bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender identity and the management of the transgender patient: a guide for non-specialists
Authors: Joseph Albert , Cliffe Charlotte , Hillyard Miriam , Majeed Azeem
Published: April 2017

In this review, we introduce the topic of transgender medicine, aimed at the non-specialist clinician working in the UK. Appropriate terminology is provided alongside practical advice on how to appropriately care for transgender people. We offer a brief theoretical discussion on transgenderism and consider how it relates to broader understandings of both gender and disease. In respect to epidemiology, while it is difficult to assess the exact size of the transgender population in the UK, population surveys suggest a prevalence of between 0.2 and 0.6% in adults, with rates of referrals to gender identity clinics in the UK increasing yearly. We outline the legal framework that protects the rights of transgender people, showing that is not legal for physicians to deny transgender people access to services based on their personal beliefs. Being transgender is often, although not always, associated with gender dysphoria, a potentially disabling condition in which the discordance between a person’s natal sex (that assigned to them at birth) and gender identity results in distress, with high associated rates of self-harm, suicidality and functional impairment. We show that gender reassignment can be a safe and effective treatment for gender dysphoria with counselling, exogenous hormones and surgery being the mainstay of treatment. The role of the general practitioner in the management of transgender patients is discussed and we consider whether hormone therapy should be initiated in primary care in the absence of specialist advice, as is suggested by recent General Medical Council guidance.
The Zurich urban micro aerial vehicle dataset
Authors: Majdik András L , Till Charles , Scaramuzza Davide
Published: April 2017

This paper presents a dataset recorded on-board a camera-equipped micro aerial vehicle flying within the urban streets of Zurich, Switzerland, at low altitudes (i.e. 5–15 m above the ground). The 2 km dataset consists of time synchronized aerial high-resolution images, global position system and inertial measurement unit sensor data, ground-level street view images, and ground truth data. The dataset is ideal to evaluate and benchmark appearance-based localization, monocular visual odometry, simultaneous localization and mapping, and online three-dimensional reconstruction algorithms for micro aerial vehicles in urban environments.
On the Benefits of Giving Social Support
Authors: Inagaki Tristen K. , Orehek Edward
Published: April 2017

People who are socially integrated and have strong social ties live happier, longer lives. The link between social connection and well-being is commonly explained in terms of the benefits of receiving care and support from others. However, the benefits of giving care and support to others for the support provider are often overlooked. We review emerging findings that suggest when, why, and how giving support to others provides benefits to the self. We identify possible mechanisms by which these benefits arise and outline boundary conditions that influence such benefits. To gain a richer understanding of the association between social ties and well-being, an important future research direction is to not only consider the support receiver but also emphasize the support provider.
The expression pattern of long non-coding RNA PVT1 in tumor tissues and in extracellular vesicles of colorectal cancer correlates with cancer progression
Authors: Guo Kai , Yao Jie , Yu Qiang , Li Zijian , Huang Hu , Cheng Jianguo , Wang Zhigang , Zhu Yunfeng
Published: April 2017

The plasmacytoma variant translocation 1 gene (PVT1) is a large non-coding locus at adjacent of c-Myc, and long non-coding RNA PVT1 is now recognized as a cancerous gene co-amplified with c-Myc in various cancers. But the expression and functional role of PVT1 in colorectal cancer are still unelucidated. In addition, all the reported long non-coding RNAs so far are discovered in either cells or tissues, but no research about long non-coding RNAs detection in extracellular vesicles has been reported yet. In the present study, we firstly investigated the expression of PVT1 in colorectal cancer specimens and its correlation with the expression of c-Myc and other related genes by real-time polymerase chain reaction. Then, we isolated the extracellular vesicles from colorectal cancer cells culturing medium by differential centrifugation and detected the PVT1 expression in extracellular vesicles by using real-time polymerase chain reaction. The PVT1 targeting siRNA was transfected into SW480 and SW620 cells, and 3-(4, 5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium assay and flow cytometry were used to evaluate the cell proliferation and apoptosis. The results showed that the PVT1 expression in tumor tissues was higher than that in normal tissues, which was significantly correlated with the expression of c-Myc and three c-Myc regulating genes FUBP1, EZH2, and NPM1 and also correlated with the expression of two other PVT1-associated transcript factors nuclear factor-κB and myocyte-specific enhancer factor 2A. Here, we reported for the first time that PVT1 as a long non-coding RNA was successfully detected in extracellular vesicles excluded from SW620 and SW480 cells, and the expression level of PVT1 was higher in extracellular vesicles from the more aggressive cell SW620 than from SW480. The results also showed that by down-regulating the PVT1 expression, the c-Myc expression was suppressed, the cell proliferation was inhibited, and cell apoptosis was increased. Taken together, these findings implicated that PVT1 may be a new oncogene co-amplified with c-Myc in colorectal cancer tissues and extracellular vesicles and functionally correlated with the proliferation and apoptosis of colorectal cancer cells.
In search of an adequate European policy response to the platform economy
Authors: Fabo Brian , Karanovic Jovana , Dukova Katerina
Published: April 2017

