bluuebunny/crossref_metadata_2025 huggingface dataset:
To Look East or to West? An Analysis of India’s Trade Policy from Employment Perspective
Authors: Jena Devasmita
Published: December 2020

In the face of mounting protectionist sentiments, aggravated further due to COVID-19, India is redefining its trade policy. This is evident from the fact that India has decided to not join the mega-trade deal, Regional Comprehensive Economic Partnership (RCEP), giving in to the concern of massive trade deficit with China and other countries of the Association of South East Asian Nations (ASEAN). This stance is complete opposite to India’s ‘Look East Policy’. Instead, India is looking for closer trade ties with the United States (US) and the European Union (EU). In this context, this article evaluates the performance of India’s trade, in general, as well as with its Eastern (ASEAN, China, RCEP) and Western partners (US and EU), on its industrial sector employment. Employment is a better measure than trade deficit because employment gives a picture of both growth and distributional aspects of trade effects. Using a dynamic econometric model in a panel framework, it is found that, in general, while export intensity had favourable impact, import penetration had a detrimental impact on industrial sector employment during 1996–1997 to 2016–2017. Region wise analysis shows that trade with ASEAN has been employment enhancing while that with China had a negative impact on employment. On the East versus West looking trade policy debate, analysis suggests that the long run impact of exports, to both the West (EU plus USA) and the East (RCEP) partners, on employment is positive. Also, contrary to the mainstream view, the negative effects of imports, on industrial sector employment, from RCEP appears to be insignificant than that associated with imports from the EU plus USA. Thus, trade agreements with the EU and the US cannot be a substitute for dis-engaging with the resilient Eastern partners. Rather, India should strengthen its trade prospects with its East Asian partners and simultaneously look for export market in the West to enhance its employment creation.
Deep Persian sentiment analysis: Cross-lingual training for low-resource languages
Authors: Ghasemi Rouzbeh , Ashrafi Asli Seyed Arad , Momtazi Saeedeh
Published: December 2020

With the advent of deep neural models in natural language processing tasks, having a large amount of training data plays an essential role in achieving accurate models. Creating valid training data, however, is a challenging issue in many low-resource languages. This problem results in a significant difference between the accuracy of available natural language processing tools for low-resource languages compared with rich languages. To address this problem in the sentiment analysis task in the Persian language, we propose a cross-lingual deep learning framework to benefit from available training data of English. We deployed cross-lingual embedding to model sentiment analysis as a transfer learning model which transfers a model from a rich-resource language to low-resource ones. Our model is flexible to use any cross-lingual word embedding model and any deep architecture for text classification. Our experiments on English Amazon dataset and Persian Digikala dataset using two different embedding models and four different classification networks show the superiority of the proposed model compared with the state-of-the-art monolingual techniques. Based on our experiment, the performance of Persian sentiment analysis improves 22% in static embedding and 9% in dynamic embedding. Our proposed model is general and language-independent; that is, it can be used for any low-resource language, once a cross-lingual embedding is available for the source–target language pair. Moreover, by benefitting from word-aligned cross-lingual embedding, the only required data for a reliable cross-lingual embedding is a bilingual dictionary that is available between almost all languages and the English language, as a potential source language.
Commodity Branding and Textual Potmarks: Three Bread Mould Intaglios from Tell Gabbara
Authors: Rampersad Sabrina R.
Published: December 2020

Departing from the traditional approaches taken toward ancient Egyptian potmark interpretation, this paper draws on modern conventions of commodity branding to show how internally placed textual markings on bread moulds functioned as brands for marking the surfaces of select loaves at Tell Gabbara during the late Second Dynasty. Specific properties of three potmarks are examined with the aims of elucidating their brand characteristics and showing how they might have functioned in diverse capacities simultaneously, serving not only as linguistically based messages, but also as logos. Furthermore, the ability of bread brands to convey a unified message to members of a blended literate and non-literate workforce is assessed briefly through multidisciplinary findings from fields such as marketing, psycholinguistics, and clinical neuropsychology. The author suggests that these disciplines have the potential to inform and transform our perceptions of the cognitive capabilities of illiterate people with regard to negotiating the messages inherent in early Egyptian brand markings.
Effect of Culture on Gender Differences in Risky Driver Behavior through Comparative Analysis of 32 Countries
Authors: Granié Marie-Axelle , Thévenet Chloé , Varet Florent , Evennou Myriam , Oulid-Azouz Noureddine , Lyon Craig , Meesmann Uta , Robertson Robyn , Torfs Katrien , Vanlaar Ward , Woods-Fry Heather , Van den Berghe Wouter
Published: December 2020

