bluuebunny/crossref_metadata_2025 huggingface dataset:
Introducing echocardiography to medical students: A novel echocardiography E‐Learning experience
Authors: Torabi Asad J. , Feigenbaum Harvey , Bateman Pantila V.
Published: March 2021

Background

Echocardiography is fundamental in the understanding of cardiology; however, echocardiography is not routinely taught in medical schools. The aim of this study is to assess whether teaching echocardiography to preclinical medical students using an e‐learning software (ELS) is practical and appropriate.

Methods

From 2017 to 2019, 1084 second‐year medical students at Indiana University School of Medicine were introduced to echocardiography by using the ELS. In 2017 and 2018 students had a postcourse survey to assess echocardiography appropriateness and cardiology learning. Students in 2018 and 2019 were assessed for any association between the use of the ELS and learning cardiology by comparing examination scores.

Results

In 2017‐2018, 127 students responded to the survey (18% response rate). In 2017, 79% of responders and in 2018, 89% reported that introducing echocardiography to medical students is appropriate. In 2017, 78% and in 2018, 87% reported that it improved the understanding of cardiology. Student ELS usage was high for 2017‐2018 (93% and 70%) but dropped in 2019 (30%). In 2018 and 2019, students who used ELS did statistically significantly better on the examination (total scores 84% vs. 82% (P = .008) in 2018; 84% vs. 81% (P = .002) in 2019).

Conclusions

Many 2nd year medical students felt learning echocardiography with ELS was appropriate and enhanced their learning cardiology. Using echocardiography to help learn cardiology appears to be supported with an association of ELS usage and improved examination scores. Our study suggests that echocardiography learning can and probably should begin in medical school.
Ventricular pre‐excitation in primary care patients: Evaluation of the risk of mortality
Authors: Paixão Gabriela M. M. , Lima Emilly M. , Batista Luisa M. , Santos Luis Felipe , Araujo Sabrina L. O. , Araujo Rodrigo M. , Oliveira Derick M. , Nascimento Jamil S. , Gomes Paulo R. , Ribeiro Antonio L.
Published: March 2021

Background

Ventricular pre‐excitation is characterized by the presence of atrioventricular accessory pathways, predisposing to arrhythmias. Although it is well established that risk stratification in symptomatic patients should be invasive, there is a lack of evidence of the benefit in asymptomatic.

Objective

Evaluate ventricular pre‐excitation in the electrocardiogram (ECG) as a risk factor for overall mortality in patients of Telehealth Network of Minas Gerais (TNMG), Brazil.

Methods

This observational study was developed with the database of digital ECGs (2010–2017) from TNMG. The electronic cohort was obtained by linking data from ECG exams and those from the national mortality information system. Only the first ECG was considered. Clinical data were self‐reported, and ECGs were interpreted manually by cardiologists and automatically by the Glasgow University Interpreter software. Hazard ratio (HR) for mortality was estimated using weighted Cox regression.

Results

Nearly 1 665 667 patients were included (median age: 50 [Q1: 34; Q3: 63] years; 41.4% were male). In a mean follow‐up of 3.7 years, the overall mortality rate was 3.1%. The prevalence of ventricular pre‐excitation was 0.07%. In multivariate analysis, adjusting for sex and age, ventricular pre‐excitation was not associated with an increased risk of mortality (HR: 1.41; 95% confidence interval [CI]: 0.56–3.57; p = .47) when compared to the whole sample or to patients with normal ECG (HR: 1.41; 95% CI: 0.53–4.36; p = .43). In a subanalysis on accessory pathway location, there was no evidence of a higher risk of death related to any location.

Conclusion

Ventricular pre‐excitation was not associated with an increased risk of mortality in a primary care cohort.
Atrial electrophysiological characteristics of aging
Authors: van der Does Willemijn F.B. , Houck Charlotte A. , Heida Annejet , van Schie Mathijs S. , van Schaagen Frank R.N. , Taverne Yannick J.H.J. , Bogers Ad J.J.C. , de Groot Natasja M.S.
Published: March 2021

Introduction

Advancing age is a known risk factor for developing atrial fibrillation (AF), yet it is unknown which electrophysiological changes contribute to this increased susceptibility. The goal of this study is to investigate conduction disturbances and unipolar voltages (UV) related to aging.

