bluuebunny/crossref_metadata_2025 huggingface dataset:
Inward Rectifier K
+
Currents Contribute to the Proarrhythmic Electrical Phenotype of Atria Overexpressing Cyclic Adenosine Monophosphate Response Element Modulator Isoform CREM‐IbΔC‐X
Authors: Pluteanu Florentina , Seidl Matthias D. , Hamer Sabine , Scholz Beatrix , Müller Frank U.
Published: November 2020

BACKGROUND

Transgenic mice (TG) with heart‐directed overexpresion of the isoform of the transcription factor cyclic adenosine monophosphate response element modulator (CREM), CREM‐IbΔC‐X, display spontaneous atrial fibrillation (AF) and action potential prolongation. The remodeling of the underlying ionic currents remains unknown. Here, we investigated the regulatory role of CREM‐IbΔC‐X on the expression of K
+
channel subunits and the corresponding K
+
currents in relation to AF onset in TG atrial myocytes.

METHODS AND RESULTS

ECG recordings documented the absence or presence of AF in 6‐week‐old (before AF onset) and 12‐week‐old TG (after AF onset) and wild‐type littermate mice before atria removal to perform patch clamp, contractility, and biochemical experiments. In TG atrial myocytes, we found reduced repolarization reserve K
+
currents attributed to a decrease of transiently outward current and inward rectifier K
+
current with phenotype progression, and of acetylcholine‐activated K
+
current, age independent. The molecular determinants of these changes were lower mRNA levels of
Kcnd2/3
,
Kcnip2
,
Kcnj2/4
, and
Kcnj3/5
and decreased protein levels of K
+
channel interacting protein 2 (KChIP2 ), Kir2.1/3, and Kir3.1/4, respectively. After AF onset, inward rectifier K
+
current contributed less to action potential repolarization, in line with the absence of outward current component, whereas the acetylcholine‐induced action potential shortening before AF onset (6‐week‐old TG mice) was smaller than in wild‐type and 12‐week‐old TG mice. Atrial force of contraction measured under combined vagal‐sympathetic stimulation revealed increased sensitivity to isoprenaline irrespective of AF onset in TG. Moreover, we identified
Kcnd2
,
Kcnd3
,
Kcnj3
, and
Kcnh2
as novel CREM‐target genes.

CONCLUSIONS

Our study links the activation of cyclic adenosine monophosphate response element–mediated transcription to the proarrhythmogenic electrical remodeling of atrial inward rectifier K
+
currents with a role in action potential duration, resting membrane stability, and vagal control of the electrical activity.
Decreased Absolute Lymphocyte Count and Increased Neutrophil/Lymphocyte Ratio With Immune Checkpoint Inhibitor–Associated Myocarditis
Authors: Drobni Zsofia D. , Zafar Amna , Zubiri Leyre , Zlotoff Daniel A. , Alvi Raza M. , Lee Charlotte , Hartmann Sarah , Gilman Hannah K. , Villani Alexandra‐Chloe , Nohria Anju , Groarke John D. , Sullivan Ryan J. , Reynolds Kerry L. , Zhang Lili , Neilan Tomas G.
Published: November 2020

Background

Myocarditis attributable to immune checkpoint inhibitor (ICI) therapy is a potentially fatal immune‐related adverse event. Limited data have suggested an association between baseline and on‐treatment absolute lymphocyte count (ALC) and neutrophil/lymphocyte ratio (NLR) and the development of other immune‐related adverse events; there are no data characterizing the role of ALC and NLR in ICI‐associated myocarditis.

Methods and Results

This was a case control study of 55 patients with ICI myocarditis and 55 controls without any post‐ICI immune‐related adverse events. We leveraged clinical testing, where patients underwent routine serial blood counts before and with each ICI cycle to compare the baseline and change in ALC and NLR between cases and controls. The association between the change in these parameters with clinical variables and major adverse cardiac events was also tested. In cases, there was a statistically significant decrease in ALC with myocarditis from baseline (1.6 thousands per cubic milliliter (K/μL); interquartile range, 1.1–1.9 K/μL) to admission (1.1 K/μL; interquartile range, 0.7–1.3 K/μL;
P
<0.001). Similarly, there was an increase in NLR from baseline (3.5; interquartile range, 2.3–5.4) to admission (6.6; interquartile range, 4.5–14.1;
P
<0.001). There was no statistically significant change in controls. In follow‐up, there were 20 events; larger decreases in ALC (44.6% versus 18.2%;
P
<0.001) or increases in NLR (156.5% versus 65.1%;
P
=0.019) were associated with major adverse cardiac events.

