bluuebunny/crossref_metadata_2025 huggingface dataset:
Racial Differences in the Association Between Luminal Master Regulator Gene Expression Levels and Breast Cancer Survival
Authors: Byun Jung S. , Singhal Sandeep K. , Park Samson , Yi Dae Ik , Yan Tingfen , Caban Ambar , Jones Alana , Mukhopadhyay Partha , Gil Sara M. , Hewitt Stephen M. , Newman Lisa , Davis Melissa B. , Jenkins Brittany D. , Sepulveda Jorge L. , De Siervi Adriana , Nápoles Anna María , Vohra Nasreen A. , Gardner Kevin
Published: January 2020

Purpose:

Compared with their European American (EA) counterparts, African American (AA) women are more likely to die from breast cancer in the United States. This disparity is greatest in hormone receptor–positive subtypes. Here we uncover biological factors underlying this disparity by comparing functional expression and prognostic significance of master transcriptional regulators of luminal differentiation.

Experimental Design:

Data and biospecimens from 262 AA and 293 EA patients diagnosed with breast cancer from 2001 to 2010 at a major medical center were analyzed by IHC for functional biomarkers of luminal differentiation, including estrogen receptor (ESR1) and its pioneer factors, FOXA1 and GATA3. Integrated comparison of protein levels with network-level gene expression analysis uncovered predictive correlations with race and survival.

Results:

Univariate or multivariate HRs for overall survival, estimated from digital IHC scoring of nuclear antigen, show distinct differences in the magnitude and significance of these biomarkers to predict survival based on race: ESR1 [EA HR = 0.47; 95% confidence interval (CI), 0.31–0.72 and AA HR = 0.77; 95% CI, 0.48–1.18]; FOXA1 (EA HR = 0.38; 95% CI, 0.23–0.63 and AA HR = 0.53; 95% CI, 0.31–0.88), and GATA3 (EA HR = 0.36; 95% CI, 0.23–0.56; AA HR = 0.57; CI, 0.56–1.4). In addition, we identify genes in the downstream regulons of these biomarkers highly correlated with race and survival.

Conclusions:

Even within clinically homogeneous tumor groups, regulatory networks that drive mammary luminal differentiation reveal race-specific differences in their association with clinical outcome. Understanding these biomarkers and their downstream regulons will elucidate the intrinsic mechanisms that drive racial disparities in breast cancer survival.
Tumor Analyses Reveal Squamous Transformation and Off-Target Alterations As Early Resistance Mechanisms to First-line Osimertinib inEGFR-Mutant Lung Cancer
Authors: Schoenfeld Adam J. , Chan Joseph M. , Kubota Daisuke , Sato Hiroki , Rizvi Hira , Daneshbod Yahya , Chang Jason C. , Paik Paul K. , Offin Michael , Arcila Maria E. , Davare Monika A. , Shinde Ujwal , Pe'er Dana , Rekhtman Natasha , Kris Mark G. , Somwar Romel , Riely Gregory J. , Ladanyi Marc , Yu Helena A.
Published: January 2020

Purpose:

Patterns of resistance to first-line osimertinib are not well-established and have primarily been evaluated using plasma assays, which cannot detect histologic transformation and have differential sensitivity for copy number changes and chromosomal rearrangements.

Experimental Design:

To characterize mechanisms of resistance to osimertinib, patients with metastatic EGFR-mutant lung cancers who received osimertinib at Memorial Sloan Kettering Cancer Center and had next-generation sequencing performed on tumor tissue before osimertinib initiation and after progression were identified.

Results:

Among 62 patients who met eligibility criteria, histologic transformation, primarily squamous transformation, was identified in 15% of first-line osimertinib cases and 14% of later-line cases. Nineteen percent (5/27) of patients treated with first-line osimertinib had off-target genetic resistance (2 MET amplification, 1 KRAS mutation, 1 RET fusion, and 1 BRAF fusion) whereas 4% (1/27) had an acquired EGFR mutation (EGFR G724S). Patients with squamous transformation exhibited considerable genomic complexity; acquired PIK3CA mutation, chromosome 3q amplification, and FGF amplification were all seen. Patients with transformation had shorter time on osimertinib and shorter survival compared with patients with on-target resistance. Initial EGFR sensitizing mutation, time on osimertinib treatment, and line of therapy also influenced resistance mechanism that emerged. The compound mutation EGFR S768 + V769L and the mutation MET H1094Y were identified and validated as resistance mechanisms with potential treatment options.

Conclusions:

Histologic transformation and other off-target molecular alterations are frequent early emerging resistance mechanisms to osimertinib and are associated with poor clinical outcomes.