This article contributes to the debate on labour platforms (e.g. TaskRabbit, CoContest, ListMinut) by analysing the potential of such platforms. Although we see potential in online platforms in terms of job creation and providing opportunities to discouraged and disadvantaged people, we also address some of the challenges related to such work. Presenting empirical data, we argue that the current labour market and working conditions created by online platforms resemble 19th century laissez-faire. We thus call for the urgent creation of a regulatory framework taking into consideration the suggestions presented in our article.
Multidisciplinary design optimization under correlated uncertainties
Authors: Xu Huanwei , Li Wei , Xing Liudong , Zhu Shun-Peng
Published: April 2017

Uncertainty analysis is a hot research topic in multidisciplinary design optimization for complex mechanical systems. Existing multidisciplinary design optimization works typically assume that uncertainties are uncorrelated of each other. In real-world engineering systems, however, correlations do exist between different uncertainties. The multidisciplinary design optimization methods without considering correlations between uncertainties may cause inaccuracy and thus misleading optimization results. In this article, we make contributions by proposing a new multidisciplinary design optimization approach based on the ellipsoidal set theory to investigate the characteristics of correlated uncertainties and incorporate their effects in the multidisciplinary design optimization through an advanced collaborative optimization method, where the quantitative model of correlated uncertainties is transformed into constrains of subsystems. Both a mathematical example and a case study of an engineering system are provided to illustrate feasibility and validity of the proposed method.
Task-based programming in COMPSs to converge from HPC to big data
Authors: Conejero Javier , Corella Sandra , Badia Rosa M , Labarta Jesus
Published: April 2017

Task-based programming has proven to be a suitable model for high-performance computing (HPC) applications. Different implementations have been good demonstrators of this fact and have promoted the acceptance of task-based programming in the OpenMP standard. Furthermore, in recent years, Apache Spark has gained wide popularity in business and research environments as a programming model for addressing emerging big data problems. COMP Superscalar (COMPSs) is a task-based environment that tackles distributed computing (including Clouds) and is a good alternative for a task-based programming model for big data applications. This article describes why we consider that task-based programming models are a good approach for big data applications. The article includes a comparison of Spark and COMPSs in terms of architecture, programming model, and performance. It focuses on the differences that both frameworks have in structural terms, on their programmability interface, and in terms of their efficiency by means of three widely known benchmarking kernels: Wordcount, Kmeans, and Terasort. These kernels enable the evaluation of the more important functionalities of both programming models and analyze different work flows and conditions. The main results achieved from this comparison are (1) COMPSs is able to extract the inherent parallelism from the user code with minimal coding effort as opposed to Spark, which requires the existing algorithms to be adapted and rewritten by explicitly using their predefined functions, (2) it is an improvement in terms of performance when compared with Spark, and (3) COMPSs has shown to scale better than Spark in most cases. Finally, we discuss the advantages and disadvantages of both frameworks, highlighting the differences that make them unique, thereby helping to choose the right framework for each particular objective.
Trade and Spatial Growth
Authors: Abeyratne Sirimal , Cooray N. S.
Published: April 2017

Comparative advantage is based on ‘locational factors’ so that trade leads to growth and its spatial concentration. Until recently, the nexus between trade and spatial growth received little space within trade analyses though it did not appear to be a missing link in initial contributions to trade theory. The reshaping of the global economy with greater integration has called for analyses of trade and spatial growth. This article examines theoretical premises of the link between international trade and spatial growth, and the implications of reshaping of the global economy for the study of spatial growth within trade theory.
Is there a credibility crisis in strategic management research? Evidence on the reproducibility of study findings
Authors: Bergh Donald D , Sharp Barton M , Aguinis Herman , Li Ming
Published: April 2017

Recent studies report an inability to replicate previously published research, leading some to suggest that scientific knowledge is facing a credibility crisis. In this essay, we provide evidence on whether strategic management research may itself be vulnerable to these concerns. We conducted a study whereby we attempted to reproduce the empirical findings of 88 articles appearing in the Strategic Management Journal using data reported in the articles themselves. About 70% of the studies did not disclose enough data to permit independent tests of reproducibility of their findings. Of those that could be retested, almost one-third reported hypotheses as statistically significant which were no longer so and far more significant results were found to be non-significant in the reproductions than in the opposite direction. Collectively, incomplete reporting practices, disclosure errors, and possible opportunism limit the reproducibility of most studies. Until disclosure standards and requirements change to include more complete reporting and facilitate tests of reproducibility, the strategic management field appears vulnerable to a credibility crisis.
AMP-activated kinase and the endogenous endocannabinoid system might contribute to antinociceptive effects of prolonged moderate caloric restriction in mice
Authors: King-Himmelreich Tanya S , Möser Christine V , Wolters Miriam C , Schmetzer Julia , Möller Moritz , Schreiber Yannik , Ferreirós Nerea , Geisslinger Gerd , Niederberger Ellen
Published: April 2017

Background

Caloric restriction is associated with broad therapeutic potential in various diseases and an increase in health and life span. In this study, we assessed the impact of caloric restriction on acute and inflammatory nociception in mice, which were either fed ad libitum or subjected to caloric restriction with 80% of the daily average for two weeks.

