bluuebunny/crossref_metadata_2025 huggingface dataset:
Constructions of young migrants’ situations in kinship care in a Swedish suburb by social workers in a non-governmental organisation mentoring programme
Authors: Moberg Stephenson Maria , Källström Åsa
Published: January 2020

Young migrants defined as ‘unaccompanied’ tend to be constructed as a homogeneous group with specific vulnerabilities and strengths in social work practice. ‘Unaccompanied’ young migrants placed in kinship care in Sweden are constructed with further vulnerabilities. Such constructions of these young people and their situations may have consequences for how social support for them is designed. The aim of this study is to explore how the social workers employed at a non-governmental organisation mentoring programme construct young migrants’ situations in kinship care in a Swedish suburb, and if and how these constructions change during the course of the programme. Methods used are semi-structured interviews with the social workers at the youth centre where the mentoring work takes place and analysis of the non-governmental organisation’s policy documents. The results consist of three constructions of situations the young people are in: (1) loneliness and (a lack of) support in the kinship homes; (2) alienation in the local neighbourhood and the kinship home and (3) social, cultural and family contexts creating a sense of safety. The results show variation in how the mentors describe each situation with both vulnerabilities and strengths. This highlights a complexity in the constructions that contests the image of young migrants in kinship care as merely vulnerable. These results reveal consideration of individual differences and contexts, and are used to discuss how people’s struggles and resources can be dealt with in social work.
Renal protective effect of sodium ferulate on pulmonary hypertension patients undergoing computed tomography pulmonary angiography
Authors: Zhao Ying , Wang Haiyan , Zhao Jiayu , Wang Xun , Wang Yanbo , Li Wei , Song Tingting , Hao Guozhen , Fu Xianghua , Gu Xinshun
Published: January 2020

This study aimed to explore the correlation of sodium ferulate and the renal protective effect on computed tomography pulmonary angiography in patients suffering from pulmonary hypertension. This prospective study enrolled 92 consecutive patients with pulmonary hypertension diagnosed by echocardiography, and all included patients underwent computed tomography pulmonary angiography after admission. The participants were randomized, divided into sodium ferulate group (n = 49) and control group (n = 43), of which patients in the sodium ferulate group received intravenous sodium ferulate 3.0 g per day from 12 h before computed tomography pulmonary angiography examination to 72 h after that, and patients in the control group were provided with routine treatment. Renal function was assessed by measuring serum creatinine, estimated glomerular filtration rate, Cystatin‐C as well as 24 h, 48 h, and 72 h after computed tomography pulmonary angiography, followed by the calculation of the incidence of contrast‐induced nephropathy for contrast‐induced nephropathy and non‐contrast‐induced nephropathy grouping. Besides, renal resistive index was determined via Doppler ultrasound examination before, after 1 h and 24 h after computed tomography pulmonary angiography. There were no significant differences between the two groups in serum creatinine at baseline and 24 h after computed tomography pulmonary angiography (P > 0.05, respectively), but at 48 h and 72 h, it was lower in the sodium ferulate group (P < 0.05). There were no significant differences of estimated glomerular filtration rate between the two groups (P > 0.05). The level of Cystatin‐C at 48 h and 72 h after computed tomography pulmonary angiography was lower than in the sodium ferulate group (P < 0.05). Contrast‐induced nephropathy was identified in nine patients (9.78%). Sodium ferulate was associated with a decline in the incidence of contrast‐induced nephropathy (4.08 vs. 16.28 %, P < 0.05). Compared to patients with contrast‐induced nephropathy, lower renal resistive index were observed at 1 h and 24 h after computed tomography pulmonary angiography in patients without contrast‐induced nephropathy (P < 0.05). Infusion of sodium ferulate before and after computed tomography pulmonary angiography was associated with a decline in incidence of contrast‐induced nephropathy.
A Cautionary Note on Microcredentialing in Entrepreneurship Education
Authors: Phelan Steven E. , Glackin Caroline E.
Published: January 2020

A recent trend in entrepreneurship education has been the emergence of microcredentials. This note provides some cautionary observations on the current state of microcredentials in entrepreneurship, organized around the themes of credibility, legitimacy, and relevance. It then provides some recommendations for the future development of the field, including creating evaluation mechanisms, establishing international standards in entrepreneurship, undertaking more research to establish credibility, forming alliances, and safeguarding relevance.
Do prescribers deprescribe psychotropic medication for children in foster care?
Authors: O’Brien Conor , Rapp John T. , Kierce Erica D.
Published: January 2020

Approximately one third of children in foster care in the U.S. receive psychotropic medication; however, few studies have evaluated the extent to which either the number or dosage of drugs changes across time. We conducted a retrospective descriptive study of Medicaid files for 30 individuals placed in a foster care system that included an analysis of 10 consecutive visits with a prescribing practitioner spanning 8–14 months. Specifically, we evaluated the data for evidence of deprescribing. Results indicate practitioners changed psychotropic medication during 70% of visits and most changes involved removing and adding psychotropic medication within the same class. Results also show 60% of visits across participants involved prescriptions for four or more psychotropic medications, whereas only 0.33% of trials involved no psychotropic medication. Furthermore, results show the mean number of psychotropic medications per foster child at the end of the study ( M = 3.97) did not decrease in comparison to the start of the study ( M = 3.53). Taken together, these results indicate that prescribers do not regularly engage in a clear deprescribing process for psychotropic medication when serving foster youth. We discuss some limitations to the current study and directions for future research on prescribing patterns with foster children.
Deficiency of Gankyrin in the small intestine is associated with augmented colitis accompanied by altered bacterial composition of intestinal microbiota
Authors: Sakurai Toshiharu , Nishiyama Hiroki , Nagai Tomoyuki , Goto Susumu , Ogata Hiroyuki , Kudo Masatoshi
Published: January 2020

Background

Gankyrin (GK) is an oncoprotein which regulates inflammatory responses and its inhibition is considered as a possible anti-inflammatory therapy for inflammatory bowel disease (IBD).