This study examines the effect of culture on gender differences in road user risky behaviors. With the hypothesis that gender differences are not solely because of biological factors, and that the existence and magnitude of differences between gender groups vary according to cultural context, because of differentiated social expectations in relation to gender roles, a secondary analysis was made of the E-Survey of Road Users’ Attitudes (ESRA) 2018 database, comprising 25,459 car drivers (53% male) surveyed by an online questionnaire in 32 countries distributed in eight cultural clusters. The interactions between gender and culture in reported behavior, and personal and social acceptability of four violations were analyzed: drinking and driving, speeding, not wearing a seatbelt, and the use of a cellphone while driving. The results show significant gender differences on risky behaviors and attitudes and complex interactions between gender and culture, with men valuing crash-risk behaviors more than women do in all cultural clusters observed. Interactions between gender and culture are more frequent on declared behaviors and personal acceptability than on perceived social acceptability, and on drinking and driving, and not wearing a seatbelt, more than on speeding and the use of a cellphone while driving. In addition, gender differences are greater in Western countries than in the Global South. These gender differences in road user behaviors, attitudes, and perceptions as results of an interaction between biological and evolutionary factors and cultural and social factors are discussed. These results could be useful to better tailor road safety campaigns and education.
Simulation Model of Crowd Evacuation Navigation in a Multi-Obstacle Environment
Authors: Ni Zhongrui , Liu Zhen , Liu Tingting , Chai Yanjie , Liu Cuijuan
Published: December 2020

The simulation of a crowd evacuating public buildings can be an important reference in planning the layout of buildings and formulating evacuation strategies. This paper proposes an agent-based crowd model; a crowd evacuation navigation simulation model is proposed for the multi-obstacle environment. We introduce the concept of navigation factor to describe the proximity of the navigation point to the exit. An algorithm for creating navigation points in multi-obstacle environment is proposed along with the global navigation and local navigation control algorithms of the crowd. We construct a crowd evacuation simulation prototype system with different simulation scenes using the scene editor. We conduct the crowd evacuation simulation experiment in the multi-obstacle scene, recording and analyzing the relevant experimental data. The simulation prototype system can be used to derive the evacuation time of the crowd and analyze the evacuation behavior of the crowd. It is expected to provide a visual deduction method for crowd management in an evacuation emergency.
Greater Arterial Stiffness in Children with or without Second-generation Antipsychotic Treatment for Mental Health Disorders: Rigidité Artérielle Plus Importante Chez Les Enfants Avec ou Sans Traitement Par Antipsychotiques de la Deuxième Génération Pour des Troubles de Santé Mentale
Authors: Henderson Amanda M. , Islam Nazrul , Sandor George G. S. , Panagiotopoulos Constadina , Devlin Angela M.
Published: December 2020

Objective:

Second-generation antipsychotics (SGAs) are used for a variety of mental disorders and are associated with cardiometabolic side effects in children. The objective of this study was to assess the cardiovascular health of children with mental disorders that are SGA-treated or SGA-naive.

Methods:

SGA-treated ( n = 47) or SGA-naive ( n = 37) children (aged 6 to 18 years) with mental disorders and control children ( n = 83, no mental disorder) underwent assessment for cardiac function and morphology by echocardiography, aortic pulse wave velocity (PWV), and carotid intima-media thickness (cIMT). Body mass index (BMI) z-scores, waist circumference z-scores, systolic and diastolic blood pressure (BP) percentiles for height and sex, and fasting plasma glucose, insulin, triglycerides, and cholesterol were also assessed. Differences between SGA-treated, SGA-naive, and control children were assessed by linear and log-linear regression models.

Results:

SGA-treated children had greater BMI z-scores and overweight/obesity (BMI ≥ 85th percentile for age and sex) and hypertension than SGA-naive and control children. The PWV geometric mean was 11.1% higher in SGA-treated (95%CI, 3.95 to 18.77) and 12.9% higher in SGA-naive children (95% CI, 5.60 to 20.59) compared to controls in models adjusted for age, sex, BMI, and systolic BP percentile. Left ventricular (LV) end-diastolic dimension/body surface area (BSA), LV end-systolic dimension/BSA, and LV ejection fraction were lower in SGA-treated and SGA-naive children compared to controls in models adjusted for sex and age.

Conclusions:

Children with mental disorders have greater arterial stiffness and altered cardiac structure/function than children with no mental health diagnosis. SGA treatment in children is not associated with alterations in cardiovascular structure/function.
Social justice for sex workers as a ‘politics of doing’: Research, policy and practice
Authors: FitzGerald Sharron , O’Neill Maggie , Wylie Gillian
Published: December 2020

The Republic of Ireland is a good case study to highlight the problems associated with uncritical appeals to criminal law as the only appropriate tool to tackle demand and protect sex workers from harm. In 2017, the Criminal Law (Sexual Offences) Act came into force in the Republic of Ireland (hereafter Ireland) making it a criminal offence to purchase sex in the jurisdiction. Ireland’s decision to introduce Swedish-style laws followed a protracted public campaign instigated in 2009 by the Irish and radical feminist inspired neo-abolitionist organisation, Turn off the Red Light. In this article, we confront and de-centre the Turn off the Red Light campaign’s hegemonic narrative that the criminal rather than social justice responses provide a more effective vehicle for sex workers’ empowerment. Undertaking our intervention in Irish feminist prostitution politics as a ‘politics of doing’ social justice through our separate and combined research, we extend our analysis by invoking Nancy Fraser and Barbara Hudson’s theoretical work on social and restorative justice. We wish to develop a theoretical framework that can serve as a roadmap for restorative social justice – the process of achieving rights, recognition and redistribution through relational, reflective and discursive interventions in sex work research, policy and practice. We argue that by ‘thinking’ sex workers’ positionality in social relations differently, the ‘doings’ of restorative social justice for sex workers can begin or take place.
Evaluating sociometer theory in children’s everyday lives: Inclusion, but not exclusion by peers at school is related to within-day change in self-esteem
Authors: Schmidt Andrea , Dirk Judith , Neubauer Andreas B , Schmiedek Florian
Published: December 2020