Results

The behavioral tests revealed that inflammatory nociception in the formalin test and in zymosan-induced mechanical hypersensitivity were significantly decreased when mice underwent caloric restriction. As potential mediators of the diet-induced antinociception, we assessed genes typically induced by inflammatory stimuli, AMP-activated kinase, and the endocannabinoid system which have all already been associated with nociceptive responses. Zymosan-induced inflammatory markers such as COX-2, TNFα, IL-1β, and c-fos in the spinal cord were not altered by caloric restriction. In contrast, AMPKα2 knock-out mice showed significant differences in comparison to C57BL/6 mice and their respective wild type littermates by missing the antinociceptive effects after caloric restriction. Endocannabinoid levels of anandamide and 2-arachidonyl glyceroldetermined in serum by LC-MS/MS were not affected by either caloric restriction alone or in combination with zymosan treatment. However, cannabinoid receptor type 1 expression in the spinal cord, which was not altered by caloric restriction in control mice, was significantly increased after caloric restriction in zymosan-induced paw inflammation. Since increased cannabinoid receptor type 1 signaling might influence AMP-activated kinase activity, we analyzed effects of anandamide on AMP-activated kinase in cell culture and observed a significant activation of AMP-activated kinase. Thus, endocannabionoid-induced AMP-activated kinase activation might be involved in antinociceptive effects after caloric restriction.

Conclusion

Our data suggest that caloric restriction has an impact on inflammatory nociception which might involve AMP-activated kinase activation and an increased activity of the endogenous endocannabinoid system by caloric restriction-induced cannabinoid receptor type 1 upregulation.
Severe Hallux Valgus With Coalition of the Hallux Sesamoids Treated With Modified Lapidus Procedure: A Case Report
Authors: Kurashige Toshinori , Suzuki Seiichi
Published: April 2017

Coalition of the hallux sesamoids is an extremely rare condition. To our knowledge, only 1 case report has been published. We report a case of severe hallux valgus deformities with coalitions of the hallux sesamoids. The coalitions themselves were asymptomatic; however, this severe hallux valgus deformity needed to be surgically treated. The hallux sesamoids in both feet appeared to be fused and heart shaped on anteroposterior radiographs and dumbbell shaped on axial radiographs. It is known that postoperative incomplete reduction of the medial sesamoids can be a risk factor for the recurrence of hallux valgus. The computed tomography scan demonstrated a groove in the bottom of the center of the heart-shaped sesamoid. The flexor hallucis longus tendon was located in the groove. Therefore, a modified Lapidus procedure was performed considering the medial half of the heart-shaped sesamoid as the medial sesamoid. Although delayed union occurred, successful correction of the deformity was achieved.

Levels of Evidence: Level IV
Correlation of arterial blood gas markers and lactate levels with outcomes in pediatric traumatic brain injury
Authors: Ng Zhi Min , Hong Wei Jie , Chong Shu-Ling , Allen John C , Loh Lik Eng , Low David Chyi Yeu , Lee Jan Hau
Published: April 2017

Background:

Various physical markers have been used to predict outcome of traumatic brain injury in children. However, the utility of metabolic alterations for prognostication has been poorly described. Thus, we aim to correlate arterial blood gas markers and lactate levels with outcomes in children with moderate to severe traumatic brain injury.

Methods:

This is a retrospective cohort study that included all patients <16 years old who presented to the Emergency Department with moderate to severe traumatic brain injury (Glasgow Coma Scale ⩽13). Serial arterial blood gas results and lactate levels in the first five days of admission to a pediatric intensive care unit (PICU) were reviewed. Primary outcome was in-hospital mortality. Secondary outcomes were 28-day ventilator-free and PICU-free days. A stepwise logistic regression analysis in conjunction with receiver operating characteristic analysis were used to identify variables that were associated with in-hospital mortality. Secondary outcomes were analyzed using multiple linear regression.

Results:

Among the 43 patients analyzed, more than half of the patients (60%) had severe traumatic brain injury (Glasgow Coma Scale 8). Twenty-seven of the 43 (65%) patients underwent neurosurgical intervention and overall mortality was 9/43 (20.9%). The worst base excess and lactate levels of Day 2 of PICU stay were found to be most predictive for mortality with maximal area-under-curve (95% confidence interval) of 0.967 (0.906, 1.000). Worst lactate level on day 2 of PICU stay was also found to be associated with ventilator-free days and PICU-free days.

Conclusion:

In children with moderate to severe traumatic brain injury, base excess and lactate on Day 2 of PICU stay were predictors of mortality, duration of mechanical ventilation and length of PICU stay.
Increasing the Rate of Living Donor Kidney Transplantation in Ontario: Donor- and Recipient-Identified Barriers and Solutions
Authors: Getchell Leah E. , McKenzie Susan Q. , Sontrop Jessica M. , Hayward Jade S. , McCallum Megan K. , Garg Amit X.
Published: April 2017

Purpose of Review:

To hear from living kidney donors and recipients about what they perceive are the barriers to living donor kidney transplantation, and how patients can develop and lead innovative solutions to increase the rate and enhance the experiences of living donor kidney transplantation in Ontario.