Conclusions

A reduction in ALC and an increase in NLR was seen with ICI myocarditis. A greater decrease in ALC or increase in NLR was associated with subsequent major adverse cardiac events.
Exploring Opportunities for Primary Prevention of Unprovoked Venous Thromboembolism: Ready for Prime Time?
Authors: Folsom Aaron R. , Cushman Mary
Published: November 2020

Venous thromboembolism (VTE) is an important vascular disease and public health problem. Prevention of VTE has focused mainly on using thromboprophylaxis to avoid provoked VTE or recurrent VTE, with little attention paid to the possibility of preventing the one third to one half of VTEs that are unprovoked. We review growing research suggesting that unhealthy lifestyle risk factors may cause a considerable proportion of unprovoked VTE. Using epidemiologic data to calculate population attributable risks, we estimate that in the United States obesity may contribute to 30% of VTEs, physical inactivity to 4%, current smoking to 3%, and Western dietary pattern to 11%. We also review possibilities for VTE primary prevention either through a high‐risk individual approach or a population‐wide approach. Interventions for outpatients at high VTE risk but without VTE provoking factors have not been fully tested; yet, improving patient awareness of risk and symptoms, lifestyle counseling, and possibly statins or direct oral anticoagulants may prove useful in primary prevention of unprovoked VTE. A population approach to prevention would bolster awareness of VTE and aim to shift lifestyle risk factors downward in the whole population using education, environmental changes, and policy. Assuming the epidemiological associations are accurate, causal, and independent of each other, a reduction of obesity, physical inactivity, current smoking, and Western diet by 25% in the general population might reduce the incidence of unprovoked VTE by 12%. We urge further research and consideration that primary prevention of unprovoked VTE may be a worthwhile public health aim.
Lower Bounds for Non-Elitist Evolutionary Algorithms via Negative
Multiplicative Drift
Authors: Doerr Benjamin
Published: November 2020

A decent number of lower bounds for non-elitist population-based evolutionary algorithms has been shown by now. Most of them are technically demanding due to the (hard to avoid) use of negative drift theorems—general results which translate an expected movement away from the target into a high hitting time. We propose a simple negative drift theorem for multiplicative drift scenarios and show that it can simplify existing analyses. We discuss in more detail Lehre's (2010) negative drift in populations method, one of the most general tools to prove lower bounds on the runtime of non-elitist mutation-based evolutionary algorithms for discrete search spaces. Together with other arguments, we obtain an alternative and simpler proof of this result, which also strengthens and simplifies this method. In particular, now only three of the five technical conditions of the previous result have to be verified. The lower bounds we obtain are explicit instead of only asymptotic. This allows us to compute concrete lower bounds for concrete algorithms, but also enables us to show that super-polynomial runtimes appear already when the reproduction rate is only a (1-ω(n-1/2)) factor below the threshold. For the special case of algorithms using standard bit mutation with a random mutation rate (called uniform mixing in the language of hyper-heuristics), we prove the result stated by Dang and Lehre (2016b) and extend it to mutation rates other than Θ(1/n), which includes the heavy-tailed mutation operator proposed by Doerr et al. (2017). We finally use our method and a novel domination argument to show an exponential lower bound for the runtime of the mutation-only simple genetic algorithm on OneMax for arbitrary population size.
Between the Foreign and the Familiar
Authors: Kazani Zahra
Published: November 2020

A Qurʾan manuscript (British Library Add 5548–5551), attributed to fifteenth-century India, features a curious case of English annotations within its folios. The annotations take the form of interlinear translations superimposed onto its Persian counterpart. This article takes the contents of the English annotations and its physical placement within the body of the text as a platform to investigate the socio-cultural contexts of the manuscript’s circulation. In doing so, it illustrates the life of its owner, Charles Hamilton, an eighteenth-century military official and Orientalist at the East India Company. The content of the annotations suggests the manuscript’s function as a tool for language acquisition in the midst of Orientalist attempts at colonizing Indian knowledge; its physical placement, an embodiment of British encounters in India. The article builds on the nature of manuscript collecting by Company officials and the role that objects can play as they intersect with intellectual history.
Educational Peace Theory in the Holy Qurʾan
Authors: Karama Muneer Jebreel , Khater Nada Ali
Published: November 2020

This study aimed to explore the educational theory of peace in the Holy Qurʾan by conducting a holistic, systematic analysis of the word “peace” and introducing its different meanings in the Holy Qurʾan. To achieve this aim, the researchers utilized a scientific approach that consisted of the following procedures: conducting a meta-analysis of the word “peace” in the Holy Qurʾan by using statistics from Quran Explorer, resulting in 136 words for peace mentioned in 48 chapters; classifying the meanings of “peace”, resulting in 13 different meanings; and creating a meta-synthesis of the word “peace” according to three different subgroups that share common concepts. Finally, the theory of Islamic interactive peace was formulated. The paper concludes that of all mentions of peace in the Qurʾan, external peace constitutes 68%, internal peace 21% and meta peace 11%. This result emphasizes the importance of peace between nations and states to gain stability in the world.
Empirical–Statistical Downscaling of Austral Summer Precipitation over South America, with a Focus on the Central Peruvian Andes and the Equatorial Amazon Basin
Authors: Sulca Juan , Vuille Mathias , Timm Oliver Elison , Dong Bo , Zubieta Ricardo
Published: November 2020