Sociometer theory proposes that a person’s self-esteem is a permanent monitor of perceived social inclusion and exclusion in a given situation. Despite this within-person perspective, respective research in children’s everyday lives is lacking. In three intensive longitudinal studies, we examined whether children’s self-esteem was associated with social inclusion and exclusion by peers at school. Based on sociometer theory, we expected social inclusion to positively predict self-esteem and social exclusion to negatively predict self-esteem on within- and between-person levels. Children aged 9–12 years reported state self-esteem twice per day (morning and evening) and social inclusion and exclusion once per day for two (Study 1) and four weeks (Studies 2–3). Consistently across studies, we found that social inclusion positively predicted evening self-esteem on within- and between-person levels. By contrast, social exclusion was not associated with evening self-esteem on the within-person level. On the between-person level, social exclusion was negatively linked to evening self-esteem only in Study 1. Multilevel latent change score models revealed that children’s self-esteem changed from mornings (before school) to evenings (after school) depending on their perceived daily social inclusion, but not exclusion. The findings are discussed in light of sociometer theory and the bad-is-stronger-than-good phenomenon.
Modular dual-mobility cups using ceramic liners: an original solution for selected indications?
Authors: D’Apolito Rocco , Bandettini Guido , Jacquot Filippo Maria Piana , Zagra Luigi
Published: December 2020

Background:

Dual mobility (DM) has been shown to improve stability both in primary and revision total hip arthroplasty (THA) and is increasingly used in patients at high risk of dislocation and in the treatment of THA instability. The introduction of modular liners has helped to overcome some of the limitations of monoblock DM cups. In this context, the use of a ceramic liner would avoid the conventional cobalt-chromium liner in the titanium shell, which can be problematic in some situations. The aim of this paper is to report the outcomes of a consecutive series of patients undergoing revision THA using a modular DM cup with a ceramic liner instead of the conventional metal one, and to clarify the rationale for this currently “off-label” use.

Patients and methods:

This is a retrospective series of patients who received this new DM bearing in a single institution. Patients were followed up clinically and radiologically at 1 month, 3 months, 6 months and yearly thereafter.

Results:

5 patients received the ceramic liner in the study period (2014–2019). The indications were instability or high risk of dislocation in ceramic liner fracture and ARMD with soft tissue damage after MoM THA. The mean age at surgery was 74 (63–82) years, the mean follow-up was 36 (12–72) months. No dislocation occurred, and no adverse events related to the implant were recorded.

Conclusions:

The use of a ceramic liner in a modular DM cup offers several advantages in selected patients, and the results of our cohort are encouraging. However, caution is needed in introducing this new bearing because knowledge is currently limited. Further studies on a larger number of patients and with longer follow-ups are needed to confirm these findings and before widespread use of the device.
Hip hemiarthroplasty with modular neck: is it useful in residents’ learning curve? A prospective clinical trial
Authors: Solarino Giuseppe , Moretti Lorenzo , Vicenti Giovanni , Bizzoca Davide , Piazzolla Andrea , Moretti Biagio
Published: December 2020

Background:

The number of femoral neck fractures (FNFs) worldwide will drastically increase in the next few decades, reaching 6.3 million by 2050. In the future, therefore, newly-qualified orthopaedic surgeons will treat this kind of injury more frequently than in past decades. This prospective observational study aims to assess whether hip hemiarthroplasty with modular neck, performed via the Hardinge approach, can be safely carried out by orthopaedic residents.

Methods:

Patients referred to our Level I trauma centre, between January 2016 and June 2017, with displaced intra-articular femoral fractures, were prospectively recruited. All patients underwent cemented modular bipolar hip hemiarthroplasty (Profemur Z, MicroPort Orthopedics Inc., Arlington, TN, USA) via the Hardinge approach, with the patient positioned in lateral decubitus. The surgical procedures were performed by the same surgical and anesthesiology team, under spinal anaesthesia. All patients underwent clinical and radiographic follow-up up to 24 months. Complications and re-operations were recorded. Clinical evaluation was performed using the Harris Hip Score (HHS), Osteoporosis Quality of Life Questionnaire QUALEFFO-41 and EuroQol-5D (EQ-5D) questionnaire. Anteroposterior pelvis x-rays were performed preoperatively, postoperatively and at 1, 3, 6, 12 and 24 months follow-up.

Results:

118 patients met the inclusion criteria (male: 50; female: 68; mean age: 74.3 years; range 65–88 years) and were included in the current study. 67 patients out of 118 (56.8%) were managed by senior orthopaedic surgeons (Group A), whereas the remaining 51 patients out of 118 (43.2%) were treated by orthopaedic residents (Group B). Hip hemiarthroplasties performed by senior surgeons showed the prevalent use of straight (short or long) necks, whereas, in surgical procedures performed by residents, there was a significantly higher use of varus/valgus, anteverted or retroverted necks. The overall complication rate was significantly higher in Group-B patients, compared with Group-A patients ( p = 0.002). The length of hospital stay and the mean clinical scores at 24 months follow-up showed no significant differences.