Sources of Information:

A one-day patient-led workshop on March 10th, 2016 in Toronto, Ontario.

Methods:

Participants who were previously engaged in priority-setting exercises were invited to the meeting by patient lead, Sue McKenzie. This included primarily past kidney donors, kidney transplant recipients, as well as researchers, and representatives from renal and transplant health care organizations across Ontario.

Key Findings:

Four main barriers were identified: lack of education for patients and families, lack of public awareness about living donor kidney transplantation, financial costs incurred by donors, and health care system-level inefficiencies. Several novel solutions were proposed, including the development of a peer network to support and educate patients and families with kidney failure to pursue living donor kidney transplantation; consistent reimbursement policies to cover donors’ out-of-pocket expenses; and partnering with the paramedical and insurance industry to improve the efficiency of the donor and recipient evaluation process.

Limitations:

While there was a diversity of experience in the room from both donors and recipients, it does not provide a complete picture of the living kidney donation process for all Ontario donors and recipients. The discussion was provincially focused, and as such, some of the solutions suggested may already be in practice or unfeasible in other provinces.

Implications:

The creation of a patient-led provincial council was suggested as an important next step to advance the development and implementation of solutions to overcome patient-identified barriers to living donor kidney transplantation.
An acoustic eikonal equation for attenuating orthorhombic media
Authors: Hao Qi , Alkhalifah Tariq
Published: April 2017

Attenuating orthorhombic models are often used to describe the azimuthal variation of the seismic wave velocity and attenuation in finely layered hydrocarbon reservoirs with vertical fractures. In addition to the P-wave related medium parameters, S-wave parameters are also present in the complex eikonal equation needed to describe the P-wave complex-valued traveltime in an attenuating orthorhombic medium, which increases the complexity of using the P-wave traveltime to invert for the medium parameters in practice. We have used the acoustic assumption to derive an acoustic eikonal equation that approximately governs the complex-valued traveltime of P-waves in an attenuating orthorhombic medium. For a homogeneous attenuating orthorhombic media, we solve the eikonal equation using a combination of the perturbation method and Shanks transform. For a horizontal attenuating orthorhombic layer, the real and imaginary parts of the complex-valued reflection traveltime have nonhyperbolic behaviors in terms of the source-receiver offset. Similar to the roles of normal moveout (NMO) velocity and anellipticity, the attenuation NMO velocity and the attenuation anellipticity characterize the variation of the imaginary part of the complex-valued reflection traveltime around zero source-receiver offset.
Sustainability of treatment effect of a 3-year early intervention programme for first-episode psychosis
Authors: Chang Wing Chung , Yan Kwong Vivian Wing , Lau Emily Sin Kei , So Hon Cheong , Wong Corine Sau Man , Chan Gloria Hoi Kei , Jim Olivia Tsz Ting , Hui Christy Lai Ming , Chan Sherry Kit Wa , Lee Edwin Ho Ming , Chen Eric Yu Hai
Published: April 2017

Background

Evidence indicates that the positive effects of 2-year early intervention services for psychosis are not maintained after service withdrawal. Optimal duration of early intervention in sustaining initial improved outcomes remains to be determined.

Aims

To examine the sustainability of the positive effects of an extended, 3-year, early intervention programme for patients with first-episode psychosis (FEP) after transition to standard care.

Method

A total of 160 patients, who had received a 2-year early intervention programme for FEP, were enrolled to a 12-month randomised-controlled trial (ClinicalTrials.gov: NCT01202357) comparing a 1-year extension of the early intervention (3-year specialised treatment) with step-down care (2-year specialised treatment). Participants were followed up and reassessed 2 and 3 years after inclusion to the trial.

Results

There were no significant differences between the treatment groups in outcomes on functioning, symptom severity and service use during the post-trial follow-up period.

Conclusions

The therapeutic benefits achieved by the extended, 3-year early intervention were not sustainable after termination of the specialised service.
Cost and Cost-Effectiveness of Childhood Cancer Treatment in El Salvador: A Collaborative Budget Model
Authors: Fuentes-Alabi Soad , Vasquez Roberto Franklin , Bhakta Nickhill , Rodriguez-Galindo Carlos , Frazier A. Lindsay , Atun Rifat , Gupta Sumit , Horton Susan
Published: April 2017

Abstract 32

Background:

Cure rates for childhood cancer in El Salvador (ES) have increased from 5% in 1991 to 68% today as a result of national and international support. Approximately 200 new cases of pediatric cancer are diagnosed annually in ES—all are treated centrally at the National Children’s Hospital Benjamin Bloom. The cost of childhood cancer treatment in low- and middle-income countries (LMICs), such as ES, has not been well investigated. Such data are integral to inform national childhood cancer treatment plans. We undertook this work to determine the cost of operating a national childhood cancer treatment center in ES and to provide an analytic model framework for similar cost analyses in other LMICs.