Methods

We included 216 patients (182 male, age: 36–83 years) without a history of AF undergoing elective coronary artery bypass surgery. Five seconds of sinus rhythm were recorded intraoperatively at the right atrium (RA), Bachmann's bundle (BB), the left atrium and the pulmonary vein area (PVA). Conduction delay (CD), ‐block (CB), ‐velocity (CV), length of longest CB lines and UV were assessed in all regions.

Results

With aging, increasing conduction disturbances were found, particularly at RA and BB (RA: longest CB line rs = .158, p = .021; BB: CB prevalence rs = .206, p = .003; CV rs = −.239, p < .0005). Prevalence of low UV areas (UV <5th percentile) increased with aging at the BB and PVA (BB: rs = .237, p < .0005 and PVA: rs = .228, p = .001).

Conclusions

Aging is accompanied by an increase in conduction disturbances during sinus rhythm and a higher prevalence of low UV areas, particularly at BB and in the RA. These electrophysiological alterations could in part explain the increasing susceptibility to AF development associated with aging.
Establishment of an efficient seed fluorescence reporter‐assisted CRISPR/Cas9 gene editing in maize
Authors: Yan Yuanyuan , Zhu Jinjie , Qi Xiantao , Cheng Beijiu , Liu Changlin , Xie Chuanxiao
Published: March 2021

Genome editing by clustered regularly interspaced short palindromic sequences (CRISPR)/CRISPR‐associated protein 9 (Cas9) has revolutionized functional gene analysis and genetic improvement. While reporter‐assisted CRISPR/Cas systems can greatly facilitate the selection of genome‐edited plants produced via stable transformation, this approach has not been well established in seed crops. Here, we established the seed fluorescence reporter (SFR)‐assisted CRISPR/Cas9 systems in maize (Zea mays L.), using the red fluorescent DsRED protein expressed in the endosperm (En‐SFR/Cas9), embryos (Em‐SFR/Cas9), or both tissues (Em/En‐SFR/Cas9). All three SFRs showed distinct fluorescent patterns in the seed endosperm and embryo that allowed the selection of seeds carrying the transgene of having segregated the transgene out. We describe several case studies of the implementation of En‐SFR/Cas9, Em‐SFR/Cas9, and Em/En‐ SFR/Cas9 to identify plants not harboring the genome‐editing cassette but carrying the desired mutations at target genes in single genes or in small‐scale mutant libraries, and report on the successful generation of single‐target mutants and/or mutant libraries with En‐SFR/Cas9, Em‐SFR/Cas9, and Em/En‐SFR/Cas9. SFR‐assisted genome editing may have particular value for application scenarios with a low transformation frequency and may be extended to other important monocot seed crops.
Association between dental extraction after radiotherapy and osteoradionecrosis: A multi‐centre retrospective study
Authors: Saito Izumi , Hasegawa Takumi , Kawashita Yumiko , Kato Shinichiro , Yamada Shin‐ichi , Kojima Yuka , Ueda Nobuhiro , Umeda Masahiro , Shibuya Yasuyuki , Kurita Hiroshi , Kirita Tadaaki , Akashi Masaya
Published: March 2021

Objective

Radiotherapy (RT) carries a substantial risk for the development of osteoradionecrosis (ORN) of the jaw. This study was performed to investigate the relationship between dental extractions after RT and the development of ORN.

Material and Methods

Thirty‐two patients with head and neck cancer who underwent tooth extraction after RT were investigated for correlations between the development of ORN and various factors.

Results

Postextraction ORN was diagnosed in 12 (12.1%) teeth of 9 patients. The RT dose against the site of tooth extraction was 62.0 and 37.4 Gy in the ORN and Non‐ORN groups, respectively (p < .001). The duration from RT to tooth extraction was 41.2 and 28.2 months in the ORN and Non‐ORN groups, respectively (p = .025). Tooth extraction was significantly associated with ORN in patients with a high RT dose against the site (odds ratio = 1.231) and a longer duration of time from RT (odds ratio = 1.084).