Conclusions:

Hip hemiarthroplasty with modular neck can be safely employed during the learning curve of orthopaedic residents. Great efforts, however, should be made in future to improve residents’ training in the management of FNFs.
Risk of Depression in Patients With Psoriatic Disease: A Systematic Review and Meta-Analysis
Authors: Lukmanji Aysha , Basmadjian Robert B. , Vallerand Isabelle A. , Patten Scott B. , Tang Karen L.
Published: December 2020

Background

Previous systematic reviews have assessed the prevalence and odds ratio (OR) of depression for patients with psoriatic disease. Due to probable bidirectional effects, prevalence and prevalence ORs are difficult to interpret. No prior reviews have quantified the relative risk (RR) of depression following a diagnosis of psoriatic disease.

Objective

To estimate the RR of depression in individuals with psoriasis and in psoriatic arthritis (PsA), clear-to-moderate psoriasis, and moderate-to-severe psoriasis subgroups.

Methods

Observational studies investigating the risk of depression in adults with psoriatic disease were systematically searched for in Medline, EMBASE, PsycINFO, and CINAHL databases; 4989 unique references were screened. Studies that reported measures of incident depression in psoriasis patients were included. Thirty-one studies were included into the systematic review, of which 17 were meta-analyzed. Random effects models were employed to synthesize relevant data. Sources of heterogeneity were explored with subgroup analysis and meta-regression.

Results

Seventeen studies were included in meta-analyses. The pooled RR of depression in psoriasis patients compared to nonpsoriasis controls was 1.48 (95% CI: 1.16-1.89). Heterogeneity was high (I2 = 99.8%). Subgroup analysis and meta-regression did not indicate that PsA status or psoriasis severity (clear-to-mild, moderate-to-severe) were sources of heterogeneity. No evidence of publication bias was found.

Conclusions

This review demonstrates that the risk of depression is greater in patients with psoriasis and PsA. Future research should focus on developing strategies to address the mental health needs of this patient population for depression, including primary prevention, earlier detection, and treatment strategies.
Accurate classification of secondary progression in multiple sclerosis using a decision tree
Authors: Ramanujam Ryan , Zhu Feng , Fink Katharina , Karrenbauer Virginija Danylaitė , Lorscheider Johannes , Benkert Pascal , Kingwell Elaine , Tremlett Helen , Hillert Jan , Manouchehrinia Ali ,   The BeAMS Study group
Published: December 2020

Background:

The absence of reliable imaging or biological markers of phenotype transition in multiple sclerosis (MS) makes assignment of current phenotype status difficult.

Objective:

The authors sought to determine whether clinical information can be used to accurately assign current disease phenotypes.

Methods:

Data from the clinical visits of 14,387 MS patients in Sweden were collected. Classifying algorithms based on several demographic and clinical factors were examined. Results obtained from the best classifier when predicting neurologist recorded disease classification were replicated in an independent cohort from British Columbia and were compared to a previously published algorithm and clinical judgment of three neurologists.

Results:

A decision tree (the classifier) containing only most recently available expanded disability scale status score and age obtained 89.3% (95% confidence intervals (CIs): 88.8–89.8) classification accuracy, defined as concordance with the latest reported status. Validation in the independent cohort resulted in 82.0% (95% CI: 81.0–83.1) accuracy. A previously published classification algorithm with slight modifications achieved 77.8% (95% CI: 77.1–78.4) accuracy. With complete patient history of 100 patients, three neurologists obtained 84.3% accuracy compared with 85% for the classifier using the same data.

Conclusion:

The classifier can be used to standardize definitions of disease phenotype across different cohorts. Clinically, this model could assist neurologists by providing additional information.
Journeys to HIV testing and diagnosis among adults aged 50+ years in England: A qualitative interview study
Authors: Bell Sadie , Doran Tim , Martin Fabiola , Adamson Joy
Published: December 2020

Objectives

In England, older adults (aged ≥50 years) are at greater risk of being diagnosed with advanced stage HIV infection than younger adults. We explored journeys to testing and diagnosis among older adults, examining factors associated with late HIV diagnosis in this age group.

Methods

Semi-structured qualitative interviews were performed with 12 adults diagnosed with HIV at age 50+ years and 12 health care professionals working in sexual health/HIV services. Data were analysed thematically, using the Model of Pathways to Treatment as a framework for analysis.

Results

Older adults were often found to experience non-linear and complex diagnostic journeys. Pathways to diagnosis were affected by 6 factors: (i) the non-specific nature of HIV symptoms and their misattribution as being age-related; (ii) symptom severity, impact, and visibility; (iii) HIV health literacy; (iv) perceptions of HIV risk; (v) geographical location; and (vi) assessment in non-specialist settings.