Methods:

We conducted a cross-sectional study to evaluate the cost of childhood cancer treatment covered by a collaborative budget model in ES. We calculated costs on the basis of annual cases diagnosed and admitted to National Children’s Hospital Benjamin Bloom, and captured supportive expenses for families that are essential to reducing abandonment. Cost-effective analyses were performed and compared with traditional thresholds.

Results:

Initial estimates indicate an annual total operating budget of $5.3 million to treat 200 new cases annually. When combined with current survival outcomes, this represents a cost-effective model using WHO-CHOICE thresholds.

Conclusion:

Providing the first such comprehensive, institution-based estimate for the cost of treatment of childhood cancer in LMICs, we show that a childhood cancer treatment center represents a cost-effective intervention. This baseline information can be used to prioritize future treatments and interventions in ES. This methodology also allows similar studies to be conducted in other LMICs. Together, these data will inform a case for investment in global access to childhood cancer treatment.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

Soad Fuentes-Alabi No relationship to disclose Roberto Franklin Vasquez No relationship to disclose Nickhill Bhakta No relationship to disclose Carlos Rodriguez-Galindo Honoraria: Novimmune A. Lindsay Frazier Consulting or Advisory Role: Decibel Therapeutics Rifat Atun No relationship to disclose Sumit Gupta No relationship to disclose Susan Horton No relationship to disclose
Impact of a Patient Navigator on Time to Diagnosis Among Pediatric Oncology Patients in Tanzania
Authors: Alvi Fatima , Mafwimbo Judy , McHenry Kathryn , Masalu Nestory , Schroeder Kristin
Published: April 2017

Abstract 12

Background:

Oncology patient navigation programs have been successfully implemented at hospitals throughout the United States and have enhanced the quality of care through financial guidance, treatment coordination, and psychosocial support. In low-resource settings, barriers to receiving cancer care are increased and a patient navigator in this setting has the potential to significantly impact outcomes; however, there is limited research on the efficacy of such programs in these settings. At Bugando Medical Centre in Mwanza, Tanzania, a patient navigation program was established to identify potential pediatric oncology patients, then assist these patients and their families throughout the diagnosis and treatment process with the goals of reducing time to oncology evaluation and diagnosis and, ultimately, improving survival outcomes.

Methods:

A retrospective analysis of hospital records was conducted of all pediatric oncology patients who were evaluated at Bugando Medical Centre from 2010 to 2016, separated by presentation date before or after establishment of the navigation program. Collected data include demographics, diagnosis, and time from presentation to oncology evaluation and diagnosis.

Results:

A total of 238 patient files were reviewed, with 169 patients pre- and 69 patients postprogram initiation. Patient groups did not differ by age or gender ( P = .329 and .744, respectively) or diagnosis distribution. After establishing a patient navigator program, average time to oncology evaluation decreased from 49.7 days to 16.6 days ( P = .015), and time to diagnosis decreased from 49.1 days to 23.6 days ( P = .07).

Conclusion:

In pediatric cancer, early diagnosis is critical for initiation of chemotherapy and improvement of outcomes. This study has shown that a patient navigation program has the potential to significantly impact patient outcomes through reductions in time to evaluation and diagnosis and should be included in comprehensive pediatric cancer care programs.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from the authors.
Historical Evolution of the Malawi National Cancer Registry: A Collaborative Effort to Develop and Sustain an Impactful Cancer Control Resource in a Low-Income Country
Authors: Chasimpha Steady , Horner Marie-Josèphe , Dzamalala Charles , Gopal Satish
Published: April 2017

Abstract 26

Background:

Population-based cancer registration is essential to inform cancer control, yet high-quality cancer registration is absent in much of Africa. We undertook this work to initiate and sustain the Malawi National Cancer Registry (MNCR) to: collect high-quality, population-based cancer data to describe the national burden; inform national cancer control programs and policies; provide a rich national resource for epidemiologic cancer research; and develop collaborations with other partners to increase MNCR impact.

Methods:

MNCR began in 1989 as a hospital-based pathology registry in Blantyre, Malawi. A population-based component was introduced in 1993 that initially covered the Blantyre district with active case finding. By using this platform, regular national surveys were initiated in 2005 and are carried out every 5 years. Building on this surveillance program, MNCR has pursued collaborations with the Malawi HIV unit to conduct a national HIV-Cancer Match Study to assess the evolving cancer burden in the antiretroviral scale-up era. MNCR has also collaborated with other regional registries through the African Cancer Registry Network.

Results:

MNCR has published descriptions of the cancer burden in Malawi and is one of few African data sources to contribute to the WHO’s Cancer Incidence in Five Continents. Kaposi sarcoma and cervical cancer are the most common cancers in men and women, respectively. Approximately 93,000 records from MNCR and the two largest HIV cohorts in Malawi have been linked, with preliminary data demonstrating 3,499 cancers among 15,920 antiretroviral initiators in Lilongwe. MNCR has also contributed to regional studies that have described the high incidence and young age for esophageal cancer in Africa.