Methods

In this study, we investigated the role of GK in epithelial cells using mice with intestinal epithelial cell-specific GK deletion in (i) the entire small intestine and colon (Villin-Cre;Gankyrinf/f) and (ii) the distal intestine and colon (Cdx2-Cre;Gankyrinf/f).

Result

Unexpectedly, GK-deficiency in the upper small bowel augmented inflammatory activity compared with control mice when colitis was induced with dextran sodium sulfate. Biochemical analyses have revealed GK-deficiency to have caused reduction in the expression of antimicrobial peptides, α-Defensin-5 and -6, in the upper small bowel. Examination of human samples have further confirmed that the reduction of GK expression in the small bowel is associated with colonic involvement in human Crohn’s disease. Through the sequencing of bacterial 16S rRNA gene amplicons, bacteria potentially deleterious to intestinal homeostasis such as Helicobacter japonicum and Bilophila were found to be over-represented in colitis induced Villin-Cre;Gankyrinf/f mice when compared to Gankyrinf/f control mice under the same condition.

Conclusion

These results highlight the distinct site dependence of the pro- and anti-inflammatory functions of GK and provide important insights into the pathogenesis of IBD.
The changing epidemiology of hepatitis B and C infections in Nanoro, rural Burkina Faso: a random sampling survey
Authors: Lingani Moussa , Akita Tomoyuki , Ouoba Serge , Nagashima Shintaro , Boua Palwende Romuald , Takahashi Kazuaki , Kam Basile , Sugiyama Aya , Nikiema Théodore , Yamamoto Chikako , Somé Athanase , Derra Karim , Ko Ko , Sorgho Hermann , Tarnagda Zekiba , Tinto Halidou , Tanaka Junko
Published: January 2020

Background

This study sought to provide up-to-date hepatitis B (HBV) and C (HCV) seroprevalence in rural Burkina Faso decade after hepatitis B vaccine was introduced in the national immunization scheduled for children.

Methods

In 2018, a community-based, random sampling strategy with probability proportional to population size was conducted in Nanoro to investigate the prevalence of viral hepatitis in children and their mothers. Sociodemographic, vaccination history and risk factors were assessed by interview and health books. HBsAg rapid tests were done by finger prick and Dried Blood Spots (DBS) were collected for hepatitis seromarkers by chemiluminescence enzyme immunoassay. Positive samples underwent confirmatory PCR and phylogenetic analysis.

Results

Data were presented on 240 mother-child pairs. HBsAg Prevalence was 0.8% in children and 6.3% in mothers. Hepatitis B core antibody positivity was 89.2% in mothers, 59.2% in children and was associated with age, sex and scarification. Hepatitis B surface antibodies prevalence was 37.5% in children and 5.8% in mothers. Good vaccination coverage was limited by home delivery. Phylogenetic analysis of HBV strains based on full genome sequences (n = 7) and s-fragment sequences (n = 6) revealed genotype A, E, and recombinant A3/E. Viral genome homology was reported in one mother-child pair. Anti-HCV prevalence was 5.4% in mothers, 2.1% in children and strains belonged to genotype 2.

Conclusions

In Nanoro, HBsAg prevalence was low in children, intermediate in mothers and mother-to-child transmission persists. Home delivery was a limiting factor of Hepatitis B vaccination coverage. HBV genotype E was predominant and genotype A3/E is reported for the first time in Burkina Faso.
Does chemoradiotherapy benefit elderly patients with esophageal squamous cell cancer? A propensity-score matched analysis on multicenter data (3JECROG R-03A)
Authors: Chen Mingqiu , Liu Xiaohong , Han Chun , Wang Xin , Zhao Yidian , Pang Qingsong , Sun Xinchen , Li Gaofeng , Zhang Kaixian , Li Ling , Qiao Xueying , Lin Yu , Chen Junqiang , Xiao Zefen
Published: January 2020

Background

The aim of the present study was to assess the efficacy of concurrent chemoradiotherapy (CRT) or radiotherapy alone (RT-alone) in elderly patients with esophageal squamous cell carcinoma (ESCC).

Methods

The clinical data of patients with ESCC treated with RT-alone or CRT were collected and retrospectively reviewed. The 1-, 3- and 5-year overall survival (OS) rates and the clinical characteristics correlated with survival were analyzed statistically. Propensity score matching (PSM) analyses were used to compensate for differences in baseline characteristics between the CRT and RT-alone groups to confirm the survival difference.