Conclusions

Extraction of non‐restorable teeth and those with a poor prognosis should not necessarily be postponed even when patients are undergoing RT. However, clinicians should pay special attention to postoperative management after tooth extraction in patients with a high RT dose and longer time from RT.
The Thick-Film Lubrication of Full Journal Bearings of Finite Width
Authors: Muskat M. , Morgan F.
Published: March 2021

A discussion is given of the results of analytical and experimental studies of the thick-film lubrication of full journal bearings of finite width. The Reynolds differential equation has been solved by a successive approximation method for (a) flooded full journal bearings, (b) full journal bearings with central circumferential grooves, and (c) full journal bearings provided with point sources of lubricant. Calculations were made on the variation of the journal eccentricity, load-carrying capacity, and friction coefficients with the Sommerfeld dimensionless variable for the three cases and for different bearing widths. Direct experimental tests are described which confirmed the theoretical predictions for bearings fed with lubricant at point sources.
Forty-Eight Ordinate Harmonic Analysis and the Harmonic Spectrum of Two-Cycle Diesel Torque
Authors: Klock Nancy
Published: March 2021

For the harmonic analysis of periodic curves, machines as well as numerical methods are available. The machines are expensive and not generally available, and time is required to learn their operation. Therefore, an occasional analysis of a curve consumes even less time by the numerical method than by the machine. The best known numerical method is that of Runge (1) described in many places; a good account is found in Scarborough’s book (2). The principle is clear, but writers usually give the method for 6, 12, or 24 ordinates for the sake of simplicity, which is not sufficiently accurate for most applications. In this paper the 48-ordinate scheme is fully given in Tables 1, 2, and 3.

For the analysis of torsional vibrations the harmonic content of the torque curve of the disturbing engine is required. Such analyses have been published for the four-cycle Diesel engine (3) and for the four-cycle gasoline engine for aviation purposes (4). But to the author’s knowledge none have been published for the two-cycle Diesel engine. Such a spectrum is given herein.
Rare cause of haemoptysis: bronchopulmonary sequestration
Authors: Shafiq Muhammad , Ali Amjad , Dawar Ujaas , Setty Niranjan
Published: March 2021

Bronchopulmonary sequestration is a rare congenital pulmonary abnormality of the lower airways, which includes an abnormal and non-functioning lung tissue not communicating with the tracheobronchial tree and having aberrant blood supply from systemic circulation with variable venous drainage. The incidence of sequestration is around 0.15%–6.4% of all congenital lung malformations.Common presenting features are cough and expectoration. Misdiagnosed cases may present with recurrent infections and haemoptysis. CT of the chest with contrast is the imaging modality of choice.This is a case report of a 32-year-old woman who presented with cough and haemoptysis. CT of the chest showed a multiloculated mass-like lesion in the left lower lobe with a feeding artery from coeliac plexus and venous drainage via the normal left pulmonary vein.Based on CT chest findings, diagnosis of intralobar pulmonary sequestration was made. The patient was reviewed by cardiothoracic surgeons and underwent surgical resection of the sequestrated lung.

Common presenting features are cough and expectoration. Misdiagnosed cases may present with recurrent infections and haemoptysis. CT of the chest with contrast is the imaging modality of choice.
K3 carpets on minimal rational surfaces and their smoothings
Authors: Bangere Purnaprajna , Mukherjee Jayan , Raychaudhury Debaditya
Published: March 2021

In this paper, we study K3 double structures on minimal rational surfaces [Formula: see text]. The results show there are infinitely many non-split abstract K3 double structures on [Formula: see text] parametrized by [Formula: see text], countably many of which are projective. For [Formula: see text] there exists a unique non-split abstract K3 double structure which is non-projective (see [J.-M. Drézet, Primitive multiple schemes, preprint (2020), arXiv:2004.04921, to appear in Eur. J. Math.]). We show that all projective K3 carpets can be smoothed to a smooth K3 surface. One of the byproducts of the proof shows that unless [Formula: see text] is embedded as a variety of minimal degree, there are infinitely many embedded K3 carpet structures on [Formula: see text]. Moreover, we show any embedded projective K3 carpet on [Formula: see text] with [Formula: see text] arises as a flat limit of embeddings degenerating to 2:1 morphism. The rest do not, but we still prove the smoothing result. We further show that the Hilbert points corresponding to the projective K3 carpets supported on [Formula: see text], embedded by a complete linear series are smooth points if and only if [Formula: see text]. In contrast, Hilbert points corresponding to projective (split) K3 carpets supported on [Formula: see text] and embedded by a complete linear series are always smooth. The results in [P. Bangere, F. J. Gallego and M. González, Deformations of hyperelliptic and generalized hyperelliptic polarized varieties, preprint (2020), arXiv:2005.00342] show that there are no higher dimensional analogues of the results in this paper.
Theoretical Formulation of Three-Mass Vehicle Model for Vehicle–Bridge Interaction
Authors: Yang Judy P.
Published: March 2021