Precipitation is one of the most difficult variables to estimate using large-scale predictors. Over South America (SA), this task is even more challenging, given the complex topography of the Andes. Empirical–statistical downscaling (ESD) models can be used for this purpose, but such models, applicable for all of SA, have not yet been developed. To address this issue, we construct an ESD model using multiple-linear-regression techniques for the period 1982–2016 that is based on large-scale circulation indices representing tropical Pacific Ocean, Atlantic Ocean, and South American climate variability, to estimate austral summer [December–February (DJF)] precipitation over SA. Statistical analyses show that the ESD model can reproduce observed precipitation anomalies over the tropical Andes (Ecuador, Colombia, Peru, and Bolivia), the eastern equatorial Amazon basin, and the central part of the western Argentinian Andes. On a smaller scale, the ESD model also shows good results over the Western Cordillera of the Peruvian Andes. The ESD model reproduces anomalously dry conditions over the eastern equatorial Amazon and the wet conditions over southeastern South America (SESA) during the three extreme El Niños: 1982/83, 1997/98, and 2015/16. However, it overestimates the observed intensities over SESA. For the central Peruvian Andes as a case study, results further show that the ESD model can correctly reproduce DJF precipitation anomalies over the entire Mantaro basin during the three extreme El Niño episodes. Moreover, multiple experiments with varying predictor combinations of the ESD model corroborate the hypothesis that the interaction between the South Atlantic convergence zone and the equatorial Atlantic Ocean provoked the Amazon drought in 2015/16.
Observations and Modeling of Evapotranspiration and Dewfall during the 2018 Meteorological Drought in Southern England
Authors: Osborne Simon R. , Weedon Graham P.
Published: November 2020

A meteorological drought in 2018 led to senescence of the C3 grass at Cardington, Bedfordshire, United Kingdom. Observations of near-surface atmospheric variables and soil moisture are compared to simulations by the JULES land surface model (LSM) as used for Met Office forecasts. In years without drought, JULES provides better standalone simulations of evapotranspiration (ET) and soil moisture when the canopy height and rooting depth are reduced to match local conditions. During drought with the adjusted configuration, JULES correctly estimates total ET, but the components are in the wrong proportions. Several factors affect the estimation of ET including modeled skin temperatures, dewfall, and bare-soil evaporation. A diurnal range of skin temperatures close to observed is produced via the adjusted configuration and doubling the optical extinction coefficient. Although modeled ET during drought matches observed ET, this includes simulation of transpiration but in reality the grass was senescent. Excluding transpiration, the modeled bare-soil evaporation underestimates the observed midday latent heat flux. Part of the missing latent heat may relate to inappropriate parameterization of hydraulic properties of dry soils and part may be due to insufficient evaporation of dew. Dew meters indicate dewfall of up to 20 W m−2 during drought when the surface is cooling radiatively and turbulence is minimal. These data demonstrate that eddy-covariance techniques fail to reliably record the times, intensity, and variations in negative latent heat flux. Furthermore, the parameterization of atmospheric turbulence as used in LSMs fails to represent accurately dewfall during calm conditions when the surface is radiatively cooled.
A Climatological Analysis of the Linkages between Tropopause Polar Vortices, Cold Pools, and Cold Air Outbreaks over the Central and Eastern United States
Authors: Biernat Kevin A. , Bosart Lance F. , Keyser Daniel
Published: November 2020

Coherent vortices in the vicinity of the tropopause, referred to as tropopause polar vortices (TPVs), may be associated with tropospheric-deep cold pools. TPVs and associated cold pools transported from high latitudes to middle latitudes may play important roles in the development of cold air outbreaks (CAOs). The purpose of this study is to examine climatological linkages between TPVs, cold pools, and CAOs occurring in the central and eastern United States. To conduct this study, 1979–2015 climatologies of TPVs and cold pools are constructed using the ERA-Interim dataset and an objective tracking algorithm, and are compared to a 1979–2015 climatology of CAOs occurring in six NCEI-defined climate regions over the central and eastern United States. The climatologies of TPVs and cold pools indicate that central and eastern North America is a preferred corridor for their equatorward transport, and that the occurrence frequency of TPVs and cold pools is higher over northern regions of the United States compared to southern regions of the United States. Correspondingly, there is a higher percentage of CAOs linked to cold pools associated with TPVs over northern regions of the United States (32.1%–35.7%) compared to southern regions of the United States (4.4%–12.5%). TPVs and cold pools contributing to CAOs form most frequently over northern Canada and the Canadian Archipelago, and generally move southeastward toward southern Canada and the northern United States. TPVs and cold pools contributing to CAOs tend to be statistically significantly colder and longer lived when compared to all TPVs and cold pools transported to middle latitudes.
Isolation and immunity within the family: Commuter marriages in Southeast Asia
Authors: Gregorio Veronica L
Published: November 2020