Results

A total of 729 patients fulfilling the inclusion criteria were reviewed. Diabetes, primary tumor volume (pTV), primary tumor location (pTLo), clinical T stage,(cT) clinical N stage (cN), clinical M stage (cM) and short-term response to RT were independent factors influencing OS (P = 0.002–0.044). The 5-year OS rate was 26.6, 26.0 and 30.1% in the whole cohort, RT-alone and CRT groups, respectively. The survival difference between RT alone and CRT was not significant before or following PSM. Compared with the corresponding subgroups treated with RT alone, CRT significantly benefited patients with diabetes (P = 0.003), cT4 (P = 0.030) and cN0 (P = 0.049), whereas no benefit was identified between CRT and RT alone in the other subgroups, including cT1–3, cN1, cM, pTLo, pTV, age and gender.

Conclusions

CRT with the current chemotherapy regimens may not improve the survival of elderly ESCC patients compared to RT-alone, except in patients with cT4 stage, cN0 stage or diabetes. However, due to the limitation of the retrospective nature of the current study, further clinical trials are required for confirmation.
Early relapse on adjuvant gemcitabine associated with an exceptional response to 2nd line capecitabine chemotherapy in a patient with pancreatic adenosquamous carcinoma with strong intra-tumoural expression of cytidine deaminase: a case report
Authors: Connell Claire M. , Brais Rebecca , Whitaker Hayley , Upponi Sara , Beh Ian , Risdall Jane , Corrie Pippa , Janowitz Tobias , Jodrell Duncan I.
Published: January 2020

Background

Pancreatic adenosquamous carcinoma has a poor prognosis, with limited prospective trial data to guide optimal treatment. The potential impact of drug metabolism on the treatment response of patients with pancreatic adenosquamous carcinoma is largely unknown.

Case presentation

We describe the case of a 51 year old woman with pancreatic adenosquamous carcinoma who, following surgical resection, experienced early disease relapse during adjuvant gemcitabine therapy. Paradoxically, this was followed by an exceptional response to capecitabine therapy lasting 34.6 months. Strong expression of cytidine deaminase was detected within the tumour.

Conclusions

This case study demonstrates that early relapse during adjuvant chemotherapy for pancreatic adenosquamous carcinoma may be compatible with a subsequent exceptional response to second line chemotherapy, an important observation given the poor overall prognosis of patients with adenosquamous carcinoma. Cytidine deaminase is predicted to inactivate gemcitabine and, conversely, catalyze capecitabine activation. We discuss strong intra-tumoural expression of cytidine deaminase as a potential mechanism to explain this patient’s disparate responses to gemcitabine and capecitabine therapy, and highlight the benefit that may be gained from considering similar determinants of response to chemotherapy in clinical practice.
Crowdsourcing contests to facilitate community engagement in HIV cure research: a qualitative evaluation of facilitators and barriers of participation
Authors: Zhao Yang , Day Suzanne , Yang Nancy S. , Bao Huanyu , Li Linghua , Mathews Allison , Tucker Joseph D.
Published: January 2020

Background

As HIV cure research advances, there is an increasing need for community engagement in health research, especially in low- and middle-income countries with ongoing clinical trials. Crowdsourcing contests provide an innovative bottom-up way to solicit community feedback on clinical trials in order to enhance community engagement. The objective of this study was to identify facilitators and barriers to participating in crowdsourcing contests about HIV cure research in a city with ongoing HIV cure clinical trials.

Methods

We conducted in-depth interviews to evaluate facilitators and barriers to participating in crowdsourcing contests in Guangzhou, China. Contests included the following activities: organizing a call for entries, promoting the call, evaluating entries, celebrating exceptional entries, and sharing entries. We interviewed 31 individuals, including nine HIV cure clinical trial participants, 17 contest participants, and five contest organizers. Our sample included men who have sex with men (20), people living with HIV (14), and people who inject drugs (5). We audio-recorded, transcribed, and thematically analyzed the data using inductive and deductive coding techniques.

Results

Facilitators of crowdsourcing contest participation included responsiveness to lived experiences, strong community interest in HIV research, and community trust in medical professionals and related groups. Contests had more participants if they responded to the lived experiences, challenges, and opportunities of living with HIV in China. Strong community interest in HIV research helped to drive the formulation and execution of HIV cure contests, building support and momentum for these activities. Finally, participant trust in medical professionals and related groups (community-based organizations and contest organizers) further strengthened the ties between community members and researchers. Barriers to participating in crowdsourcing contests included persistent HIV stigma and myths about HIV. Stigma associated with discussing HIV made promotion difficult in certain contexts (e.g., city squares and schools). Myths and misperceptions about HIV science confused participants.

Conclusions

Our data identified facilitators and barriers of participation in HIV cure crowdsourcing contests in China. Our findings could complement existing HIV community engagement strategies and help to design HIV contests for community engagement in other settings, particularly in low- and middle-income countries.
Predicting professional school performance with a unique lens: are there other cognitive predictors?
Authors: Davies Theresa A. , Miller Madeline B. , Moore Vincent A. , Kaye Elizabeth A.
Published: January 2020

Background

We investigated the associations between admissions criteria and performance in four cohorts of pre-dental MS in Oral Health Sciences (OHS) program at Boston University Schools of Medicine and Dental Medicine. Previously we have reported that OHS serves as a successful pre-dental pipeline program for students from underrepresented groups.