See related commentary by Piotrowska and Hata, p. 2441
Diverse BRAF Gene Fusions Confer Resistance to EGFR-Targeted Therapy via Differential Modulation of BRAF Activity
Authors: Stangl Christina , Post Jasmin B. , van Roosmalen Markus J. , Hami Nizar , Verlaan-Klink Ingrid , Vos Harmjan R. , van Es Robert M. , Koudijs Marco J. , Voest Emile E. , Snippert Hugo J.G. , Kloosterman W.P.
Published: January 2020

Fusion genes can be oncogenic drivers in a variety of cancer types and represent potential targets for targeted therapy. The BRAF gene is frequently involved in oncogenic gene fusions, with fusion frequencies of 0.2%–3% throughout different cancers. However, BRAF fusions rarely occur in the same gene configuration, potentially challenging personalized therapy design. In particular, the impact of the wide variety of fusion partners on the oncogenic role of BRAF during tumor growth and drug response is unknown. Here, we used patient-derived colorectal cancer organoids to functionally characterize and cross-compare BRAF fusions containing various partner genes (AGAP3, DLG1, and TRIM24) with respect to cellular behavior, downstream signaling activation, and response to targeted therapies. We demonstrate that 5′ fusion partners mainly promote canonical oncogenic BRAF activity by replacing the auto-inhibitory N-terminal region. In addition, the 5′ partner of BRAF fusions influences their subcellular localization and intracellular signaling capacity, revealing distinct subsets of affected signaling pathways and altered gene expression. Presence of the different BRAF fusions resulted in varying sensitivities to combinatorial inhibition of MEK and the EGF receptor family. However, all BRAF fusions conveyed resistance to targeted monotherapy against the EGF receptor family, suggesting that BRAF fusions should be screened alongside other MAPK pathway alterations to identify patients with metastatic colorectal cancer to exclude from anti-EGFR–targeted treatment.

Implications:

Although intracellular signaling and sensitivity to targeted therapies of BRAF fusion genes are influenced by their 5′ fusion partner, we show that all investigated BRAF fusions confer resistance to clinically relevant EGFR inhibition.
The Effect of Autophagic Activity on the Function of Apheresis Platelets and on the Efficacy of Clinical Platelet Transfusion
Authors: Tang Hao , Gao Meng , Fu Yunfeng , Gui Rong , Ma Xianjun
Published: January 2020

Platelet activation and survival jointly determine the efficacy of clinical platelet transfusion. This study aimed to discuss the effect of autophagic activity on activation and aggregation of apheresis platelets and on the efficacy of clinical platelet transfusion. In this study, we investigated the effects of autophagic activity of apheresis platelets for different blood types and after different storage durations on platelet activation and aggregation functions. By Western blot, immunofluorescence, and RT-qPCR detection, we found that with the prolongation of the storage duration, the expressions of both autophagy-related proteins and genes were upregulated in apheresis platelets and their expressions were insignificantly higher in the apheresis platelets of type A and O blood than in those of type B and type AB blood. After RAPA/IGF-1 pretreatment, there was a significant increase/reduction in autophagic activity. After RAPA and IGF-1 pretreatment, an opposite variation trend was observed with platelet activation and aggregation. Autophagic activity of platelets correlated negatively with the efficacy of clinical platelet transfusion. These research findings provide a theoretical basis for effective clinical platelet transfusion.
Convexity Subarachnoid Hemorrhage Accompanied by Hyperacute Ischemic Stroke
Authors: Sato Takeo , Sakai Kenichiro , Mimori Masahiro , Komatsu Teppei , Sakuta Kenichi , Terasawa Yuka , Umehara Tadashi , Omoto Shusaku , Mitsumura Hidetaka , Murakami Hidetomo , Shimizu Tetsuya , Matsushima Satoshi , Iguchi Yasuyuki
Published: January 2020

Introduction and Objectives: The clinical characteristics of convexity subarachnoid hemorrhage (cSAH) accompanying hyperacute ischemic stroke are unknown. We aimed to investigate the incidence and clinical characteristics of cSAH with hyperacute ischemic stroke. Methods: Participants comprised symptomatic ischemic stroke patients with ≤4.5 h from onset to door who also underwent initial MRI ≤4.5 h from onset. We reviewed initial and follow-up MRI during admission to identify cSAH. Retrospective reviews of cSAH incidence and clinical characteristics were performed. Results: We screened 1,249 consecutive symptomatic ischemic stroke patients, including 384 patients (279 males [73%]; median age, 67 years). Of the 384 patients, arterial ischemic stroke was seen in 382 patients, and venous ischemic stroke in 2 patients. Of the hyperacute arterial ischemic stroke, cSAH was identified within 4.5 h of ischemic stroke onset in 2 patients (0.5%) and around 6 days from ischemic stroke onset in 2 patients (0.5%). Of the hyperacute venous ischemic stroke, cSAH was observed in 1 patient on initial MRI. Comparing the clinical characteristics of hyperacute arterial ischemic stroke with and without cSAH, patients with cSAH were more likely to have arterial stenosis or occlusion ipsilateral to the cSAH (100 vs. 47%, p = 0.048), and the ischemic lesion only in the right hemisphere (100 vs. 33%, p = 0.013). In all cases, outcomes were favorable (modified Rankin Scale 0–1 at 3 months from onset). Conclusions: Convexity SAH was observed in 0.5% of hyperacute ischemic patients within 4.5 h of ischemic stroke onset and in 0.5% around 6 days from ischemic stroke onset.
No Relationship between Visual Field Damage and Choroidal Thickness in Eyes with Primary Open-Angle Glaucoma
Authors: Karaca Umut , Ozge Gokhan , Mumcuoglu Tarkan , Usta Gulsah
Published: January 2020