This article examines the gendered subjectivities and family ideologies of commuter wives and commuter husbands in Southeast Asia, in relation to being part of bilateral households and multigeneration extended families. It emphasizes that, first, the understanding of gendered subjectivities should come from looking at femininities alongside masculinities, and second, despite criticisms, there is still value in using family ideology in examining family life that is consistently experiencing changes within the broader socio-political contexts. The article analyzes ethnographic accounts and in-depth interviews with rural families in Malaysia and the Philippines by engaging with the concepts of transient subjectivities and particular family ideology. While literature on commuter marriages sees the phenomenon as middle class, career driven, and temporary, the article reveals that the case is different for societies where jobs are almost constantly precarious and where couples do not have the luxury of time to settle for a transitory lifestyle. It proposes the concepts of ‘family isolation’ and ‘family immunity’ as a result of multiple gendered subjectivities and discusses their formation in line with the particular family ideologies that farming families in Southeast Asia adhere to.
School Matters: The Contribution of Positive School Climate to Equal Educational Opportunities among Ethnocultural Minority Students
Authors: Berkowitz Ruth
Published: November 2020

This study carefully examined compensating, mediating, and moderating effects of positive school climate on the relationship of socioeconomic status (SES) and achievement in a nationally representative sample of ethnocultural minority Arabic speaking students in Israel ( N = 21,873). Positive school climate was predominantly influential in schools with vulnerable ethnic groups and students from disadvantaged backgrounds. Narrower achievement gaps among students with different personal SES backgrounds were achieved in schools with positive climates. Results suggest improving school climate can increase students’ academic opportunities and offer special benefits for students from less advantaged backgrounds. Implications for research, practice, and policy are discussed.
How Have Hospitals in the Mississippi Delta Fared Under the 2019 Revised Hospital Readmissions Reduction Program?
Authors: Chen Hsueh-Fen , Schuldt Robert F. , Brown Clare , Tilford John Mick
Published: November 2020

In 2013, the Centers for Medicare and Medicaid Services (CMS) implemented the Hospital Readmissions Reduction Program (2013 HRRP), which financially penalized hospitals if their 30-day readmissions were higher than the national average. Without adjusting for socioeconomic status of patients, the 2013 HRRP overly penalized hospitals caring for the poor, especially hospitals in the Mississippi Delta region, one of the poorest regions in the U.S. In 2019, CMS revised the HRRP (2019 Revised HRRP) to stratify hospitals into quintiles based on the proportion of patients that are dual-eligible Medicare and Medicaid beneficiaries. This study aimed to examine the effect of the 2019 Revised HRRP on financial penalties for Delta hospitals using a difference-in-difference (DID) approach with data from the 2018 and 2019 HRRP Supplemental Files. The DID analysis found that relative to non-Delta hospitals, penalties in Delta hospitals were reduced by 0.08 percentage points from 2018 to 2019 (95% CI for the coefficient: −0.15, −0.01; P = .02), and the probability of a penalty was reduced by 6.64 percentage points (95% CI for the coefficient: −9.54, −3.75; P < .001). The stratification under the 2019 Revised HRRP is an important first step in reducing unfair penalties to hospitals that serve poor populations.
Unmasked: A comparative analysis of the physician’s ethical and legal duty to treat during a pandemic
Authors: Pelkas Cristina , Boisseau Matthew
Published: November 2020

For the first time in over a hundred years, the world faces a devastating pandemic. Millions have been infected with the severe acute respiratory syndrome (SARS)-CoV-2 virus and thousands have died. Unprecedented global shortages of protective equipment have resulted in the infection and death of healthcare workers. The legal and ethical duty of a doctor to treat during a pandemic has evolved over time, shaped by legislation and ethical guidance following SARS and the September 11 terrorism attacks. A positive ethical obligation to treat is arguably outweighed by the inability to meet occupational safety standards and high risk of personal harm, in addition to a physician’s competing duties to future patients, their families and colleagues. Nevertheless, individuals who continue working should be acknowledged by society with accessible worker’s compensation, alternative accommodation, hazard pay and student debt forgiveness so that healthcare workers continue to serve patients, answering far beyond the call of duty.
Household Energy Use Among Female-Headed Households in Urban Ethiopia: Key Issues for the Uplift of Women
Authors: Ali Ahmed Mustofa
Published: November 2020

This article examines the linkages between cooking energy and gender based on a study conducted in Arba Minch town of southwestern Ethiopia. It primarily investigates cooking energy end-use within female-headed households (FHHs) residing in the town and specifically focuses on women who disproportionately suffer the impacts of energy accessibility. This study reveals that commercial cooking fuels are increasingly scarce and expensive, and the costs of modern cooking appliances are beyond the purchasing ability of most urban FHHs. Meeting the energy requirements in sustainable manner, thus, continues to be a major challenge that hinders FHHs’ efforts to improve their living situations. The results further show that though the income is an important factor, it is not the only powerful determinant in the consumption of cooking fuels within FHHs. Other socioeconomic characteristics were found to have a significant impact too. This study further examines the relevance of the “fuel stacking” model and finds that the majority of the FHHs, regardless of their economic status, depend on wood fuels as their primary cooking energy source. Even when family incomes rose, complete transition to cleaner fuels has not taken place; instead, it added fuels in the fuel stacking process.
Growth and Distribution Effects of Changes in Levels of Living in Rural India: A Decomposition Analysis
Authors: Sen Jayanta
Published: November 2020