Conclusion:

We must continue to improve the quality and coverage of population-based cancer registration throughout Malawi, update the HIV-cancer record linkage at regular intervals, and pursue further opportunities for collaboration.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from the authors.
Knowledge and Practices About Cervical Cancer and Screening Among Married Men in Traditional Authority Nkhumba, Phalombe District
Authors: Mthepheya Chimwemwe Cealla Lita , Chepuka Lignet
Published: April 2017

Abstract 37

Background:

Cancer of the cervix is one of the reproductive cancers that are claiming the lives of women worldwide, and Malawi has not been spared. Of the 16 countries with the highest incidence of cervical cancer in Africa, Malawi has been rated the highest, with an incidence of 75.9. Being a reproductive disease, male involvement is critical as men control approximately 95% of sexual relationships in Malawi, but their role in cervical cancer prevention is not known. This study was carried out to investigate the knowledge and practices of married men regarding cervical cancer and screening.

Methods:

A cross-sectional study recruited 396 married men. Collected data were analyzed by using SPSS for Windows version 16 (SPSS, Chicago, IL).

Results:

The majority of respondents were not knowledgeable about cervical cancer and cervical cancer screening, as 84.1% did not know the cause, nor did 88.9% know the signs or symptoms of cervical cancer. Only 4% of respondents knew the risk factors, whereas 75.5% had no knowledge. On prevention, 76.5% had no knowledge, and 68.2 % had some knowledge on cervical cancer treatment. Almost all respondents (99%) said they would encourage their spouses to undergo screening, and 71.7 % said that men, as heads of families, are responsible for deciding whether their spouse should access screening services or not.

Conclusion:

Men have a stake in taking part in cervical cancer prevention. This is a window of opportunity that the Ministry of Health can use to develop strategies that are tailored toward men to participate fully in cervical cancer prevention to reduce its burden.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from either author.
Breast Cancer Patient Navigation Program in a Resource-Constrained Health Care Setting in Asia
Authors: Jaganathan Maheswari , Hai Dhiauddin , Zainal Nur Hidayati , Rajaram Nadia , Yusof Mohamed , Teo Soo-Hwang
Published: April 2017

Abstract 23

Background:

Breast cancer incidence is rapidly increasing in Asia as a result of changes in life expectancy and lifestyle factors. In Malaysia, incidence is expected to double in the next decade and survival is poor (50% to 75%) because of late presentation and poor adherence to treatment. This burden is greater for women in underserved communities, but few studies have examined systematic approaches to reduce late presentation and poor treatment adherence. We sought to determine whether a patient navigation program (PNP) could be a community-based solution to improve outcomes of patients with breast cancer, particularly in a resource-constrained setting.

Methods:

PNP was implemented in a secondary hospital that serves a suburban area near Kuala Lumpur. A decision aid, which incorporated local key messages, was developed. Nurses and community workers in the program received skills training in navigation, communications, patient management, and resource identification and utilization. Data were retrieved from baseline questionnaires and a patient tracking system and was analyzed by using descriptive statistics.

Results:

In the first year of the program, 225 women were served, of whom 137 were patients with breast cancer. Compared with the prior year, more patients in the PNP received diagnoses within 14 days of their first visit (67.7% v 62.4%; P = .516) and had surgery within 28 days from diagnosis (68.4% v 61.3%; P = .487). There were also fewer reported patients who experienced default in the PNP (4.4% v 6.6%; P = .797).

Conclusion:

This 1-year evaluation showed that patient navigation is feasible in a resource-constrained setting, but longer follow-up is required to determine the impact on outcomes. Moving forward, we seek to increase the efficiency of patient navigation by increasing access to palliative care and improving interdepartment coordination and patient tracking systems.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

Maheswari Jaganathan No relationship to disclose Dhiauddin Hai No relationship to disclose Nur Hidayati Zainal No relationship to disclose Nadia Rajaram No relationship to disclose Mohamed Yusof No relationship to disclose Soo-Hwang Teo Honoraria: AstraZeneca Consulting or Advisory Role: AstraZeneca Speakers' Bureau: AstraZeneca Research Funding: AstraZeneca Travel, Accommodations, Expenses: AstraZeneca
Awareness and Knowledge of Human Papillomavirus and Cervical Cancer Among Female Medical and Health Science Students at University of Gondar
Authors: Tesfaye Zelalem Tilahun , Gebreyohannes Eyob Alemayehu , Bhagavathula Akshaya Srikanth , Getaneh Melaknesh Minda , Tegegn Henok Getachew
Published: April 2017

Abstract 6

Background:

Cervical cancer is causing a burden in sub-Saharan Africa, with human papillomavirus (HPV) identified as the necessary cause of cervical cancer. HPV mainly affects young women, which puts female university students at risk of cervical cancer. Knowledge and awareness of cervical cancer and HPV in sub-Saharan Africa, including Ethiopia, is poor. The aim of this study was to assess the knowledge and awareness of cervical cancer and HPV in University of Gondar medicine and health science female students.