Purpose: To evaluate the association between visual field damage and choroidal thickness (ChT) in subjects with primary open-angle glaucoma. Methods: In this cross-sectional study, 115 eyes of 58 glaucoma patients and 112 eyes of 56 healthy subjects were enrolled. ChT at the fovea, 0.5 mm temporal, 1.5 mm temporal, 0.5 mm nasal, 1.5 mm nasal to the fovea, and all quadrants in the peripapillary region were analyzed. The subjects with glaucoma were further classified by Hodapp-Anderson-Parrish scores. Results: There was no difference between glaucoma and healthy subjects in mean age, gender, and refractive errors. The overall average thickness of the retinal nerve fiber layer (RNFL) was significantly lower in the eyes with glaucoma compared to the normal subjects (p < 0.01) and decreased in proportion to the severity of glaucoma (normal, 99.4; no defect, 89; early, 80.4; moderate, 63.1; and severe, 51 µm). ChT measured from the foveal region, at a distance of 500 μm from the fovea (nasal and temporal), and 1,500 μm from the fovea (nasal and temporal) did not significantly vary between the two groups. As well, peripapillary ChT did not significantly differ in proportion to the severity of glaucoma (p > 0.05 for all quadrants). The RNFL and ChT measurements were not significantly correlated with any peripapillary location (|r| ≤ 0.17, p > 0.05). The visual field mean deviation/pattern standard deviation and ChT measurements were also not significantly correlated with any peripapillary and macular location (|r| ≤ 0.12, p > 0.05). Conclusions: There was no significant difference in macular and peripapillary ChT between healthy and glaucomatous eyes that differed in severity of visual field damage. This suggests that the structural features of the choroid may not be associated with severity of primary open-angle glaucoma.
Reactive power control to enhance the VSC-HVDC system performance under faulty and normal conditions
Authors: Ghayad Mohamed S. , Badra Niveen M. , Abdelaziz Almoataz Y. , Attia Mahmoud A.
Published: January 2020

This paper studied the reactive power control of the voltage source converters based high-voltage direct current system (VSC-HVDC). PI (proportional & integration) controller was used in this work to enhance the dynamic response of the system. Gravitational search algorithm (GSA) and sine cosine algorithm (SCA) are used to get optimal parameters of the PI controller. GSA algorithm is based on the gravity law for Newton while SCA depends on mathematical model based on cosine and sine functions. These algorithms have an efficient global Search capability. The VSC-HVDC is exposed to different disturbances for checking the controller robustness. First disturbance was applying three phase faults on the system. While the second one was applying a step change in AC voltage. Finally, Applying step change in regulators reference values. Simulation results proved the controller superiority also verified the enhancement of the system dynamic response.
New studies on network frequency responses considering dynamic loads
Authors: Trang L. T. M. , Nouri H.
Published: January 2020

The dynamic model construction of transmission network components that include generator buses, load buses and power branches, within MATLABSimulink environment is presented. The degree of frequency deviation of buses when the power of motor loads and static loads vary, is studied. Furthermore, the influence of motor loads with different inertia constants are considered in the control technique of load frequency using a PID controller. The results show that the frequency oscillation of the dynamic load is greater than the frequency oscillation of static load. Also the speed of frequency control of the dynamic load is greater than the speed of the frequency control of the static load and the inertia constants of the dynamic load has significant influence on the frequency control characteristics.
Five new Pycnomerus Erichson (Coleoptera: Zopheridae: Pycnomerini) from Raivavae, French Polynesia
Authors: PORCH NICK , SMITH TESSA R. , GREIG KELLY
Published: January 2020

We describe five new species of Pycnomerus (P. mahanatoa, P. rairua, P. raivavae, P. taralewisae, and P. vavitu spp. nov.) from subfossil material collected on the island of Raivavae in the Austral Archipelago of French Polynesia. Like the two species of Pycnomerus recently described from Rimatara (Porch & Smith 2017), we consider it is probable that some or even most of the endemic Raivavae species are globally extinct. This is because the species have, so far, only been found in as subfossil specimens in sediments that date to the period immediately before or just after human arrival on the island (c.1300 AD), they have not been collected historically, and very little indigenous forest of Raivavae remains. These species add to the growing body of knowledge regarding the zopherid fauna of eastern Polynesia, which is, and unfortunately will always likely be, based primarily on the subfossil record from the region.
Revision of Mesojassus Tillyard, 1916, from the Late Triassic of Queensland (Hemiptera: Cicadomorpha: Membracoidea: Archijassidae)
Authors: LAMBKIN KEVIN J.
Published: January 2020