This article deals with the changing pattern of levels of living in the rural regions of India during the period of 1993–1994 to 2011–2012 which also corresponds to the on-going economic reforms. These changes may be attributed either to the change in growth component or to the change in equity component or to both. The article therefore examines the effects of growth and distribution components on the variations in levels of living and their relative roles by a scheme of algebraic decomposition. It also investigates the influence of socio-economic factors on levels of living using econometric models. National Sample Survey Organisation consumer expenditure data for 15 major states of India are used for this analysis. Results show an improvement in levels of living (actual) in rural areas of all Indian states. Positive growth effect more than compensates the negative distribution effect and yield positive changes in some of the states. Further, this article argues that the main drivers of this positive change in the levels of living are development of rural physical infrastructure, attainment in education, farm income per capita, non-farm employment and livelihood diversification.
Associations Between the Child Care Environment and Children’s In-Care Physical Activity and Sedentary Time
Authors: Zhang Zhiguang , Kuzik Nicholas , Adamo Kristi B. , Ogden Nancy , Goldfield Gary S. , Okely Anthony D. , Crozier Mitchell , Hunter Stephen , Predy Madison , Carson Valerie
Published: November 2020

Background

Child care centers are important for children’s behaviors.

Aims

To examine the cross-sectional associations between child care environmental characteristics and physical activity and sedentary time in children.

Methods

Participants were 124 toddlers and 118 preschoolers from 19 centers in Alberta and Ontario, Canada, in the supporting Healthy physical AcTive CHildcare setting (HATCH) study. In-care physical activity and sedentary time were assessed using Actigraph accelerometers. Child care environments, including structure (e.g., resources) and process (e.g., activities) quality, were measured using three instruments: (1) the Environment and Policy Assessment and Observation and (2) the Children’s Physical Environments Rating Scale, and (iii) the Movement Environment Rating Scale. Mixed models were performed to examine the associations between environmental characteristics and children’s sedentary time, light physical activity, and moderate-to-vigorous physical activity.

Results

A few structure quality characteristics related to child care policy and indoor environment were associated with higher physical activity and lower sedentary time in toddlers. The overall structure quality ( B = 0.04; 95% CI [0.003, 0.08]) and process quality ( B = 0.08; 95% CI [0.02, 0.15]) of the child care environment were associated with log moderate-to-vigorous physical activity in preschoolers. Specifically, structure quality characteristics of the outdoor environment and physical activity time, and process quality characteristics relevant to curriculum and pedagogy, were associated with higher physical activity and lower sedentary time in preschoolers.

Discussion and Conclusion

The child care structure quality characteristics that are important for children’ physical activity and sedentary behavior may vary by age group. Improving the overall process quality, in particular curriculum and pedagogy, of the child care environment, may promote more physical activity in preschoolers.
Exploring the Tensions Between Masculinities and Connections with Faculty and Staff among Gay Latino Collegians
Authors: Patrón Oscar E. , Rodriguez Fernando
Published: November 2020

This study utilizes Gloria E. Anzaldúa’s Border theory to explore how internalized messages of masculinities shape the ways that gay Latino men develop connections with university staff and faculty. Specifically, we highlight how such messages learned primarily in the context of the home create spaces of tension, nepantla, within heteronormative campus settings. We present portraits of five Latino collegians enrolled in a large public four-year institution, followed by three themes. The themes include gay Latinos developing relationships (1) solely for academic purposes, (2) that explicitly involve women, and, in other cases, (3) displaying resistant behaviors to developing connections. We conclude by offering practical implications for university administrators and faculty.
Optimal parameters of tuned mass dampers for an inverted pendulum with two degrees of freedom
Authors: Nguyen Duy-Chinh
Published: November 2020

In reality, an inverted pendulum can be used to model many real structures as the fluid tower, super-tall buildings, or articulated tower in the ocean, etc. However, for the inverted pendulum with two degrees of freedom, to the best knowledge of the author, there is no study to determine optimal parameters of two tuned mass dampers (TMD) by using the maximization of equivalent viscous resistance method. Therefore, the current study presents the analytical solutions to the optimization of two orthogonal TMDs, which is used to eliminate vibration of the inverted pendulum with two degrees of freedom. The parameters considered in optimizing are the natural frequency ratios and damping ratios of the two TMDs. The new results of this paper can be summarized as follows: Firstly, the equivalent resistance forces of the two TMDs acting on the inverted pendulum with two degrees of freedom are established. Secondly, the quadratic torque matrices of the vibration response of the inverted pendulum attached with two TMDs is revealed. Thirdly, the optimal expressions are derived using the maximization of equivalent viscous resistance method. The obtained formulae provide exact solutions for the proposed problem. Finally, to confirm the effectiveness of the obtained formulae, parametric studies on vibration are performed for sample articulated tower in the ocean with and without optimal TMDs. Numerical results show that vibrations of the articulated tower attached with optimal TMDs are effectively eliminated. This confirms that the optimal parameters of the two TMDs are determined in this paper are reliable and accurate.
Demoralization in the wake of the COVID-19 pandemic: Whereto the future for young Australians?
Authors: Fronek Patricia , Briggs Lynne
Published: November 2020