Conclusions

Older adults appear to encounter additional barriers to HIV testing compared with younger people, particularly when they are not part of a group targeted in HIV prevention and testing campaigns. To diagnose HIV more promptly in adults aged 50+ years, HIV knowledge and risk perception must increase in both older people and health care professionals. Health care professionals need to look beyond the ‘high risk’ groups that are most affected by HIV and consider HIV more readily in the diagnostic process.
Randomised controlled trial of the effect, cost and acceptability of a bronchiectasis self-management intervention
Authors: Brockwell Claire , Stockl Andrea , Clark Allan , Barton Garry , Pasteur Mark , Fleetcroft Robert , Hill Janice , Wilson Andrew M
Published: December 2020

Background:

Patient self-management plans (PSMP) are advised for bronchiectasis but their efficacy is not established. We aimed to determine whether, in people with bronchiectasis, the use of our bronchiectasis PSMP – Bronchiectasis Empowerment Tool (BET), compared to standard care, would improve self-efficacy.

Methods:

In a multi-centre mixed-methods randomised controlled parallel study, 220 patients with bronchiectasis were randomised to receive standard care with or without the addition of our BET plus education sessions explaining its use. BET comprised an action plan, indicating when to seek medical help based on pictorial represented indications for antibiotic therapy, and four educational support sections. At baseline and after 12 months, patients completed the Self-Efficacy to Manage Chronic Disease Scale (SEMCD), St George’s Respiratory Questionnaire (SGRQ), EQ-5D-3 L (to calculate Quality Adjusted Life Years (QALYs) and cost questionnaires. Qualitative data were obtained by focus groups.

Results:

The recruitment to the study was high (63% of eligible patients agreeing to participate) however completion rate was low (57%). BET had no effect on SEMCD (mean difference (0.14 (95% confidence interval (95%CI) −0.37 to 0.64), p = 0.59) or SGRQ, exacerbation rates, overall cost to the NHS or QALYs. Most had developed their own techniques for monitoring their condition and they did not find BET useful as it was difficult to complete. Participant knowledge was good in both groups.

Conclusion:

The demand for patient support in bronchiectasis was high suggesting a clinical need. However, the BET did not improve self-efficacy, health related quality of life, costs or clinically relevant outcome measures. BET needs to be modified to be less onerous for users and implemented within a wider package of care. Further studies, particularly those evaluating people newly diagnosed with bronchiectasis, are required and should allow for 50% withdrawal rate or utilise less burdensome outcome measures.

Clinical trials registration:

ISRCTN ISRCTN 18400127. Registered 24 June 2015. Retrospectively Registered
The acute impact of resistance training on fatigue in patients with pulmonary sarcoidosis
Authors: Grongstad Anita , Vøllestad Nina Køpke , Oldervoll Line Merethe , Spruit Martijn Arthur , Edvardsen Anne
Published: December 2020

Fatigue is the most prevalent symptom among patients with sarcoidosis, and skeletal muscle dysfunction is a common clinical feature, making resistance training (RT) a recommended treatment strategy. Despite lacking knowledge regarding whether high-intensity RT will aggravate fatigue, low to moderate-intensity is routinely used even if the evidence for this protocol to improve muscle strength is inconclusive. This study aimed to investigate whether one single session of high-intensity RT induces a higher increase in fatigue than one single session of moderate-intensity RT. In this randomized crossover study, 41 patients with pulmonary sarcoidosis (age: 53 ± 11 yr) were recruited. They randomly performed one single session of high-intensity RT, 4 sets × 5 repetitions maximum (5RM), and one single session of moderate-intensity RT, 2 sets × 25 RM. Fatigue was assessed with the Visual Analogue Scale (0–100 mm) immediately before (T0), immediately after (T1) and 24 hours after (T2) each exercise session. Fatigue development from T0 to T1 was significantly lower after 5RM (−3 ± 18 mm) than after 25RM (5 ± 15 mm), p = 0.004. No difference was seen from T0 to T2 between 5RM (0 ± 17 mm) and 25RM (6 ± 18 mm), p = 0.147. The high-intensity 5RM session did not induce a larger increase in fatigue than the moderate-intensity 25RM session. RT appears feasible and safe in patients with pulmonary sarcoidosis irrespective of the intensity. Thus, the long-term effects of high-intensity RT on fatigue should be explored in a RT programme of longer duration.
A 4-Month Whole-Systems Ayurvedic Medicine Nutrition and Lifestyle Intervention Is Feasible and Acceptable for Breast Cancer Survivors: Results of a Single-Arm Pilot Clinical Trial
Authors: Dhruva Anand , Wu Cairn , Miaskowski Christine , Hartogensis Wendy , Rugo Hope S , Adler Shelley R , Kaptchuk Ted J , Kelkar Rucha , Agarawal Sangeeta , Vadodaria Amisha , Garris Ellen , Hecht Frederick M
Published: December 2020

Purpose

Ongoing symptoms and impairments in quality of life (QOL) among breast cancer survivors remain a significant problem. We tested the feasibility and acceptability of a manualized Ayurvedic nutrition and lifestyle intervention for breast cancer survivors.

Methods

Eligible participants had Stage I–III breast cancer, underwent treatment within the past year that included chemotherapy, and were without active disease. The 4-month individualized Ayurvedic intervention included counseling on nutrition, lifestyle, yoga, and marma (like acupressure) during 8 one-on-one visits with an Ayurvedic practitioner. Feasibility and acceptability were the primary outcomes. QOL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC QLQ C30]) and symptoms—sleep disturbance (General Sleep Disturbance Scale [GSDS]), fatigue (Lee Fatigue Scale [LFS]), depressive symptoms (Center for Epidemiological Studies—Depression Scale [CES-D]), anxiety (Spielberger State-Trait Anxiety Inventory [STAI-S, STAI-T]), and stress (Perceived Stress Scale [PSS])—were measured prior to, at midpoint, and at the end of the 4-month intervention. Effect sizes (Cohen’s d) were calculated along with paired t tests comparing baseline to end of month 4 time points. Mixed effects models were used for repeated measures analyses.