Methods:

This cross-sectional study was conducted from April 1 to May 30, 2016, at University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia. Undergraduate female students from 11 different health-related departments at the College of Medicine and Health Sciences were included in the study. A 14-item, paper-based, self-administered questionnaire was provided to each of the participants to measure her level of knowledge and awareness of cervical cancer and HPV.

Results:

A total of 267 female students participated in the study, with ages ranging from 18 to 24 years (mean age, 20.58 ± 1.22 years). More than one half of participants (59.6%) stated that they did not know the main cause of cervical cancer, whereas only approximately one fifth (19.5%) identified HPV as the main cause of cervical cancer. As many as 83.9% of participants did not know other causes of cervical cancer. Binary logistic analysis revealed that students from midwifery (adjusted odds ratio [AOR], 14.14; P < .05), anesthesiology (AOR, 9.66; P < .05), and medicine (AOR, 5.84; P < .05) departments were associated with knowledge of the main cause of cervical cancer. Furthermore, fifth-year students (AOR, 16.94; P < .05) and fourth-year students (AOR, 8.32; P < .05) were found to have better knowledge of the main cause of cervical cancer. Only a few students (15%) had been vaccinated for HPV or had had a cervical smear test performed in the past.

Conclusion:

Cervical cancer mainly affects young women, which puts female university students at risk of cervical cancer. Hence, assessing the knowledge and awareness of these students will be of paramount importance to designing effective measures to increase their knowledge and awareness of the disease.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from the authors.
T-Cell Receptor Sequencing of Kaposi Sarcoma Tumors to Identify Candidate Tumor-Reactive T Cells
Authors: Phipps Warren T. , Towlerton Andrea M.H. , Coffey David G. , Niyonzima Nixon , Warren Edus H.
Published: April 2017

Abstract 60

Background:

Development of Kaposi sarcoma (KS) is strongly associated with immune dysfunction in the context of HIV infection, but little is known about T-lymphocyte responses against KS tumor cells or human herpesvirus-8, the viral cause of KS. Increasing evidence suggests that treatment response in KS is attributable in part to an antitumor immune response that is mediated by tumor-infiltrating lymphocytes (TIL). The aim of this work was to identify TIL characteristics that are associated with tumor regression in patients with KS who were treated with antiretroviral therapy and chemotherapy as well as to identify a molecular signature of response.

Methods:

High-throughput sequencing of the T-cell receptor β chain ( TRB) was used to define the repertoire of T cells that infiltrate up to two pretreatment and two post-treatment KS tumors and matched normal skin obtained from HIV-infected adults with KS who received care at the Uganda Cancer Institute. We compared TRB repertoire in serially collected tumors to identify TRB sequences carried in candidate tumor-reactive T cells.

Results:

TRB sequencing was performed on KS tumor and matched normal skin samples from 12 HIV-infected adults with KS who collectively demonstrated a range of treatment responses. Unique populations of T cells were identified in pretreatment tumors but not in normal skin in all patients, which suggested the presence of KS-specific T-cell responses. Durable complete response to treatment in one patient was associated with significant expansion of a small number of T-cell clones, one of which carried a TRB sequence that was associated with a public CD8+ Epstein-Barr virus–associated T-cell receptor.

Conclusion:

Understanding the immune response to KS through cellular and molecular dissection of TIL will provide important insights into KS biology and may ultimately guide new immune-based strategies to stage and treat this often-refractory cancer. Funding: Solid Tumor Translational Research Transformative Team Grant, Fred Hutchinson Cancer Research Center; National Institutes of Health/National Cancer Institute Grant No. K23-CA150931.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from the authors.
Comparing Cancer Mortality Estimates in Mexico By Using Two National Death Registries
Authors: Lozano-Esparza Susana , Stern Dalia , Hernandez-Avila Juan Eugenio , Morales-Carmona Evangelina , Lozano Rafael , Lazcano-Ponce Eduardo , Lopez-Ridaura Ruy , Lajous Martin
Published: April 2017

Abstract 49

Background:

Mexico has low cancer mortality compared with other Latin American countries and high-income economies. The National Institute of Geography and Statistics (INEGI) uses an automated coding system that has been adapted from the Centers for Disease Control system to process death certificates. In contrast, the System for Epidemiologic Death Statistics (SEED) relied on a standardized manual process. We hypothesized that the low cancer mortality could be explained by processing procedures. We undertook this work to compare cancer mortality rates from two national death registries that independently code and attribute cause of death from death certificates.

Methods:

We calculated age-standardized cancer mortality rates for all cancers and specific sites by sex for 2010 to 2014 by using data from INEGI and SEED. We calculated stroke mortality rates for comparison. We obtained age-adjusted mortality rates and 95% CIs by using direct method and World Population Prospects 2010 as a standard.