The vehicle–bridge interaction (VBI) is studied using a semi-analytical approach based on a three-mass vehicle model. As most work analyzes vehicle–bridge interaction numerically and/or analytically by treating the vehicle as a simplified lumped mass, to the best of the author’s knowledge, this work first presents the theoretical formulation of the three-mass VBI system, where a more realistic vehicle model equipped with a rigid mass and two unsprung mass-spring-damper systems is considered. By assuming the first modal vibration of beam, the semi-analytical solutions are derived, which can be served as the reference solutions for calibrating VBI analyses using different models or methods.
Composite Indicators as Decision Making Tools: The Joint Use of Compensatory and Noncompensatory Schemes
Authors: Gibari Samira El , Cabello José M. , Gómez Trinidad , Ruiz Francisco
Published: March 2021

Composite indicators are powerful tools for summarizing, focusing and condensing the complexity of our dynamic environment, and their use has become indispensable for managing huge amounts of information. An important aspect to emphasize when constructing composite indicators is the compensatory character among the individual indicators. In general, a fully compensatory scheme provides an overall assessment of the performance of each unit, while a non-compensatory scheme detects the worst single performances. When used in a decision making framework, the joint consideration of both schemes may, therefore, be helpful. Nevertheless, in the literature, few approaches allow the construction of composite indicators for different compensation degrees. On these premises, the aim of this paper is to illustrate the behavior of some methodologies that build composite indicators allowing different compensation degrees. We analyze the results provided by each of these methods and which of them provide a more varied complementary information when considering both compensatory and non-compensatory scenarios. An illustrative example is used to visualize the results.
Wavelet Lifting Scheme for the Numerical Solution of Dynamic Reynolds Equation for Micropolar Fluid Lubrication
Authors: Shiralashetti S. C. , Kantli M. H. , Deshi A. B.
Published: March 2021

Recently, wavelet theory has become a well recognized promising tool in science and engineering field; especially, wavelets are successfully used in fast algorithms for easy execution. In this paper, we developed wavelet lifting scheme using orthogonal and biorthogonal wavelets for the numerical solution of dynamic Reynolds equation for micropolar fluid lubrication. The numerical results gained through proposed scheme are compared with the exact solution to expose the accuracy with speed of convergence in lesser computational time as compared with the existing methods. The examples are given to demonstrate the applicability and attractiveness of proposed method.
Research of Single-Particle Compression Ratio and Prediction of Crushed Products and Wear on the 6-DOF Robotic Crusher
Authors: Duan Guochen , Shi Boqiang , Gu Jie
Published: March 2021

In order to reduce wear and increase crushing efficiency of the 6-DOF (degree of freedom) robotic crusher, the maximum single-particle compression ratio function of the granular material and the wear model of the mantle liner under eccentric compression are established. The function and model take into account the influence of crusher parameters and granular material parameters on maximum single-particle compression ratio, which is simulated by EDEM and obtained under different conditions. Combined with previous research, the theoretical distribution of crushed products and the crushing chamber size can be obtained at each time of the whole life cycle of the liner. Compared with the experimental data of Ansteel Group in previous research, the difference between the functional model and the actual results is small. This function is universal and can be used to provide reference for the 6-DOF robotic crusher’s crushing strategy and a theoretical basis and a design reference of the traditional structure cone crusher.
The Impact of Various Culture Conditions on Human Mesenchymal Stromal Cells Metabolism
Authors: Tonarova Pavla , Lochovska Katerina , Pytlik Robert , Hubalek Kalbacova Marie
Published: March 2021