New specimens and a re-examination of their holotypes have clarified the status of six nominal species of the extinct membracoid family Archijassidae from the Late Triassic (Norian) fossil insect localities at Mount Crosby, Denmark Hill and Dinmore in south-eastern Queensland. The 57 available tegmina ostensibly attributable to one or other of the six species are remarkably similar in venation and only vary in size and to a lesser extent in shape. The latter character varies subtlety across a continuum and is of no use in species definition. The tegmina, however, fall into two distinct size groups, and in the absence of any other discernible or consistent diagnostic characters, these groups are adopted as separate species, acknowledging, of course, the artificial nature of fossil insect species based on the size only of isolated wings. The following taxonomic changes result: Mesojassus Tillyard, 1916 (= Triassojassus Tillyard, 1919, syn. nov., = Triassocotis Evans, 1956, syn. nov., = Hylicellites Becker-Migdisova, 1962, syn. nov.), Mesojassus ipsviciensis Tillyard, 1916 (= Triassojassus proavitus Tillyard, 1919, syn. nov., = Triassocotis stricta Evans, 1961, syn. nov.), Mesojassus australis (Evans, 1956) comb. nov. (= Triassocotis amplicata Evans, 1961, syn. nov., = Hylicellites reducta (Evans, 1956), syn. nov.). Mesojassus is one of the four genera of the subfamily Archija` ssinae, and differs from the Jurassic Archijassus Handlirsch, 1906, Mesoledra Evans, 1956, and Ardela Ansorge, 1996, in the separation of R and M well before the arculus (at the same level or slightly beyond in the others), the proximal position of dSc, well before the apex of the clavus (at or beyond the apex in the others), and the two-branched RA (simple in the others). The separation of R and M distinctly basal to the arculus, a character of frequent occurrence in extant membracoids, is proposed as a possible apomorphy for this otherwise most plesiomorphic genus of the Membracoidea. Mesojassus, the oldest member of the extant Membracoidea, is one of a growing inventory of genera from the Late Triassic of Queensland which are the oldest representatives of extant groups, adding further evidence of the Triassic as the dawn of much of the modern insect fauna.
Adverse Effect of Europium Doping on Magneto-Optical Properties of Cr2O3
Authors: Rehani Divya , Bishnoi Swati , Saxena Manish , Sharma Shailesh Narain
Published: January 2020

The article describes in detail the effect of doping Europium (Eu) on magnetic and optical properties of Cr2O3. Undoped and Eu (1–5 mol%) doped Cr2O3 samples were synthesized using solid state synthesis method. The structural, magnetic
and optical properties of undoped and Europium (Eu) doped chromium oxide powder were studied by X-ray diffractometer (XRD), vibrating sample magnetometer (VSM) and photoluminescence (PL) measurements. The X-ray diffraction pattern confirms the polycrystalline nature of undoped and Europium
(Eu) doped chromium oxide powder. The magnetic measurements revealed decline in magnetism with increasing Eu concentration. With increasing Eu concentration, the visible luminescence of Cr2O3 improved. The study highlighted that Eu as a dopant is not suitable for improving
the magnetic properties of Cr2O3.
Relationship Between Rising Phase of Solar Cycle 23rd and 24th with Respect to Geoeffectiveness
Authors: Bhatt Beena , Chandra Harish
Published: January 2020

The current article demonstrates the geoeffectiveness of solar flare associated Coronal mass ejection (CME) accompanied with Deca-hectometric (DH) type II radio bursts by comparing the set of events in the rising phase of solar cycle 23rd (1996–2001) and 24th (2009–2014).
Our observations are: (i) Solar cycle 23rd have high Dst index than the solar cycle 24th except for the year 1999. (ii) Dst has its peak between 3rd to 5th day after the CME onset for both the solar cycles. (iii) The correlation coefficient between Interplanetary magnetic fields (IMF) and
Dst is good for both the solar cycles. (iv) Solar cycle 23rd have very strong correlation between CRI and Dst as compare to solar cycle 24th. Thus, our predictions show that solar cycle 23rd is more geoeffective than solar cycle 24th.
An Investigation of the Precipitation Net Effect on the Particulate Matter Concentration in a Narrow Valley: Role of Lower-Troposphere Stability
Authors: Roldán-Henao Natalia , Hoyos Carlos D. , Herrera-Mejía Laura , Isaza Alejandra
Published: January 2020

Precipitation modulates the pollutant concentration in the atmosphere directly and indirectly through different mechanisms. Wet deposition, including in-cloud scavenging and below-cloud scavenging, is one of the main drivers of particulate matter removal from the atmosphere. Our focus is to assess the net effect of precipitation on the pollutant concentration using observations, a nonparametric conditional analysis, and the signed overlapping coefficient complement index. The study considers not only the direct near-surface aerosol below-cloud scavenging, but also the indirect effect associated with the induced lower-troposphere stability limiting the vertical dispersion, leading to a pollutant concentration increase. We consider the precipitation effects on fine and coarse particulate matter concentration. Probability density functions of the pollutant concentration during precipitation events and under dry conditions are analyzed for every hour of the day. The net effect of precipitation on the fine and coarse particulate matter concentration is strongly dependent on the atmospheric stability. During the nighttime and before midmorning, the atmosphere is stable; a precipitation event during this time induces below-cloud scavenging, reducing the concentration of particulate matter in the atmosphere. During the afternoon, unstable atmospheric conditions are predominant, and aerosols disperse vertically; a precipitation event during this period stabilizes the atmosphere, generating early stabilization that, together with the continued anthropogenic emissions during the day, leads to near-surface pollutant accumulation, offsetting the washout effect of the precipitation.
Numerical Simulations of Two-Layer Flow past Topography. Part II: Lee Vortices
Authors: Rotunno Richard , Bryan George H.
Published: January 2020