Methods

We evaluated academic variables that further affect overall graduate GPA and grades in the first year dental school courses taken by OHS students at Boston University between 2012 and 2016 as part of the MS curriculum. Demographic data, region of residency, undergraduate grade point average, number of science and math credits, major of study, dental admissions test scores and undergraduate institution were collected. The competitiveness of the undergraduate institution was scored based on Barron’s Profiles of American Colleges. OHS-GPA was assessed and individual grades in two first year dental school courses taken as part of the OHS curriculum were collected. Analysis of variance, the Chi-square test and Fisher’s Exact test were utilized to assess associations between academic performance parameters, successful program completion and matriculation to dental school.

Results

Results indicate that undergraduate major, age and number of science course credits taken had no impact on MS performance in the Boston University MS in Oral Health Sciences program; however, students who took an undergraduate course in Physiology performed better than those who did not (p = 0.034). This was not the case with courses in Cell Biology and Biochemistry. Students with DAT scores over 20 academic average (p = 0.001), 18 total science average (p = 0.001) and 22 reading comprehension (p = 0.004) performed better in dental school courses taken in OHS.

Conclusion

We report that strong test scores, attending a mid or highly rigorous undergraduate institution and completion of an undergraduate Physiology course are positive predictors. We hope these findings will guide admission’s decisions and improve recruitment to, and future success of, graduate student’s pursuit of professional school. Understanding alternative predictors of success may help to reduce the intrinsic bias among applicants from underrepresented groups and continue to look beyond the DATs (or MCATs) to decrease the gap between professionals from underrepresented groups and those they serve.
Resistance status of Anopheles gambiae s.l. to insecticides following the 2011 mass distribution campaign of long-lasting insecticidal nets (LLINs) in the Plateau Department, south-eastern Benin
Authors: Sovi Arthur , Govoétchan Renaud , Ossé Razaki , Koukpo Come Z. , Salako Albert S. , Syme Thomas , Anagonou Rodrigue , Fongnikin Augustin , Nwangwu Udoka C. , Oké-Agbo Frédéric , Tokponnon Filémon , Padonou Gil Germain , Akogbeto Martin Codjo
Published: January 2020

Background

In 2011, Benin’s National Malaria Control Programme (NMCP) organized a nationwide mass distribution campaign of LLINs throughout the country. Following this intervention, it was important to assess whether the level of susceptibility of malaria vectors to insecticides had remained the same as compared to the pre-intervention period. The current study investigated this.

Methods

Larval collections were conducted in Ifangni, Sakété, Pobè and Kétou districts located in Plateau department, Southeastern Benin before (2009) and after (2012–2013) LLIN distribution. Anopheles gambiae sensu lato (s.l.) larvae from the 4 study districts were reared to adulthood and WHO susceptibility tests were conducted. The insecticides tested were deltamethrin (0.05%), permethrin (0.75%), bendiocarb (0.1%) and DDT (4%). Molecular species identification as well as, the characterization of the kdr L1014F mutation were also performed in the An. gambiae s.l. complex using PCR method.

Results

Overall, a significant decrease in mortality rates of An. gambiae s.l. to deltamethrin (0.05%), permethrin (0.75%) and DDT (4%) was observed post-LLIN distribution, respectively: (100% vs 80.9%, p < 0.0001), (77.5% vs 70%, p = 0.01) and, (47.8% vs 4.4%, p < 0.0001). By contrast, susceptibility of vectors to bendiocarb (0.1%) remained the same (100% mortality in the WHO susceptibility tube tests) pre- and post-intervention. An increase in the kdr L1014F frequency was observed post-LLIN distribution [F(kdr) = 0.91)] compared to the pre-intervention period [F(kdr) = 0.56], p < 0.0001. Anopheles coluzzii and An. gambiae were the two molecular species identified in the study area.

Conclusion

The decrease susceptibility to pyrethroids and DDT as well as, the increase in the frequency of the kdr L1014F mutation after the intervention stressed at the time, the need for the development and implementation of effective insecticide resistance management strategies. At present, an update of the vectors resistance status in the area is also necessary for decision-making.
Inter-site harmonization based on dual generative adversarial networks for diffusion tensor imaging: application to neonatal white matter development
Authors: Zhong Jie , Wang Ying , Li Jie , Xue Xuetong , Liu Simin , Wang Miaomiao , Gao Xinbo , Wang Quan , Yang Jian , Li Xianjun
Published: January 2020

Background

Site-specific variations are challenges for pooling analyses in multi-center studies. This work aims to propose an inter-site harmonization method based on dual generative adversarial networks (GANs) for diffusion tensor imaging (DTI) derived metrics on neonatal brains.

Results

DTI-derived metrics (fractional anisotropy, FA; mean diffusivity, MD) are obtained on age-matched neonates without magnetic resonance imaging (MRI) abnormalities: 42 neonates from site 1 and 42 neonates from site 2. Significant inter-site differences of FA can be observed. The proposed harmonization approach and three conventional methods (the global-wise scaling, the voxel-wise scaling, and the ComBat) are performed on DTI-derived metrics from two sites. During the tract-based spatial statistics, inter-site differences can be removed by the proposed dual GANs method, the voxel-wise scaling, and the ComBat. Among these methods, the proposed method holds the lowest median values in absolute errors and root mean square errors. During the pooling analysis of two sites, Pearson correlation coefficients between FA and the postmenstrual age after harmonization are larger than those before harmonization. The effect sizes (Cohen’s d between males and females) are also maintained by the harmonization procedure.