COVID-19 is changing lives. Less attention has been paid to the future of young people by governments since the onset of the pandemic. We suggest that young people are vulnerable to demoralization, a state of hopelessness and helplessness, during and post-COVID-19. This reflection drawn from journaling and ongoing reflexive conversation from December 2019 to April 2020 offers a critical perspective on the circumstances of young Australians that encompasses consideration of the structural factors that impact on health, life chances, equality and social justice as well as the personal aspects of reflection.
Expression and Clinical Significance of MMP-28 in Bladder Cancer
Authors: Wang Heng , Wu Jun-xiu , Chen Xin-Peng , Zhang Qi , Wei Hai-bin , Wang Hui-Ju , Yang Xue , Zhang Da-Hong
Published: November 2020

Aims:

The aim of this study to determine the expression of MMP-28 in bladder urothelial carcinoma and to analyze the correlation between MMP-28 and the clinicopathological characteristics of human bladder carcinoma, and its relationship with patient prognosis.

Methods:

A total of 491 surgically resected bladder cancer samples and 80 normal tissue adjacent to the tumor were stained by immunohistochemistry. The expression of MMP-28 in these samples was quantitated, and the value of MMP-28 as a marker of bladder cancer and prognosis was assessed.

Results:

The expression of MMP-28 in urinary bladder carcinoma was higher than in normal bladder mucosa. The high level of MMP-28 was significantly correlated with tumor histology grade, lymphatic metastasis, lymph node infiltration, and distant metastasis (P < 0.05). The upregulation of MMP-28 was also closely related to the risk of cancer progression and the survival of patients. Further analysis documented that high expression of MMP-28 was associated with decreased overall survival in bladder cancer patients.

Conclusions:

The abnormal expression of MMP-28 may be related to the initiation and development of urothelial carcinoma. The upregulation of MMP-28 can be used as one of the effective indicators to diagnose bladder cancer and predict tumor progression.
Special Considerations for Secondary Surgery After Upper Extremity Transplantation
Authors: Aravind Pathik , Frost Christopher , Javia Vidhi , Cooney Damon S. , Brandacher Gerald , Shores Jaimie T. , Cooney Carisa M.
Published: November 2020

Background

Upper extremity (UE) transplantation is a complex undertaking that may require emergent or elective secondary surgery (SS) days to years following transplant. Various patient and transplantation may help determine what SS is needed. In this study, we characterize the SS needed by our UE transplant patients.

Methods

We retrospectively reviewed 6 patients who underwent hand and UE transplantation by one of the authors. Transplantation and SS details were obtained from medical records. Hand and arm function was quantified both subjectively (patient-reports) and objectively (Disabilities of the Arm, Shoulder, and Hand Score; Carroll test; Action Research Arm Tests; Box and Block test).

Results

Six patients underwent transplantation for a total of 10 transplanted limbs. Five transplants were performed below and 5 above the elbow. Mean time post-transplantation at last follow-up was 5 years (range: 1-9 years). In all, 66.7% of the patients required SS: total 7 surgeries comprising 13 procedures. The most common procedures were to improve hand function—nerve decompressions and tendon transfer, both in above-elbow transplant. Both patients showed a mean improvement of 15 points on Carroll scores. One above-elbow transplant had a brachioplasty for excess skin and another had a hematoma evacuation immediately after transplantation. Procedures in the below-elbow transplants included multiple incision and drainages for a septic wrist and an open reduction and internal fixation for a forearm fracture.

Conclusion

Patients receiving UE transplantation often require one or more secondary procedures which may vary with level of transplantation. Secondary surgery should be an important aspect of pretransplant planning and cost-effectiveness determinations.

Level of Evidence

Level IV
Educating behavior clinicians in a community behavior care center for children with autism spectrum disorder: Medication administration a pilot study in the United States
Authors: Auberry Kathy
Published: November 2020

Autism Spectrum Disorder (ASD) is a multifaceted developmental disability requiring specialized supports. Due to the growing diagnoses of ASD, the demand for behavior treatment centers has also grown. These centers offer a wide range of beneficial services to children with ASD, including medication administration and management. While centers may employ highly educated and certified employees, there may be a gap in education related to medication administration and medication management knowledge. Using an evidence based education tool, this study sought to explore if clinicians in a behavior care center could gain knowledge in their ability to accurately administer and manage medications for children with ASD, and postulate if existing post-secondary curricula for behavior clinicians should be enriched to include medication administration and management training. This comprised two separate day long sessions of an implementation pilot study of best practice education in medication administration and medication management for behavior clinicians employed at a community behavior care center for children with ASD in the United States. Using the Statistical Package for the Social Sciences, 25 (SPSS), the paired samples t-test was applied for analysis. The quantitative results demonstrated the skill level treatment effect was statistically significant ( p < .001). On the basis of the results the author makes recommendations regarding how to include medication administration and medication management education into existing behavior clinician curricula in the United States.
Evaluation of the efficiency of genomic versus pedigree predictions for growth and wood quality traits in Scots pine
Authors: Calleja-Rodriguez Ainhoa , Pan Jin , Funda Tomas , Chen Zhiqiang , Baison John , Isik Fikret , Abrahamsson Sara , Wu Harry X.
Published: November 2020