This study considers a two-layer fluid with constant density in each layer connected by a layer of continuously varying density for flows past topography in which hydraulic jumps with lee vortices are expected based on shallow-water theory. Numerical integrations of the Navier–Stokes equations at a Reynolds number high enough for a direct numerical simulation of turbulent flow allow an examination of the internal mechanics of the turbulent leeside hydraulic jump and how this mechanics is related to lee vortices. Analysis of the statistically steady state shows that the original source of lee-vortex vertical vorticity is through the leeside descent of baroclinically produced spanwise vorticity associated with the hydraulic jump. This spanwise vorticity is tilted to the vertical at the spanwise extremities of the leeside hydraulic jump. Turbulent energy dissipation in flow through the hydraulic jump allows this leeside vertical vorticity to diffuse and extend downstream. The present simulations also suggest a geometrical interpretation of lee-vortex potential-vorticity creation, a concept central to interpretations of lee vortices based on the shallow-water equations.
Roles of Sea Ice–Surface Wind Feedback in Maintaining the Glacial Atlantic Meridional Overturning Circulation and Climate
Authors: Sherriff-Tadano Sam , Abe-Ouchi Ayako
Published: January 2020

During glacial periods, climate varies between two contrasting modes, the interstadials and stadials. These climate changes are often associated with drastic reorganizations of the Atlantic meridional overturning circulation (AMOC). Previous studies highlight the important role of sea ice in maintaining contrasting modes of the AMOC through its insulating effect on the oceanic heat flux and the buoyancy flux (sea ice–buoyancy flux feedback); however, the effect of feedback from the atmosphere remains unclear. Here, the effect of sea ice–surface wind interactions over the North Atlantic Ocean on the AMOC is explored. For this purpose, results from comprehensive atmosphere–ocean coupled general circulation models (AOGCMs) are analyzed. Then, sensitivity experiments are conducted with the atmospheric component of the AOGCM. Last, to explore the impact of modifications in surface winds induced by sea ice on the maintenance of the AMOC, partially coupled experiments are conducted with the AOGCMs. Experiments show that the expansion of sea ice associated with a weakening of the AMOC reduces surface winds by suppressing the oceanic heat flux and increasing the atmospheric static stability. This wind anomaly then causes a weakening of the wind-driven ocean salt transport to the northern North Atlantic and maintains the weak AMOC, therefore working as a positive feedback. It is shown that, together with the sea ice–buoyancy flux and sea ice–surface wind feedback, changes in sea ice and oceanic heat flux sustain the contrasting modes of the AMOC. These results may provide useful information for interpreting the differences in the self-sustained internal oscillations of the AMOC produced by recent AOGCMs.
Fear-of-intimacy in the interpersonal process model: An investigation in two parts
Authors: Manbeck Katherine E. , Kanter Jonathan W. , Kuczynski Adam M. , Maitland Daniel W. M. , Corey Mariah
Published: January 2020

The interpersonal process model (IPM) suggests that closeness develops in relationships when two people reciprocally engage in vulnerable self-disclosure, respond to each other, and perceive each other’s responses as validating, understanding, and caring (responsive). Little is known about how fear-of-intimacy relates to this foundational intimacy process. We conducted two studies of fear-of-intimacy and the IPM. In Study 1, 146 high fear-of-intimacy participants were randomly assigned to either interact for 1 hr with a research assistant (RA) demonstrating high responsiveness, to interact for 1 hr with an RA displaying low responsiveness, or to view a nature video for 1 hr. Unlike previous experiments with undergraduates documenting that high responsiveness predicts closeness up to 2 weeks after the interaction, the current study with high fear-of-intimacy individuals found that high responsiveness predicted closeness immediately after the interaction but this was not sustained over time. In Study 2, we conducted structural modeling in a diverse sample of 216 survey respondents with a range of fear-of-intimacy scores. Consistent with previous studies, perceived responsiveness strongly predicted closeness. Fear-of-intimacy had negative direct effects on vulnerable self-disclosure and perceived responsiveness but a positive direct effect on closeness.
Emotional Well-Being in Adults Born With Cleft Lip and/or Palate: A Whole of Life Survey in the United Kingdom
Authors: Ardouin Kenny , Hare Jess , Stock Nicola Marie
Published: January 2020

Objectives:

Previous research with adults born with cleft lip and/or palate (CL/P) has identified a range of concerns regarding mental health and quality of life, concluding that overall emotional functioning is poorer compared to the general population. The aim of the current study was to build on this previous work by investigating the self-reported emotional well-being of adults born with CL/P in the United Kingdom.

Design:

An online, mixed methods survey was designed by the Cleft Lip and Palate Association in collaboration with the Centre for Appearance Research at the University of the West of England. A total of 207 eligible responses were received between July and October 2018. Qualitative data were analyzed using inductive content analysis, while quantitative data were analyzed using descriptive statistics and independent t tests.

Results:

Almost half of the sample reported a diagnosis of a mental health condition. Scores on standardized measures indicated significantly lower global self-worth, higher levels of fear of negative appearance evaluation, and lower self-perceived job competence compared to normative data. Scores of overall body esteem were in line with the general population. Most participants had not received psychological support from their regional CL/P team and 41% were unaware of their entitlement to treatment from the National Health Service.