Conclusions

The proposed dual GANs-based harmonization method is effective to harmonize neonatal DTI-derived metrics from different sites. Results in this study further suggest that the GANs-based harmonization is a feasible pre-processing method for pooling analyses in multi-center studies.
Fecal incontinence after total mesorectal excision for rectal cancer—impact of potential risk factors and pelvic intraoperative neuromonitoring
Authors: Kauff Daniel W. , Roth Yvonne D. S. , Bettzieche Rika S. , Kneist Werner
Published: January 2020

Background

Fecal incontinence frequently occurs after total mesorectal excision for rectal cancer. This prospective study analyzed predictive factors and the impact of pelvic intraoperative neuromonitoring at different follow-up intervals.

Methods

Fifty-two patients were included undergoing total mesorectal excision for rectal cancer, and 29 under control of pelvic intraoperative neuromonitoring. Fecal incontinence was assessed using the Wexner Score at 3 and 6 months after stoma closure (follow-ups 1 and 2) as well as 1 and 2 years after surgery (follow-ups 3 and 4). Risk factors were identified by means of logistic regression.

Results

New onset of fecal incontinence was significantly lower in the neuromonitoring group at each follow-up (follow-up 1: 2 of 29 patients (7%) vs. 8 of 23 (35%), (p = 0.014); follow-up 2: 3 of 29 (10%) vs. 9 of 23 (39%), (p = 0.017); follow-up 3: 5 of 29 (17%) vs. 11 of 23 (48%), p = 0.019; follow-up 4: 6 of 28 (21%) vs. 11 of 22 (50%), p = 0.035).

Non-performance of neuromonitoring was found to be an independent predictor for fecal incontinence throughout the survey. Neoadjuvant chemoradiotherapy was an independent predictor in the further course 1 and 2 years after surgery.

Conclusions

Performance of pelvic intraoperative neuromonitoring is associated with significantly lower rates of fecal incontinence. Neoadjuvant chemoradiotherapy was found to have negative late effects. This became evident 1 year after surgery.
Apoptotic mimicry as a strategy for the establishment of parasitic infections: parasite- and host-derived phosphatidylserine as key molecule
Authors: Wanderley João Luiz Mendes , DaMatta Renato Augusto , Barcinski Marcello André
Published: January 2020

The establishment of parasitic infection is dependent on the development of efficient strategies to evade the host defense mechanisms. Phosphatidylserine (PS) molecules are pivotal for apoptotic cell recognition and clearance by professional phagocytes. Moreover, PS receptors are able to trigger anti-inflammatory and immunosuppressive responses by phagocytes, either by coupled enzymes or through the induction of regulatory cytokine secretion. These PS-dependent events are exploited by parasites in a mechanism called apoptotic mimicry. Generally, apoptotic mimicry refers to the effects of PS recognition for the initiation and maintenance of pathogenic infections. However, in this context, PS molecules can be recognized on the surface of the infectious agent or in the surface of apoptotic host debris, leading to the respective denomination of classical and non-classical apoptotic mimicry. In this review, we discuss the role of PS in the pathogenesis of several human infections caused by protozoan parasites.
A meta-analysis of the efficacy of postoperative adjuvant radiotherapy versus no radiotherapy for extrahepatic cholangiocarcinoma and gallbladder carcinoma
Authors: Ren Bixin , Guo Qi , Yang Yongqiang , Liu Lei , Wei Shaohua , Chen Wei , Tian Ye
Published: January 2020

Objective

The benefit of adjuvant radiotherapy (ART) for extrahepatic cholangiocarcinoma (EHCC) and gallbladder carcinoma (GBC) is unclear, with conflicting results from nonrandomized studies. We reported a meta-analysis to determine the impact of adjuvant radiotherapy on survival.

Methods

PubMed, EMBASE, Cochrane Library and CNKI databases were searched to identify clinical trials of postoperative ART versus no radiotherapy for EHCC and GBC. The obtained data were analyzed using RevMan 5.3 and Stata 14.0 statistical software. Differences between two groups were estimated by calculating the odds ratio (OR) and 95% confidence interval (CI).

Results

A total of 21 clinical trials involving 1465 EHCC and GBC patients were selected according to the inclusion and exclusion criteria and included in this meta-analysis. The meta-analysis showed the following: The 5-year overall survival (OS) rate was higher in the ART group than in the no radiotherapy group (OR = 0.63; 95% CI = 0.50–0.81, p = 0.0002). The 5-year OS rate was significantly higher for those with lymph node-positive disease (OR = 0.15; 95% CI 0.07–0.35; p < 0.00001) and margin-positive disease (OR = 0.40; 95% CI 0.19–0.85; p = 0.02) in the ART group than in the no radiotherapy group. ART had a tendency to bring benefit to the 5-year OS of patients with margin-negative disease but the difference was not statistically significant (OR = 0.57, 95% CI 0.30–1,07, p = 0.08). The local recurrence rate was significantly lower in the ART group than in the no radiotherapy group (OR = 0.54; 95% CI = 0.38–0.76, p = 0.0004), and there was no significant difference in the distant metastasis rate between the two groups (OR = 1.33; 95% CI = 0.95–1.87, p = 0.10).