Background

Genomic selection (GS) or genomic prediction is a promising approach for tree breeding to obtain higher genetic gains by shortening time of progeny testing in breeding programs. As proof-of-concept for Scots pine (Pinus sylvestrisL.), a genomic prediction study was conducted with 694 individuals representing 183 full-sib families that were genotyped with genotyping-by-sequencing (GBS) and phenotyped for growth and wood quality traits. 8719 SNPs were used to compare different genomic with pedigree prediction models. Additionally, four prediction efficiency methods were used to evaluate the impact of genomic breeding value estimations by assigning diverse ratios of training and validation sets, as well as several subsets of SNP markers.

Results

Genomic Best Linear Unbiased Prediction (GBLUP) and Bayesian Ridge Regression (BRR) combined with expectation maximization (EM) imputation algorithm showed slightly higher prediction efficiencies than Pedigree Best Linear Unbiased Prediction (PBLUP) and Bayesian LASSO, with some exceptions. A subset of approximately 6000 SNP markers, was enough to provide similar prediction efficiencies as the full set of 8719 markers. Additionally, prediction efficiencies of genomic models were enough to achieve a higher selection response, that varied between 50-143% higher than the traditional pedigree-based selection.

Conclusions

Although prediction efficiencies were similar for genomic and pedigree models, the relative selection response was doubled for genomic models by assuming that earlier selections can be done at the seedling stage, reducing the progeny testing time, thus shortening the breeding cycle length roughly by 50%.
Impact of HPV-16/18 AS04-adjuvanted vaccine on preventing subsequent infection and disease after excision treatment: post-hoc analysis from a randomized controlled trial
Authors: Zhao Shuang , Hu Shangying , Xu Xiaoqian , Zhang Xun , Pan Qinjing , Chen Feng , Zhao Fanghui
Published: November 2020

Background

It is widely acknowledged that HPV prophylactic vaccine could prevent new infections and their associated lesions among women who are predominantly HPV-naive at vaccination. Yet there still remains uncertainty about whether HPV vaccination could benefit to individuals who have undergone surgery for cervical disease.

Methods

This post-hoc analysis intends to focus on intent-to-treat participants who underwent excision treatment at baseline and the follow-up period in a phase II/III, double-blind, randomized trial (ClinicalTrials.gov, number NCT00779766) conducted in Jiangsu province, China. We evaluate the impact of HPV vaccination on preventing women from subsequent infection and cervical lesions (LSIL+ and CIN2+) after excision treatment.

Results

One hundred sixty-eight (vaccine, n = 87; placebo, n = 81) performed excisional treatment in this clinical trial. We observed a significant effect of vaccination on acquiring 14 high-risk HPV (HR-HPV) infection after treatment (vaccine efficacy: 27.0%; 95% CI 4.9, 44.0%). The vaccine efficacy against new infections after treatment for 14 HR-HPV infection was estimated as 32.0% (95%CI 1.8, 52.8%), and was 41.2% (95%CI -162.7, 86.8%) for HPV16/18 infection. The accumulative clearance rates of the vaccine group and placebo group were 88.9 and 81.6% for HPV16/18 infection (P = 0.345), 63.4, 48.7% for 14 HR-HPV infection (P = 0.062), respectively. No significant difference was observed on the persistent rate of HPV16/18, 14 HR-HPV infection and occurrence rate of LSIL+ between the two groups.

Conclusions

No significant evidence from this study showed that HPV-16/18 AS04-adjuvanted vaccine could lead to viral faster clearance or have any effect on the rates of persistent infection among women who had excision treatment. However, the vaccine may still benefit post-treatment women with “primary prophylactic” effect. Further research is required in clarifying the effect of using the prophylactic HPV vaccine as therapeutic agents.

Trial registration

ClinicalTrials.gov identifier: NCT00779766. Date and status of trial registration: October 24, 2008. Completed; Has Results.
Hirschsprung’s disease presenting as intractable anemia: a report of two cases and review of the literature
Authors: Sun Xiaoang , Chu Jun , Li Chenchen , Deng Zhaohui
Published: November 2020

Background

This report summarizes the clinical characteristics of intractable anemia as part of the clinical presentation of Hirschsprung’s disease (HD) and aims to strengthen clinicians’ ability to recognize early signs of HD.