Results:

Age-standardized mortality rate per 100,000 women for all cancers was 74.8 (95% CI, 74.0 to 75.6) in INEGI and 74.1 (95% CI, 73.3 to 74.9) in SEED for 2010. In contrast, for men, cancer mortality rate was 69.0 (95% CI, 68.2 to 69.7) in INEGI and 68.4 (95% CI, 67.7 to 69.7) in SEED. We did not observe substantial differences across cancer sites and years; however, when analyzing cases with cancer as a contributing condition, INEGI reported approximately 50% more compared with SEED. In contrast, stroke mortality significantly differed between registries for all years. For women, in 2010, INEGI reported 29.4 (95% CI, 29.0 to 29.9) compared with 26.5 (95% CI, 26.0 to 26.9) in SEED. Corresponding estimates for men were 36.6 (95% CI, 36.0 to 37.1) and 33.0 (95% CI, 32.4 to 33.5), respectively.

Conclusion:

Cancer mortality estimates were minimally affected by use of distinct processing procedures. Death certification in Mexico should be further evaluated. Funding: AstraZeneca, GlaxoSmithKline, and Merck.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

Susana Lozano-Esparza No relationship to disclose Dalia Stern No relationship to disclose Juan Eugenio Hernandez-Avila No relationship to disclose Evangelina Morales-Carmona No relationship to disclose Rafael Lozano No relationship to disclose Eduardo Lazcano-Ponce Consulting or Advisory Role: Merck Sharp & Dohme Research Funding: Roche, Roche (Inst), BD, Qiagen (Inst) Travel, Accommodations, Expenses: GlaxoSmithKline, Merck Sharp & Dohme, Qiagen Ruy Lopez-Ridaura Research Funding: AstraZeneca Martin Lajous Research Funding: AstraZeneca
“Dreaming on Behalf of the Community”: A Conversation with Nuruddin Farah
Authors: Garuba Harry
Published: April 2017

“Dreaming on Behalf of the Community” presents the edited transcript of a conversation I had with the Somali writer Nuruddin Farah in his Cape Town home a few months before the publication of his latest novel, Hiding in Plain Sight. The previous novel, Crossbones, marked the end of his third trilogy of novels known as the Past Imperfect trilogy. The end of one cycle of novels and the beginning of another provided an opening to ask him questions about his next project and its relation to his earlier work. In this conversation, the author sheds light on these and other issues that have been central to his writing career. He discusses, among other things, his dreams for his country, the Somali diaspora, the place of African writing in the world, the question of literary prizes and their influence on writers and in setting agendas for the literary world, and so on. It is a rare glimpse of a writer's reflection on his work and the literary world.
Did the Digital Age Kill the Literary Star?
Authors: Purcell Richard
Published: April 2017

In “Did the Digital Age Kill the Literary Star?” Richard Purcell looks back on Adam Bradley's Ralph Ellison in Progress: From “Invisible Man” to “Three Days before the Shooting” in light of Edward Snowden's revelations that the White House and the National Security Agency have been secretly collecting metadata on private citizens. The essay asks what Bradley's book and Ellison's fiction have to say about the role of the critic and literature when faced with the undemocratic forces of technology and progress.
Ψυχοπολιτική: Νεοφιλελευθερισμός και νέες τεχνικές εξουσίας
Authors: Βατσινάς (Andreas Vatsinas) Ανδρέας
Published: April 2017

Book Review of Buyng-Han, Psicopolitica: Neoliberalismo y nuevas técnicas de poder, Herder Editorial, Barcelona 2014.
Αυτοκτονία: Λύση στο πρόβλημα του παραλόγου;
Authors: Ζαχαράκης (Miron Zacharakis) Μύρων
Published: April 2017

Book Review of Albert Camus, Le Mythe de Sisyphe
Resection of the ilium in patients with a sarcoma
Authors: Laitinen M. K. , Parry M. C. , Albergo J. I. , umathi V. S , Jeys L. M. , Grimer R. J.
Published: April 2017

Aims

The aim of the study was to investigate the controversial issue of whether the pelvic ring should be reconstructed following resection of the sarcomas of the ilium.

Patients and Methods

From our database, we identified 64 patients who underwent excision of a tumour involving the ilium between 1976 and 2015. A total of 35 underwent complete resection, of whom 24 were reconstructed with a non-vascularised fibula graft, and four with extracorporeal irradiation and reimplantation. A total of 29 patients had a partial resection. The mean follow-up was 9.2 years (1.1 to 25.6). Functional outcomes were assessed using the Toronto Extremity Salvation Score (TESS) at final follow-up. In all, 32 patients (50%) had a chondrosarcoma.

Results

The mean TESS for all patients was 71.6% (17% to 100%). The mean TESS for those who underwent total resection with reconstruction was 72.0% (17% to 100%) and without reconstruction it was 53.3% (20% to 90%) and for those who underwent partial resection it was 76.3% (31.3% to 100%). The rate of local recurrence was 42.2% and this was more common in those treated by partial resection (p = 0.048). The risk of local recurrence was related to the margin achieved at resection.

Conclusions

Given the high rate of local recurrence following excision of a tumour from the ilium, obtaining wide surgical margins should be a priority even if this requires more aggressive surgery. In young patients, where late recurrence may occur, more radical complete resection should be considered. When total resection of the ilium is considered, reconstruction should also be considered as it confers a higher functional outcome than total resection without reconstruction. Cite this article: Bone Joint J 2017;99-B:538–43.