Conclusions

A meta-analysis of the existing study results showed that compared with no radiotherapy, ART is an effective postoperative treatment for EHCC and GBC.
A lung rescue team improves survival in obesity with acute respiratory distress syndrome
Authors:   For the investigators of the lung rescue team, Florio Gaetano , Ferrari Matteo , Bittner Edward A. , De Santis Santiago Roberta , Pirrone Massimiliano , Fumagalli Jacopo , Teggia Droghi Maddalena , Mietto Cristina , Pinciroli Riccardo , Berg Sheri , Bagchi Aranya , Shelton Kenneth , Kuo Alexander , Lai Yvonne , Sonny Abraham , Lai Peggy , Hibbert Kathryn , Kwo Jean , Pino Richard M. , Wiener-Kronish Jeanine , Amato Marcelo B. P. , Arora Pankaj , Kacmarek Robert M. , Berra Lorenzo
Published: January 2020

Background

Limited data exist regarding ventilation in patients with class III obesity [body mass index (BMI) > 40 kg/m2] and acute respiratory distress syndrome (ARDS). The aim of the present study was to determine whether an individualized titration of mechanical ventilation according to cardiopulmonary physiology reduces the mortality in patients with class III obesity and ARDS.

Methods

In this retrospective study, we enrolled adults admitted to the ICU from 2012 to 2017 who had class III obesity and ARDS and received mechanical ventilation for > 48 h. Enrolled patients were divided in two cohorts: one cohort (2012–2014) had ventilator settings determined by the ARDSnet table for lower positive end-expiratory pressure/higher inspiratory fraction of oxygen (standard protocol-based cohort); the other cohort (2015–2017) had ventilator settings determined by an individualized protocol established by a lung rescue team (lung rescue team cohort). The lung rescue team used lung recruitment maneuvers, esophageal manometry, and hemodynamic monitoring.

Results

The standard protocol-based cohort included 70 patients (BMI = 49 ± 9 kg/m2), and the lung rescue team cohort included 50 patients (BMI = 54 ± 13 kg/m2). Patients in the standard protocol-based cohort compared to lung rescue team cohort had almost double the risk of dying at 28 days [31% versus 16%, P = 0.012; hazard ratio (HR) 0.32; 95% confidence interval (CI95%) 0.13–0.78] and 3 months (41% versus 22%, P = 0.006; HR 0.35; CI95% 0.16–0.74), and this effect persisted at 6 months and 1 year (incidence of death unchanged 41% versus 22%, P = 0.006; HR 0.35; CI95% 0.16–0.74).

Conclusion

Individualized titration of mechanical ventilation by a lung rescue team was associated with decreased mortality compared to use of an ARDSnet table.
High-frequency spinal cord stimulation at 10 kHz for the treatment of painful diabetic neuropathy: design of a multicenter, randomized controlled trial (SENZA-PDN)
Authors: Mekhail Nagy A. , Argoff Charles E. , Taylor Rod S. , Nasr Christian , Caraway David L. , Gliner Bradford E. , Subbaroyan Jeyakumar , Brooks Elizabeth S.
Published: January 2020

Background

Painful diabetic neuropathy (PDN), a debilitating and progressive chronic pain condition that significantly impacts quality of life, is one of the common complications seen with long-standing diabetes mellitus. Neither pharmacological treatments nor low-frequency spinal cord stimulation (SCS) has provided significant and long-term pain relief for patients with PDN. This study aims to document the value of 10-kHz SCS in addition to conventional medical management (CMM) compared with CMM alone in patients with refractory PDN.

Methods

In a prospective, multicenter, randomized controlled trial (SENZA-PDN), 216 subjects with PDN will be assigned 1:1 to receive 10-kHz SCS combined with CMM or CMM alone after appropriate institutional review board approvals and followed for 24 months. Key inclusion criteria include (1) symptoms of PDN for at least 12 months, (2) average pain intensity of at least 5 cm—on a 0- to 10-cm visual analog scale (VAS)—in the lower limbs, and (3) an appropriate candidate for SCS. Key exclusion criteria include (1) large or gangrenous ulcers or (2) average pain intensity of at least 3 cm on VAS in the upper limbs or both. Along with pain VAS, neurological assessments, health-related quality of life, sleep quality, and patient satisfaction will be captured. The primary endpoint comparing responder rates (≥50% pain relief) and safety rates between the treatment groups will be assessed at 3 months. Several secondary endpoints will also be reported on.

Discussion

Enrollment commenced in 2017 and was completed in 2019. This study will help to determine whether 10-kHz SCS improves clinical outcomes and health-related quality of life and is a cost-effective treatment for PDN that is refractory to CMM.

Trial registration

ClincalTrials.gov identifier: NCT03228420 (registered 24 July 2017).
Using cluster analysis to reconstruct dengue exposure patterns from cross-sectional serological studies in Singapore
Authors: Sangkaew Sorawat , Tan Li Kiang , Ng Lee Ching , Ferguson Neil M. , Dorigatti Ilaria
Published: January 2020

Background

Dengue is a mosquito-borne viral disease caused by one of four serotypes (DENV1-4). Infection provides long-term homologous immunity against reinfection with the same serotype. Plaque reduction neutralization test (PRNT) is the gold standard to assess serotype-specific antibody levels. We analysed serotype-specific antibody levels obtained by PRNT in two serological surveys conducted in Singapore in 2009 and 2013 using cluster analysis, a machine learning technique that was used to identify the most common histories of DENV exposure.

Methods

We explored the use of five distinct clustering methods (i.e. agglomerative hierarchical, divisive hierarchical, K-means, K-medoids and model-based clustering) with varying number (from 4 to 10) of clusters for each method. Weighted rank aggregation, an evaluating technique for a set of internal validity metrics, was adopted to determine the optimal algorithm, comprising the optimal clustering method and the optimal number of clusters.