Results

Participants ( n = 32) had a mean age of 48 years ( SD = 10). Retention at the end of the intervention was 84%. Among those who completed the intervention ( n = 27), adherence was high (99.5% of visits with practitioners attended). Large improvements were seen in QLQ-C30 emotional functioning ( d = 0.84, P < 0.001), QLQ-C30 cognitive functioning ( d = 0.86, P < 0.001), GSDS ( d =  –1.23, P < 0.001), and CES-D ( d =  –1.21, P < 0.001). Moderate improvements were seen in QLQ-C30 global health ( d = 0.65, p = 0.003), LFS ( d =  –0.68, P = 0.002), and PSS ( d =  –0.75, P < 0.001). No adverse events were observed due to the intervention.

Conclusion

This 4-month Ayurvedic whole-systems multimodal nutrition and lifestyle intervention was feasible and acceptable for breast cancer survivors. Promise of clinical benefit was seen in terms of improvements in symptoms and QOL that warrants further investigation.
Embodied 3D isovists: A method to model the visual perception of space
Authors: Krukar Jakub , Manivannan Charu , Bhatt Mehul , Schultz Carl
Published: December 2020

Isovist analysis has been typically applied for the study of human perception in indoor built-up spaces. Albeit predominantly in 2D, recent works have explored isovist techniques in 3D. However, 3D applications of isovist analysis simply extrapolate the assumptions of its 2D counterpart, without questioning whether these assumptions remain valid in 3D. They do not: because human perception is embodied, the perception of vertical space differs from the perception of horizontal space. We present a user study demonstrating that an embodied 3D isovist that accounts for this phenomenon (formalised based on the notion of spatial artefacts) predicts human perception of space more accurately than the generic volumetric 3D isovist, specifically with respect to spaciousness and complexity. We suggest that the embodied 3D isovist should be used for 3D analyses in which human perception is of key interest.
Using data mining to explore the spatial and temporal dynamics of perceptions of metro services in China: The case of Shenzhen
Authors: Luo Shuli , He Sylvia Y
Published: December 2020

Improving perceptions of service quality is a promising planning strategy for increasing the attractiveness and retaining the ridership of public transport systems. The widespread use of social media presents an opportunity to investigate the performance of transport services from the customer’s perspective. This study proposes a framework for integrating quantitative and qualitative analyses to investigate the perceptions of transport services by mining data from social media. We utilise Sina Weibo data related to the Shenzhen metro system to illustrate a text mining process categorised by semantic, spatial and temporal information. On the semantic front, in addition to identifying service attributes and sentiment polarity consistent with previous literature, we find attributes specific to the Chinese context. We also identify clear temporal variations among different service attributes by visualising the number of corresponding microblogs across varying time scales such as hours, days and weekdays. The spatial variations reveal five main clusters around central business districts and transport hubs, which produce the highest density of reports about crowdedness, waiting times, reliability and frequency. However, microblogs that report on perceptions of safety and personnel behaviour present a different spatial pattern. This research offers insights into the ways in which we can use social media data to identify key service areas for immediate improvement and to monitor and manage metro systems more effectively over the long term.
Socioeconomic inequalities in hypertension in Kenya: a decomposition analysis of 2015 Kenya STEPwise survey on non-communicable diseases risk factors
Authors: Gatimu Samwel Maina , John Thomas Wiswa
Published: December 2020

Background

One in four Kenyans aged 18–69 years have raised blood pressure. Despite this high prevalence of hypertension and known association between socioeconomic status and hypertension, there is limited understanding of factors explaining inequalities in raised blood pressure in Kenya. Hence, we quantified the socioeconomic inequality in hypertension in Kenya and decomposed the determinants contributing to such inequality.

Methods

We used data from the 2015 Kenya STEPwise survey for non-communicable diseases risk factors. We included 4422 respondents aged 18–69 years. We estimated the socioeconomic inequality using the concentration index (C) and decomposed the C using Wagstaff decomposition analysis.

Results

The overall concentration index of hypertension in Kenya was − 0.08 (95% CI: − 0.14, − 0.02; p = 0.005), showing socioeconomic inequalities in hypertension disfavouring the poor population. About half (47.1%) of the pro-rich inequalities in hypertension was explained by body mass index while 26.7% by socioeconomic factors (wealth index (10.4%), education (9.3%) and paid employment (7.0%)) and 17.6% by sociodemographic factors (female gender (10.5%), age (4.3%) and marital status (0.6%)). Regional differences explained 7.1% of the estimated inequality with the Central region alone explaining 6.0% of the observed inequality. Our model explained 99.7% of the estimated socioeconomic inequality in hypertension in Kenya with a small non-explained part of the inequality (− 0.0002).