Conclusions:

Individuals with CL/P may be at risk of emotional distress persisting into adulthood. The integration of routine psychological support from an early age is highly recommended, as is information for young adults about to complete routine treatment. Comprehensive psychological screening for adults returning to the service later in life is also strongly advised.
Assessing the Potential Impact of Cigarette Packs Designed for Lesbian, Gay, Bisexual, and Transgender Adults: A Randomized Experiment to Inform U.S. Regulation, 2018
Authors: Lee Joseph G. L. , Blanchflower Tiffany M. , O’Brien Kevin F. , Cofie Leslie E. , Gregory Kyle R. , Averett Paige E.
Published: January 2020

The Food and Drug Administration (FDA) can regulate the introduction of new tobacco products and some changes to existing products. Cigarette packs have been used as a marketing tool to target specific groups and priority populations. Research has shown that sexual and gender minority (SGM) adults are substantially more likely to use tobacco products than their straight and cisgender counterparts. However, research to inform the FDA’s regulatory decisions regarding cigarette packs targeting priority populations is nascent. To fill this gap, we conducted an online experiment in 2018, randomizing U.S. adults who reported current smoking ( N = 954, 52% were SGM) to view one of three cigarette packs. A graphic designer developed “Glacier” branded packs with three levels of SGM imagery: (1) no targeting, (2) subtle targeting, and (3) a rainbow “pride edition.” Participants viewed and rated the pack using cognitive, affective, and behavioral measures informed by theory. We used a linear model framework to compare the two SGM-targeted packs with the not targeted version and tested interactions between pack and SGM identity for the dependent variables. We stratified results by SGM status. SGM status was a significant moderator of the relationship between the pack and ratings of appeal, positive affect, feeling shocked, and intent to try with a coupon. Findings from this study revealed that packs designed for SGM populations can disproportionately change cognitive, affective, and behavioral intention responses for SGM smokers. Products entering the market should be assessed by FDA for the appeal of their packs to vulnerable populations.
Cigarette and E-Cigarette Retail Marketing on and Near California Tribal Lands
Authors: Begay Cynthia , Soto Claradina , Baezconde-Garbanati Lourdes , Barahona Rosa , Rodriguez Yaneth L. , Unger Jennifer B. , Smiley Sabrina L.
Published: January 2020

Introduction. Retail settings are major channels for the tobacco industry to market commercial tobacco products. However, few studies have examined marketing strategies on Tribal lands. The resulting evidence is important, especially given that American Indian/Alaska Native (AI/AN) youth and adults have the highest smoking prevalence of any racial/ethnic group in the United States. In this study, we examined cigarette, e-cigarette, and vape/vaporizer availability, advertising, and price-reducing promotions in retail settings on and within a 1-mile radius of Tribal lands in California. Method. Trained AI/AN community health representatives (n = 8) conducted store observations (n = 96) using a checklist adapted from the Standardized Tobacco Assessment for Retail Settings observation tool. Chi-square analyses were performed to look for potential differences in availability, exterior advertising, and price promotions for cigarettes, e-cigarettes, and vapes between stores. Results. All stores sold cigarettes and over 95% sold menthol cigarettes. Nearly 25% of stores on Tribal lands were located inside a casino, and 40.4% of stores on Tribal lands offered a Tribal member discount. Stores within a 1-mile radius of Tribal lands sold significantly (p < .01) more e-cigarettes (69.8%), including flavored e-cigarettes (53.4%), compared to stores on Tribal lands (37.7% and 28.3%, respectively). Price promotions for cigarettes were significantly (p < .01) more common in stores located within a 1-mile radius of Tribal lands (46.5%) than stores on Tribal lands (22.6%). Discussion. To our knowledge, this study is the first to use store observations to examine cigarette and e-cigarette availability, advertising, and price promotions in retail settings on and near California Tribal lands. We recommend future studies build on our initial efforts to take an AI/AN Tribal community-engaged approach in assessing and documenting tobacco marketing practices on and near Tribal lands. Tribal governments can consider tobacco policies to help reduce smoking disparities and advance health equity for their communities.
Predictive risk factors for postoperative pneumonia after heart transplantation
Authors: Vidal Charles , Pasqualotto Romain , James Arthur , Dureau Pauline , Rasata Julie , Coutance Guillaume , Varnous Shaida , Leprince Pascal , Amour Julien , Bouglé Adrien
Published: January 2020

Background

Pneumonia is a frequent complication in patients undergoing heart transplantation (HTx) that increases morbidity and mortality in this population. Nevertheless, the risk factors for postoperative pneumonia (POP) are still unknown. The aim of this study was to investigate the predictive risk factors for POP in HTx recipients.

Methods

In this retrospective study, all patients undergoing HTx between January 2014 and December 2015 were included. All cases of POP occurring until hospital discharge were investigated. The study aimed to determine risk factors using univariate and multivariate Cox regression models. Data are expressed in Odds Ratio [95% CI]. P < 0.05 was necessary to reject the null hypothesis.

Results

A total of 175 patients were included without any patients being lost to follow-up, and 89 instances of POP were diagnosed in 59 (34%) patients. Enterobacteriaceae and Pseudomonas aeruginosa were the most common pathogens. In the multivariate analysis, the risk factors were preoperative mechanical ventilation (OR 1.42 [1.12–1.80], P < 0.01) and perioperative blood transfusion (OR 1.42 [95% CI: 1.20–1.70], P < 0.01). POP significantly impacted mortality at 30 days (OR: 4 [1.3–12.4], P = 0.01) and 1 year (OR: 6.8 [2.5–8.4], P < 0.01) and was associated with a longer duration of mechanical ventilation, time to weaning from venoarterial extracorporeal membrane oxygenation and stay in an intensive care unit. Plasma exchanges and intravenous administration of immunoglobulins did not increase the risk of POP.