Results

The K-means algorithm with six clusters was selected as the algorithm with the highest weighted rank aggregation. The six clusters were characterised by (i) dominant DENV2 PRNT titres; (ii) co-dominant DENV1 and DENV2 titres with average DENV2 titre > average DENV1 titre; (iii) co-dominant DENV1 and DENV2 titres with average DENV1 titre > average DENV2 titre; (iv) low PRNT titres against DENV1-4; (v) intermediate PRNT titres against DENV1-4; and (vi) dominant DENV1-3 titres. Analyses of the relative size and age-stratification of the clusters by year of sample collection and the application of cluster analysis to the 2009 and 2013 datasets considered separately revealed the epidemic circulation of DENV2 and DENV3 between 2009 and 2013.

Conclusion

Cluster analysis is an unsupervised machine learning technique that can be applied to analyse PRNT antibody titres (without pre-established cut-off thresholds to indicate protection) to explore common patterns of DENV infection and infer the likely history of dengue exposure in a population.
On generalized strongly modified h-convex functions
Authors: Zhao Taiyin , Saleem Muhammad Shoaib , Nazeer Waqas , Bashir Imran , Hussain Ijaz
Published: January 2020

We derive some properties and results for a new extended class of convex functions, generalized strongly modified h-convex functions. Moreover, we discuss Schur-type, Hermite–Hadamard-type, and Fejér-type inequalities for this class. The crucial fact is that this extended class has awesome properties similar to those of convex functions.
A prediction-correction inexact alternating direction method for convex nonlinear second-order cone programming with linear constraints
Authors: Zhang Yaling , Liu Hongwei
Published: January 2020

The convex nonlinear second-order cone programming with linear constraints is equivalent to a separate structure convex programming. A prediction-correction inexact alternating direction method is proposed for the separate structure convex programming. In the proposed method, the convex objective function is not required to be Lipschitz continuous and only needs satisfy an inequality. The global convergence result is given. Numerical results demonstrate that our method is efficient for some random second-order cone programming problems in lower accuracy. In addition, our method can be extended to the convex nonlinear circular cone programming with linear constraints. We also give the simulation results of the three-fingered grasping force optimization problems.
Psych Socs: student-led psychiatry societies, an untapped resource for recruitment and reducing stigma
Authors: Pandian Haridha , Mohamedali Zahra , Chapman George E. , Vinchenzo Patricia , Ahmed Suhana , Mulliez Zoé , Bruce Helen , Burn Wendy , Korszun Ania , Tracy Derek K.
Published: January 2020

Medical recruitment and retention are national problems. Psychiatry has been more affected than many specialties, as a result of stigma from the public and other healthcare professionals. The Royal College of Psychiatrists has undertaken several initiatives to redress this, notably the ‘Choose Psychiatry’ campaign. In this editorial we argue that student-led university psychiatry societies are a wonderful but frequently untapped resource to help attract the brightest and best medical students to our profession. We describe the activities of three ‘Psych Socs’ across the UK and propose next steps to continue this work.
Factors influencing prey capture success and profitability in Australasian gannets (Morus serrator)
Authors: Cansse Thomas , Fauchet Louarn , Wells Melanie , Arnould John
Published: January 2020

Knowledge of the factors influencing foraging efficiency in top predators can provide insights into the effects of environmental variability on their populations. Seabirds are important marine predators foraging in a highly temporally and spatially variable environment. While numerous studies have focussed on search time and its effects on foraging energetics in seabirds, relatively little is known of the factors influencing capture success and prey profitability in these predators. In the present study, animal-borne cameras were used to investigate the chase durations, capture success, handling durations and profitability of prey consumed by Australasian gannets (Morus serrator) (n=95) from two breeding colonies in south-eastern Australia exposed to different oceanographic conditions. Capture success was generally lower when individuals foraged alone. However, foraging in multi-species groups and in high prey densities increased chase time, while larger prey elicited longer handling times. While prey type influenced profitability, high prey density and foraging in multispecies groups was found to lower prey profitability due to increased time expenditure. While previous studies have found group foraging reduces search time, the increased profitability explains why some animals may favour solitary foraging. Therefore future studies should combine search time and the currently found factors.
An interview with Trudi Schüpbach
Authors: Maartens Aidan
Published: January 2020

Gertrud (Trudi) Schüpbach is Emeritus Professor of Molecular Biology at Princeton University. She was a Howard Hughes Medical Institute Investigator between 1994 and 2014, was elected to the National Academy of Sciences in 2005 and to the European Molecular Biology Organization as an Associate Member in 2000, and won the Society of Developmental Biology's Edwin G. Conklin Medal in 2006. She has a long-term interest in the genetic and molecular control of oogenesis in Drosophila, work she continues in her retirement. In this interview, conducted at the Latin American Society for Developmental Biology's 2019 meeting in Buenos Aires, she surveys her career, discusses the rich seam of science that came out of a maternal-effect screen and gives her advice for people considering a career in research.
Ethnolinguistic Nationalism and Other Political Contexts of Maironis
Authors: Žvirgždas Manfredas
Published: January 2020