Conclusion

The present study shows substantial socioeconomic inequalities in hypertension in Kenya, mainly explained by metabolic risk factors (body mass index), individual health behaviours, and socioeconomic factors. Kenya needs gender- and equity-focused interventions to curb the rising burden of hypertension and inequalities in hypertension.
Attitude of nurses and midwives towards collaborative care with physicians in Jimma University medical center, Jimma, South West Ethiopia
Authors: Melkamu Eneyew , Yetwale Aynalem
Published: December 2020

Background

Good attitude on collaborative care between nurses and midwives with physicians is crucial for better team working. This further enables those vital health care professionals to provide quality and improved care for their clients.

Objective

To assess the attitude of nurses and midwives towards collaborative care with physicians in Jimma University medical center, Jimma, South West Ethiopia.

Methodology

The institution-based cross-sectional study was conducted from March 20 to April 8, 2019, using a semi-structured and standardized questionnaire. Study units were selected by simple random sampling using the lottery method. A total of 410 participants were included in the study. Data were entered into Epi data version 4.2 and exported to statistical packages for social sciences version 23 for cleaning and further analysis. Descriptive statistics were presented with tables, figures, and narratives. The level of significance was set at apvalue of less than 0.05 in multivariable logistic regression.

Results and conclusion

More than five out of ten, 234 (57.2%) of participants had a good (good attitude is defined in the operational definition section of methodology) attitude towards collaborative care with physicians, and the rest 175 (42.8%) poor attitude toward it. Participants had the highest median score in the shared education and teamwork (26.0) subscale and midwives were found to have higher mean rank scores compared to nurses. It was only in the nurse's/midwife's autonomy subscale that a statistically significant difference was found (Z = − 2.92,pvalue = 0.003). More generally, more than have of the participants had a good attitude on providing care collaboratively with physicians, though a significant proportion of nurses and midwives also rate collaborative care provision with physicians as poor.

Recommendations

The findings of this study suggested that interventions are needed to be taken to improve nurse's and midwife’s attitudes on the provision of collaborative care with physicians. Enhancement of shared education, cooperation rather than dominance and caring attitude are all vital. These all could in turn enhance the quality of care provided for clients.
Rapid acquisition of novel written word-forms: ERP evidence
Authors: Bermúdez-Margaretto Beatriz , Shtyrov Yury , Beltrán David , Cuetos Fernando , Domínguez Alberto
Published: December 2020

Background

Novel word acquisition is generally believed to be a rapid process, essential for ensuring a flexible and efficient communication system; at least in spoken language, learners are able to construct memory traces for new linguistic stimuli after just a few exposures. However, such rapid word learning has not been systematically found in visual domain, with different confounding factors obscuring the orthographic learning of novel words. This study explored the changes in human brain activity occurring online, during a brief training with novel written word-forms using a silent reading task

Results

Single-trial, cluster-based random permutation analysis revealed that training caused an extremely fast (after just one repetition) and stable facilitation in novel word processing, reflected in the modulation of P200 and N400 components, possibly indicating rapid dynamics at early and late stages of the lexical processing. Furthermore, neural source estimation of these effects revealed the recruitment of brain areas involved in orthographic and lexico-semantic processing, respectively.

Conclusions

These results suggest the formation of neural memory traces for novel written word-forms after a minimal exposure to them even in the absence of a semantic reference, resembling the rapid learning processes known to occur in spoken language.
Urine creatine metabolite panel as a screening test in neurodevelopmental disorders
Authors: Bahl Shalini , Cordeiro Dawn , MacNeil Lauren , Schulze Andreas , Mercimek-Andrews Saadet
Published: December 2020

Background

Cerebral creatine deficiency disorders (CCDD) are inherited metabolic disorders of creatine synthesis and transport. Urine creatine metabolite panel is helpful to identify these disorders.

Methods

We reviewed electronic patient charts for all patients that underwent urine creatine metabolite panel testing in the metabolic laboratory at our institution.

Results

There were 498 tests conducted on 413 patients. Clinical, molecular genetics and neuroimaging features were available in 318 patients. Two new patients were diagnosed with creatine transporter deficiency: one female and one male, both had markedly elevated urine creatine. Urine creatine metabolite panel was also used as a monitoring test in our metabolic laboratory. Diagnostic yield of urine creatine metabolite panel was 0.67% (2/297). There were six known patients with creatine transporter deficiency. The prevalence of creatine transporter deficiency was 2.64% in our study in patients with neurodevelopmental disorders who underwent screening or monitoring of CCDS at our institution.

Conclusion

Even though the diagnostic yield of urine creatine metabolite panel is low, it can successfully detect CCDD patients, despite many neurodevelopmental disorders are not a result of CCDD. To the best of our knowledge, this study is the first Canadian study to report diagnostic yield of urine creatine metabolite panel for CCDD from a single center.
Novel therapeutics in myeloproliferative neoplasms
Authors: Venugopal Sangeetha , Mascarenhas John
Published: December 2020