Conclusion

After HTx, preoperative mechanical ventilation and blood transfusion were risk factors for POP and were associated with increased mortality. Enterobacteriaceae and Pseudomonas aeruginosa are the most common pathogens of POP.
Identifying appropriate outcomes to help evaluate the impact of the Canadian Guideline for Safe and Effective Use of Opioids for Non-Cancer Pain
Authors: Allen Michael , Sproule Beth , MacDougall Peter , Furlan Andrea , Murphy Laura , Borg Debono Victoria , Buckley Norman
Published: January 2020

Background

The Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (COG) was developed in response to increasing rates of opioid-related hospital visits and deaths in Canada, and uncertain benefits of opioids for chronic non-cancer pain (CNCP). Following publication, we developed a list of evaluable outcomes to assess the impact of this guideline on practice and patient outcomes.

Methods

A working group at the National Pain Centre at McMaster University used a modified Delphi process to construct a list of clinical and patient outcomes important in assessing the uptake and application of the COG. An advisory group then reviewed this list to determine the relevance and feasibility of each outcome, and identified potential data sources. This feedback was reviewed by the National Faculty for the Guideline, and a National Advisory Group that included the creators of the COG, resulting in the final list of 5 priority outcomes.

Results

Five outcomes were judged clinically important and feasible to measure: 1) Effects of opioids for CNCP on quality of life, 2) Assessment of patient’s risk of addiction before starting opioid therapy, 3) Monitoring patients on opioid therapy for aberrant drug-related behaviour, 4) Mortality rates associated with prescription opioid overdose and 5) Use of treatment agreements with patients before initiating opioid therapy for CNCP. Data sources for these outcomes included patient’s medical charts, e-Opioid Manager, prescription monitoring programs and administrative databases.

Conclusion

Measuring the impact of best practice guidelines is infrequently done. Future research should consider capturing the five outcomes identified in this study to evaluate the impact of the COG in promoting evidence-based use of opioids for CNCP.
Youth StepCare: a pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice
Authors: Parker Belinda Louise , Achilles Melinda Rose , Subotic-Kerry Mirjana , O’Dea Bridianne
Published: January 2020

Background

General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. This service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices.

Methods

A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14 to 17 years who visited a participating GP during the screening period with their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who reported symptoms but were not currently seeking help from their GP, nor had sought help in the past. Feasibility and acceptability among GPs and practice staff were assessed using a battery of questionnaires.

Results

Five GPs and 6 practice staff took part. A total of 46 youth patients were approached, 28 consented, and 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service and that they would use it again.

Conclusions

The Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people’s symptom reduction.
Evaluating implementation and impact of a provincial quality improvement collaborative for the management of chronic diseases in primary care: the COMPAS+ study protocol
Authors: Vachon Brigitte , Gaboury Isabelle , Menear Matthew , Pomey Marie-Pascale , Roy Denis , Houle Lise , Breton Mylaine , Duhoux Arnaud , Émond Valérie , Giasson Guylaine , Kaczorowski Janusz , Légaré France , Lussier Marie-Thérèse , Pluye Pierre , Vanasse Alain
Published: January 2020

Background

Chronic conditions such as diabetes and chronic obstructive pulmonary disease (COPD) are common and burdensome diseases primarily managed in primary care. Yet, evidence points to suboptimal quality of care for these conditions in primary care settings. Quality improvement collaboratives (QICs) are organized, multifaceted interventions that can be effective in improving chronic disease care processes and outcomes. In Quebec, Canada, the Institut national d’excellence en santé et en services sociaux (INESSS) has developed a large-scale QIC province-wide program called COMPAS+ that aims to improve the prevention and management of chronic diseases in primary care. This paper describes the protocol for our study, which aims to evaluate implementation and impact of COMPAS+ QICs on the prevention and management of targeted chronic diseases like diabetes and COPD.

Methods

This is a mixed-methods, integrated knowledge translation study. The quantitative component involves a controlled interrupted time series involving nine large integrated health centres in the province. Study sites will receive one of two interventions: the multifaceted COMPAS+ intervention (experimental condition) or a feedback only intervention (control condition). For the qualitative component, a multiple case study approach will be used to achieve an in-depth understanding of individual, team, organizational and contextual factors influencing implementation and effectiveness of the COMPAS+ QICs.

Discussion

COMPAS+ is a QI program that is unique in Canada due to its integration within the governance of the Quebec healthcare system and its capacity to reach many primary care providers and people living with chronic diseases across the province. We anticipate that this study will address several important gaps in knowledge related to large-scale QIC projects and generate strong and useful evidence (e.g., on leadership, organizational capacity, patient involvement, and implementation) having the potential to influence the design and optimisation of future QICs in Canada and internationally.
First report of Cryptosporidium viatorum and Cryptosporidium occultus in humans in China, and of the unique novel C. viatorum subtype XVaA3h
Authors: Xu Ning , Liu Hua , Jiang Yanyan , Yin Jianhai , Yuan Zhongying , Shen Yujuan , Cao Jianping
Published: January 2020

Background

Cryptosporidium is a genus of common intestinal protozoa, members of which cause diarrhea in a wide variety of hosts. Previous studies on Cryptosporidium in China have mainly focused on diarrhea sufferers, children, and immunodeficient individuals such as HIV/AIDS patients. However, the epidemiological characteristics of Cryptosporidium in the population in rural areas remain unclear. Herein, we investigated the prevalence of, and risk factors for, Cryptosporidium in rural areas of Binyang County, Guangxi Zhuang Autonomous Region, China, and genetically characterized the Cryptosporidium isolates we obtained.