Case presentation

An 11-year-old boy with a 6-year history of intractable anemia, low hemoglobin level (55 g/L), poor response to oral iron supplementation and blood transfusion, and difficulty with defecation was diagnosed with HD. A 19-month-old boy with a 3-month history of intractable anemia, low hemoglobin level (64 g/L), poor response to oral iron supplementation and blood transfusion, delayed meconium passage, and history of intestinal obstruction was also diagnosed with HD. Both patients underwent surgery, after which anemia was corrected effectively in both cases. Two more cases of intractable anemia as the chief complaint and diagnoses of HD over different durations since the onset of anemia (ranging from 1.7 years to 21 years) were identified in a literature search. Both patients underwent surgery, after which anemia was corrected.

Conclusions

Intractable anemia as part of the clinical presentation of HD is extremely rare. Detailed inquiries of medical histories and physical examinations are key to early diagnoses and preventing misdiagnoses. Anemia in HD patients may primarily be caused by impaired iron absorption due to HD.
Pulmonary function and factors associated with current smoking among the hill tribe populations in northern Thailand: a cross-sectional study
Authors: Mee-inta Anongnad , Tamornpark Ratipark , Yeemard Fartima , Upala Panupong , Apidechkul Tawatchai
Published: November 2020

Background

Smoking is considered one of the major poor health behaviors leading to several health problems. Individuals with a poor education and economic status are vulnerable to smoking, particularly the hill tribe people in Thailand. This study aimed to estimate the prevalence of current smoking, assess pulmonary function, and identify factors associated with current smoking among individuals aged 20 years and older of the hill tribes in northern Thailand.

Method

A cross-sectional study was conducted to gather information from the hill tribe people living in 42 hill tribe villages. A validated questionnaire, spirometry, and pulse oximetry were used as the research tools. Face-to-face interviews were conducted to collect data from the participants in a private room after obtaining informed consent voluntarily. Chi-squared test and logistic regression were used to detect the associations between the variables at the significance level of α = 0.05.

Results

In total, 2216 participants were recruited into the study: 54.6% were women, 80.3% were aged 31–59 years, and 86.1% were married. The prevalence of smoking was 36.3%; 20.6% were current smokers (36.7% among men and 7.0% among women), and 15.7% were ever smokers. Half of the participants (50.1%) had smoked for ≤9 years, 80.1% smoked ≤10 pieces per day, 64.2% smoked traditional tobacco, 42.8% had low-to-moderate levels of knowledge of the harms of smoking, and 68.4% had low-to-moderate levels of attitudes toward the harms of smoking. Only sex was statistically significant among the different smoking behaviors (p-value< 0.001), and the participants’ pulmonary function was not significantly different. After controlling for age, sex, religion, and education, three variables were found to be associated with current smoking among the hill tribe people in Thailand: men were more likely to smoke than women (AOR = 7.52, 95% CI = 5.53–10.24); those who used amphetamines were more likely to smoke than those who did not (AOR = 2.92, 95% CI = 1.69–5.03); those who had poor attitudes toward the harms of smoking were more likely to smoke than those who had a positive attitude toward the harms of smoking (AOR = 2.47, 95% CI = 1.53–3.97).

Conclusion

Translating essential health messages into the hill tribe language and improving the channel to deliver this information to the target populations, particularly men, are crucial strategies for improving their knowledge and attitudes toward the harms of smoking and making them quit smoking.
Cycles of violence in England and Wales: the contribution of childhood abuse to risk of violence revictimisation in adulthood
Authors: Butler Nadia , Quigg Zara , Bellis Mark A.
Published: November 2020

Background

Interpersonal violence is a leading cause of death and disability globally, has immediate and long-term impacts on individuals’ health and wellbeing, and impacts global health care expenditures and national economies. A public health approach to violence prevention is crucial, and addressing risk factors is a key priority. Global research has demonstrated that childhood adversity increases risk of a range of poor outcomes across the lifecourse. This study examined the association between being a victim of child abuse and the risk of physical assault (PA), intimate partner violence (IPV), and sexual violence (SV) victimisation in adulthood.

Methods

Data from a nationally representative survey of household residents (adults aged 16 to 59 years; n = 21,845) was analysed. Types of child abuse examined included physical, sexual, and psychological abuse and witnessing domestic violence. Logistic regressions examined the independent relationships between child abuse types, experiencing multiple types, and adulthood violence outcomes.

Results

Most individual types of child abuse were significantly associated with each adulthood violence outcome, after controlling for sociodemographics and other abuse types. Compared to individuals who experienced no abuse in childhood, those who experienced one form of abuse were over twice as likely to experience PA in the past year and three times as likely to have experienced IPV and/or SV since age 16 years, whilst individuals who experienced multiple types were three, six, and seven times more likely to experience PA, IPV, and SV, respectively. After controlling for sociodemographics and multi-type childhood victimisation, the type or combination of types which remained significant differed by violence outcome; child psychological and physical abuse were significantly associated with IPV; psychological and sexual abuse with SV; and psychological abuse with PA.

Conclusions

Prevention of child abuse is an important goal, and evidence from the current study suggests such efforts will have a downstream effect on preventing interpersonal violence across the lifecourse. With adulthood victimisation likely to compound the already detrimental effects of childhood abuse, and given that many associated outcomes also represent adversities for the next generation, breaking the cycle of violence should be a public health priority.