Hyperactive signaling of the Janus-Associated Kinase/Signal Transducers and Activators of Transcription (JAK/STAT) pathway is central to the pathogenesis of Philadelphia-chromosome-negative myeloproliferative neoplasms (MPN), i.e., polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) which are characterized by inherent biological and clinical heterogeneity. Patients with MPNs suffer from substantial symptom burden and curtailed longevity due to thrombohemorrhagic complications or progression to myelofibrosis or acute myeloid leukemia. Therefore, the management strategies focus on thrombosis risk mitigation in PV/ET, alleviation of symptom burden and improvement in cytopenias and red blood cell transfusion requirements, and disease course alteration in PMF. The United States Food and Drug Administration’s (USFDA) approval of two JAK inhibitors (ruxolitinib, fedratinib) has transformed the therapeutic landscape of MPNs in assuaging the need for frequent therapeutic phlebotomy (PV) and reduction in spleen and symptom burden (PV and PMF). Despite improving biological understanding of these complex clonal hematopoietic stem/progenitor cell neoplasms, none of the currently available therapies appear to modify the proclivity of the disease per se, thereby remaining an urgent unmet clinical need and an ongoing area of intense clinical investigation. This review will highlight the evolving targeted therapeutic agents that are in early- and late-stage MPN clinical development.
HDAC2 inhibits EMT-mediated cancer metastasis by downregulating the long noncoding RNA H19 in colorectal cancer
Authors: Hu Xue-ting , Xing Wei , Zhao Rong-sen , Tan Yan , Wu Xiao-feng , Ao Luo-quan , Li Zhan , Yao Meng-wei , Yuan Mu , Guo Wei , Li Shang-ze , Yu Jian , Ao Xiang , Xu Xiang
Published: December 2020

Background

Emerging evidence suggests that epithelial mesenchymal transition (EMT) and epigenetic mechanisms promote metastasis. Histone deacetylases (HDACs) and noncoding RNAs (ncRNAs) are important epigenetic regulators. Here, we elucidated a novel role of histone deacetylase 2 (HDAC2) in regulating EMT and CRC metastasis via ncRNA.

Methods

The expression of HDACs in CRC was analyzed using the public databases and matched primary and metastatic tissues, and CRC cells with different metastatic potentials (DLD1, HCT116, SW480 and SW620). Microarray analysis was used to identify differential genes in parental and HDAC2 knockout CRC cells. EMT and histone modifications were determined using western blot and immunofluorescence. Migration ability was assessed by transwell assay, and metastasis was assessed in vivo using a tail vain injection. Gene expression and regulation was assessed by RT-PCR, chromatin immunoprecipitation and reporter assays. Protein interaction was assessed by immunoprecipitation. Specific siRNAs targeting H19, SP1 and MMP14 were used to validate their role in HDAC2 loss induced EMT and metastasis.

Results

Reduced HDAC2 expression was associated with poor prognosis in CRC patients and found in CRC metastasis. HDAC2 deletion or knockdown induced EMT and metastasis by upregulating the long noncoding RNA H19 (LncRNA H19). HDAC2 inhibited LncRNA H19 expression by histone H3K27 deacetylation in its promoter via binding with SP1. LncRNA H19 functioned as a miR-22-3P sponge to increase the expression of MMP14. HDAC2 loss strongly promoted CRC lung metastasis, which was suppressed LncRNA H19 knockdown.

Conclusion

Our study supports HDAC2 as a CRC metastasis suppressor through the inhibition of EMT and the expression of H19 and MMP14.
Giardia duodenalis multi-locus genotypes in dogs with different levels of synanthropism and clinical signs
Authors: Uiterwijk Mathilde , Mughini-Gras Lapo , Nijsse Rolf , Wagenaar Jaap A. , Ploeger Harm W. , Kooyman Frans N. J.
Published: December 2020

Background

In dogs, infections withGiardia duodenalisare mainly caused by assemblages C and D, but also by the potentially zoonotic assemblages A and B. The aims of this study were to assess differences in assemblages (i) between dogs living mainly in close proximity to humans (synanthropic dogs)versusdogs living mainly among other dogs, (ii) between samples of dogs with or without loose stool, and (iii) related to the amount of cysts shedding.

Methods

One hundred eighty-nine qPCRGiardiapositive fecal samples of dogs originating from four groups (household, sheltered, hunting, and dogs for which a veterinarian sent a fecal sample to a diagnostic laboratory) were used for genotyping. For this, multi-locus genotyping of beta-giardin, triose phosphate isomerase, and glutamate dehydrogenase and genotyping ofSSU rDNAgene fragments were performed. Fecal consistency was scored (loose or non-loose stool), and cysts per gram of feces were determined with qPCR.

Results

Assemblage D was the most prevalent in all groups, followed by the other canid assemblage C. Also, mixed C/D was common. In two (synanthropic) household dogs, the potentially zoonotic assemblage AI was present. Although occurrence of assemblage AI in household dogs was not significantly different from dogs living among other dogs (sheltered and hunting dogs), it was significantly higher compared to dogs for which a sample was sent to a diagnostic laboratory. Dogs with assemblage D shed significantly more cysts than dogs with other assemblages (except for mixed C/D results) or dogs in which no assemblage could be determined. None of the assemblages was significantly associated with loose stool.

Conclusion

Not only do dogs mainly shed the canidGiardia duodenalisassemblages D and/or C, the numbers of cysts per gram for the canid assemblage D were also higher than for the potential zoonotic assemblage AI. Based on the assemblages shed by dogs, the risk to public health posed by dogs is estimated to be low, even though the dogs that shed AI were synanthropic household dogs. Loose stool in infected dogs was not associated with any particularGiardiaassemblage.