Methods

From August to December 2016, two villages in Binyang County, Guangxi, were sampled using a random cluster sampling method. Fresh fecal samples were collected from all eligible residents (residence time > 6 months). Molecular characterization of Cryptosporidium was carried out based on its SSU rRNA, gp60, actin and hsp70 gene sequences. Fisher’s exact test were conducted to assess the risk factors for Cryptosporidium infection.

Results

A total of 400 fecal samples were collected from 195 males (48.8%) and 205 females (51.2%). Two samples (0.5%) were positive for Cryptosporidium and were identified as C. viatorum and C. occultus respectively. Moreover, a new C. viatorum subtype XVaA3h was identified based on the sequence of the gp 60 gene.

Conclusions

To our knowledge, this is the first report of C. viatorum and C. occultus infections in humans in China and of C. viatorum subtype XVaA3h. The findings provide important information on the prevalence of Cryptosporidium in the Chinese population, and expand the range of Cryptosporidium species known to infect people in China.
A man with recurrent fever, arthritis, and rashes-brucellosis? A case report
Authors: Wang Wen , Lu Xu , Li Chengbo , Ri Myong Jun , Cui Wei
Published: January 2020

Background

We report a rare case of chronic brucellosis accompanied with myelodysplastic syndrome and neutrophilic dermatosis, which to the best of our knowledge, has never been reported.

Case presentation

A young man was admitted to our hospital complaining of recurrent fever, arthritis, rashes and anemia. He had been diagnosed with brucellosis 6 years prior and treated with multiple courses of antibiotics. He was diagnosed with myelodysplastic syndrome and neutrophilic dermatosis following bone marrow puncture and skin biopsy. After anti-brucellosis treatment and glucocorticoid therapy, the symptoms improved.

Conclusions

Clinicians should consider noninfectious diseases when a patient who has been diagnosed with an infectious disease exhibits changing symptoms.
Case report: targeted whole exome sequencing enables the first prenatal diagnosis of the lethal skeletal dysplasia Osteocraniostenosis
Authors: Pemberton Lara , Barker Robert , Cockell Anna , Ramachandran Vijaya , Haworth Andrea , Homfray Tessa
Published: January 2020

Background

Osteocraniostenosis (OCS) is a rare genetic disorder characterised by premature closure of cranial sutures, gracile bones and perinatal lethality. Previously, diagnosis has only been possible postnatally on clinical and radiological features. This study describes the first prenatal diagnosis of OCS.

Case presentation

In this case prenatal ultrasound images were suggestive of a serious but non-lethal skeletal dysplasia. Due to the uncertain prognosis the parents were offered Whole Exome Sequencing (WES), which identified a specific gene mutation in the FAMIIIa gene. This mutation had previously been detected in two cases and was lethal in both perinatally. This established the diagnosis, a clear prognosis and allowed informed parental choice regarding ongoing pregnancy management.

Conclusions

This case report supports the use of targeted WES prenatally to confirm the underlying cause and prognosis of sonographically suspected abnormalities.
Experienced pain after stroke: a cross-sectional 5-year follow-up study
Authors: Westerlind Emma , Singh Ramanjit , Persson Hanna C. , Sunnerhagen Katharina S.
Published: January 2020

Background

Stroke is one of the most common cause of disability worldwide. Pain is common in both stroke survivors and in the general population. Consequences of post-stroke pain (PSP) include reduced quality of life and are important to consider. The aim of the current study was to explore the experience of pain 5 years after stroke, and factors associated with the experience of pain.

Methods

Inclusion criteria were: First ever stroke, treated at Sahlgrenska University Hospital, Sweden, during an 18 months period in 2009–2010, aged 18 years or older. Furthermore, the participants had to respond to a set of questionnaires 5 years post-stroke. Baseline data were collected from medical records and follow-up data from the set of questionnaires. The primary outcome was based on the question Do you experience pain? Predictors and explanatory factors for experiencing more frequent pain were analysed with logistic regression.

Results

A total of 281 participants were included. Almost 40% experienced pain to some degree 5 years post-stroke (15% reported pain frequently), and 25% felt that their needs for pain treatment were not met. The participants experiencing more frequent pain reported poorer quality of life, self-perceived health status and recovery post-stroke. Functional dependency at discharge from hospital, experiencing depression at follow up and restricted mobility at follow up were all associated with more frequent pain.

Conclusion

Pain is common 5 years post-stroke and the treatment is not perceived as optimal. The persons experiencing more frequent pain seem to rate their health and recovery worse than the persons experiencing less frequent pain. Most of the factors associated with more frequent pain were treatable and this emphasize the importance of standardised follow-up care that takes pain into consideration.