Widely acclaimed as the Lithuanian national poet, the Catholic clergyman Jonas Mačiulis-Maironis (1862–1932) in his canonical poems of the epoch of national revival expressed his romantic primordialist point of view that every nation has an inherent right to its independence that had been given by divine institution. Linguistic factors determined national identity in Eastern Europe of the late 19th century. Maironis as a follower of linguocentric nationalism modelled the conditions for the elite Lithuanian culture which would be significant at the European level. The longing for the so-called European virtues (universally based on Christian ethics) penetrated through all the poet’s world-view, therefore he was impressed by the diligence and activism of Western nations but did not support the ideas of social activism and individual liberties, opposed the ideas of secular philosophical trends, especially socialism and scientism. Eurocentrist motives in his rhetoric did not mean any challenge to the governing conservative Russian regime because they did not invoke opposition to the ideology of Pan-Slavism which was supported by the Tsarist ideologues. The poetical archetype of springtime awakening was related to the youthful activism of the “new” political nations of Eastern and Central Europe. Maironis was one of the first Lithuanian authors who openly criticized ideas of socialism and positivism; on the other hand, he provoked discussions of the enlightened group of the developing Lithuanian-speaking elite. He regarded the slogans of liberty, equality and fraternity as deceptive justification of populism and collective violence. Sceptically regarding parliamentary democracy, he emphasized the principles of Classical-Christian law and justice and the need for solidarity, consciousness and creativity. Maironis related the ideological dispute of conservative and radical trends to the decisive struggle of Christianity and atheism. He was a consistent and orthodox Catholic thinker, the opponent of any revolutionary upheavals; discussing social questions he emphasized that politicians should take into account doctrine of the Holy See on the obligations of Christians and principles of charity.
Pedro Lemebel’s Mi Amiga Gladys: The Role of Emotions in the Reconstruction of Fragmented Memories
Authors: Uribe Ugalde Julio
Published: January 2020

The last book by the Chilean writer Pedro Lemebel (1952–2015) is entitled Mi Amiga Gladys (2016), a production entirely dedicated to his friend Gladys Marín (1938–2005). To date, this work has attracted little attention from academia, perhaps due to its apparently less confrontational discourse, one of the common characteristics of Lemebel’s previous works. However, this essay proposes that Lemebel’s last book in fact reveals a political statement, yet disguised as an intimate/sensitive declaration. This element would reflect a literary strategy employed by the writer, possibly aiming at eliciting a sympathetic response from the reader, by appealing to his/her emotions. By drawing on Affect theory, this essay argues that Lemebel’s personal/emotional stories with Gladys aim at recuperating her legacy, highlighting his friend’s social commitment and spirit of resistance. His contribution is indeed relevant to Chilean culture, as Lemebel views Chile’s recent past, so arguably conflicted and fragmented in its post-dictatorship period (from 1990 onwards). This study aims at being an innovative contribution to Lemebel’s studies, as it approaches his political discourse from an affective perspective, possibly establishing an original model for future analyses of his work.
Small Literature as a Problem. Could It Be Solved?
Authors: Satkauskytė Dalia
Published: January 2020

Th e article discusses the status and functioning of so-called small literatures, including Lithuanian literature, in the global system of world literature. Referring to Franco Moretti and Pascale Casanova’s interpretation of world literature system as based on the principle of inequality, the author discusses the conception of belonging to small literatures as a destiny and interprets the onecentric world literary system as hegemonic. Being dominated by grand literatures, small literatures have very restricted possibilities of gravitation towards the center of world literature. In that theoretical context, the article considers the following issues: is it possible and how is it possible to avoid the destiny of small literatures staying in the periphery of world literature, what role in this situation plays the writer himself, what depends on the culture and research politics, could literary scholars play the role of mediators and what could be the alternatives for onecentered world literary system.
Pro-Social Trickstars in Khaled Hosseini’s A Thousand Splendid Suns
Authors: Rüsse Paul , Krasnova Anastassia
Published: January 2020

Tricksters are usually defined as non-heroic male characters obsessed with food, sex, and general merrymaking, occasionally changing shape and even gender but eventually returning to their masculine self. But is this necessarily true in contemporary ethnic literature? The current essay explores the notion of the trickstar, or the female trickster, in Afghan- American fiction, analysing the three heroines in Khaled Hosseini’s 2007 novel A Thousand Splendid Suns, which is a mother-daughter story set in Kabul at the turn of the millennium. In order to place this text into a cultural context and underscore the significance of the trickstar figure, it is compared to a traditional Afghan folk tale, “Women’s Tricks.” Two research questions are at the centre of this article: (1) In what ways are trickstars from Afghan folklore similar to the heroines of Hosseini’s novel? and (2) What roles do his heroines perform as pro-social trickstars?
“Black Balts” Abroad: White Racism, Homosexuality and (Non-)Tolerance in Lithuanian and Latvian Emigration Narratives
Authors: Laurušaitė Laura
Published: January 2020

The present article will use the method of literary imagology in order to study the 21st-century Lithuanian and Latvian (e)migration literature and experiences in the context of racial, sexual, and cultural otherness. It will discusses marriage to a foreigner as something more than an official legitimation of one’s love for a person of other ethnicity, the introduction of foreignness into the world of one’s own culture, and the ideological penetration of the other into that which is inherited, ordinary and familiar. Provinciality, intolerance, and inability to admit and accept the Other or perceive oneself as a sexual Other remain an important part of Lithuanian and Latvian identity. In turn, emigrants in the host communities are a minority with counter-negative images, especially social ones.