at baseline, were used in this study. The endpoints were CVD events, whereas their measurements were demographic, lifestyle components, socio-economics, anthropometric measures, laboratory findings, quality of life status, and psychological factors. A Bayesian structural equation modelling was used to determine the relationships among 21 relevant factors associated with total CVD, stroke, acute coronary syndrome (ACS), and fatal CVDs.

Results

In this study, a total of 3161 individuals with complete information were involved in the study. A total of 407 CVD events, with an average age of 54.77(10.66) years, occurred during follow-up. The causal associations between six latent variables were identified in the causal network for fatal and non-fatal CVDs. Lipid profile, with the coefficient of 0.26 (0.01), influenced the occurrence of CVD events as the most critical factor, while it was indirectly mediated through risky behaviours and comorbidities. Lipid profile at baseline was influenced by a wide range of other protective factors, such as quality of life and healthy lifestyle components.

Conclusions

Analysing a causal network of risk factors revealed the flow of information in direct and indirect paths. It also determined predictors and demonstrated the utility of integrating multi-factor data in a complex framework to identify novel preventable pathways to reduce the risk of CVDs.
Association between patient-reported outcomes and exercise test outcomes in patients with COPD before and after pulmonary rehabilitation
Authors: Meys Roy , Stoffels Anouk A. F. , Houben-Wilke Sarah , Janssen Daisy J. A. , Burtin Chris , van Hees Hieronymus W. H. , Franssen Frits M. E. , van den Borst Bram , Wouters Emiel F. M. , Spruit Martijn A. ,   on behalf of the BASES-consortium
Published: September 2020

Background

Over the years, the scope of outcomes assessment in chronic obstructive pulmonary disease (COPD) has broadened, allowing for the evaluation of various patient-reported outcomes (PROs). As it still remains unclear whether and to what extent PROs mirror the exercise performance of patients with COPD, the current study aimed to assess the association between different exercise test outcomes and PROs, before and after pulmonary rehabilitation (PR).

Methods

Correlations between PROs used to describe health-related quality of life (HRQoL), mood status, level of care dependency and dyspnea in patients with COPD and commonly used laboratory- and field-based exercise test outcomes were evaluated in 518 individuals with COPD attending PR.

Results

Overall, correlations between PROs and exercise test outcomes at baseline were statistically significant. The correlation between modified Medical Research Council (mMRC) dyspnea score and 6-min walking distance (6MWD) was strongest (ρ:-0.65; p<0.001). HRQoL related PROs showed weak correlations with exercise outcomes at baseline. Moderate correlations were found between St George’s Respiratory Questionnaire total score and 6MWD (r:-0.53; p<0.001) and maximal workload achieved during cardiopulmonary exercise testing (ρ:-0.48; p<0.001); and between Clinical COPD Questionnaire (CCQ) total score and 6MWD (r:-0.48; p<0.001) and maximal workload (ρ:-0.43; p<0.001). When significant, correlations between changes in exercise test outcomes and changes in PROs after PR were generally very weak or weak. The highest correlation was found between changes in CCQ total score and changes in 6MWD (ρ: − 0.36; p<0.001).

Conclusions

PROs and exercise test outcomes, although significantly correlated with each other, assess different disease features in patients with COPD. Individual PROs need to be supported by additional functional measurements whenever possible, in order to get a more detailed insight in the effectiveness of a PR program.

Trial registration

Netherlands Trial Register (NL3263/NTR3416). Registered 2 May 2012.
Immunohistochemical basigin expression level in thyroid cancer tissues
Authors: Guo Wan-Ping , Tang Deng , Pang Yu-Yan , Li Xiao-Jiao , Chen Gang , Huang Zhi-Guang , Tang Xiao-Zhun , Lai Qin-Qiao , Gan Jin-Yan , Huang Xiao-Li , Liu Xiao-Fan , Wei Zhi-Xiao , Ma Wei
Published: September 2020

Background

Thyroid cancer (TC) is the most common endocrine malignancy; basigin (also known as BSG) plays a crucial role in tumor cell invasion, metastasis, and angiogenesis. This study was designed to identify the change of BSG expression in TC and its possible potential mechanism.

Methods

The BSG expression levels in TC were demonstrated using data collected from in-house immunohistochemical (IHC), RNA-sequencing (RNA-seq), microarrays, and literatures. Integrated analysis was performed to determined BSG expression levels in TC comprehensively. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed with the integration of BSG co-expressed genes and differentially expressed genes (DEGs) in TC tissues to explore the potential mechanisms of BSG in TC.

Results

The protein expression level of BSG was significantly higher in TC cases based on the IHC experiments. In addition, the combined SMD for BSG expression was 0.39 (p < 0.0001), the diagnostic odds ratio was 3.69, and the AUC of the sROC curve was 0.6986 using 1182 TC cases and 437 non-cancerous cases from 17 independent datasets. Furthermore, BSG co-expressed genes tended to be enriched in gene terms of the extracellular matrix (ECM), cell adhesion, and cell-cell interactions. The expression levels of nine hub BSG co-expressed genes were markedly upregulated in TC cases.

Conclusion

BSG expression levels were closely correlated with the progression of TC and may affect the signals of the ECM, cell adhesion, and cell-cell interactions.