In vitro and in vivo analyses are closely connected, and the reciprocal relationship between the two comprises a key assumption with concern to the conducting of meaningful research. The primary purpose of in vitro analysis is to provide a solid background for in vivo and clinical study purposes. The fields of cell therapy, tissue engineering, and regenerative medicine depend upon the high quality and appropriate degree of the expansion of mesenchymal stromal cells (MSCs) under low-risk and well-defined conditions. Hence, it is necessary to determine suitable alternatives to fetal bovine serum (FBS—the laboratory gold standard) that comply with all the relevant clinical requirements and that provide the appropriate quantity of high-quality cells while preserving the required properties. Human serum (autologous and allogeneic) and blood platelet lysates and releasates are currently considered to offer promising and relatively well-accessible MSC cultivation alternatives. Our study compared the effect of heat-inactivated FBS on MSC metabolism as compared to its native form (both are used as the standard in laboratory practice) and to potential alternatives with concern to clinical application—human serum (allogeneic and autologous) or platelet releasate (PR-SRGF). The influence of the origin of the serum (fetal versus adult) was also determined. The results revealed the key impact of the heat inactivation of FBS on MSCs and the effectiveness of human sera and platelet releasates with respect to MSC behaviour (metabolic activity, proliferation, morphology, and cytokine production).
Experimental Study on the Mechanical Properties of Sandstone under the Action of Chemical Erosion and Freeze‐Thaw Cycles
Authors: Cui Lizhuang , Qin Nan , Wang Shuai , Feng Xuezhi
Published: March 2021

In order to study the mechanical properties of sandstone under the coupling action of chemical erosion and freeze‐thaw cycles, the fine‐grained yellow sandstone in a mining area in Zigong, China, is collected as the research object. The changes in mechanical properties of yellow sandstone under the coupling action of chemical solution erosion and freeze‐thaw cycles are analyzed based on uniaxial compression tests (UCTs) and triaxial compression tests (TCTs). The results show that, with the increase in freeze‐thaw cycles, the compressive strength, elastic modulus, and cohesion of the sandstone samples decrease with varying degrees. Under constant freeze‐thaw cycles, the most serious mechanical properties of degradation are observed in acidic solution, followed by alkaline solution and neutral solution. Under different confining pressures, the compressive strength and elastic modulus of the sandstone samples decrease exponentially with the increase in freeze‐thaw cycles. Under the action of the chemical solution erosion and freeze‐thaw cycles, the internal friction angle fluctuates around 30°. For the cohesion degradation, 35.4%, 29.3%, and 27.2% degradation are observed under acidic, alkaline, and neutral solutions. Nuclear magnetic resonance imaging shows that the chemical erosion and freeze‐thaw cycles both promote the degradation of rock properties from surface to interior; after 45 freeze‐thaw cycles, the mechanical properties drop sharply. To properly design rock tunneling support and long‐term protection in the cold region, the impact of both freeze‐thaw cycles and chemical erosion should be considered.
Cell of Origin Influences Pancreatic Cancer Subtype
Authors: Flowers Brittany M. , Xu Hang , Mulligan Abigail S. , Hanson Kathryn J. , Seoane Jose A. , Vogel Hannes , Curtis Christina , Wood Laura D. , Attardi Laura D.
Published: March 2021

Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease with a 5-year survival rate of approximately 9%. An improved understanding of PDAC initiation and progression is paramount for discovering strategies to better detect and combat this disease. Although transcriptomic analyses have uncovered distinct molecular subtypes of human PDAC, the factors that influence subtype development remain unclear. Here, we interrogate the impact of cell of origin and different Trp53 alleles on tumor evolution, using a panel of tractable genetically engineered mouse models. Oncogenic KRAS expression, coupled with Trp53 deletion or point mutation, drives PDAC from both acinar and ductal cells. Gene-expression analysis reveals further that ductal cell–derived and acinar cell–derived tumor signatures are enriched in basal-like and classical subtypes of human PDAC, respectively. These findings highlight cell of origin as one factor that influences PDAC molecular subtypes and provide insight into the fundamental impact that the very earliest events in carcinogenesis can have on cancer evolution.

Significance:

Although human PDAC has been classified into different molecular subtypes, the etiology of these distinct subtypes remains unclear. Using mouse genetics, we reveal that cell of origin is an important determinant of PDAC molecular subtype. Deciphering the biology underlying pancreatic cancer subtypes may reveal meaningful distinctions that could improve clinical intervention.

This article is highlighted in the In This Issue feature, p. 521
Poorer Clinical Outcomes for Black Patients with AML: A Wake-Up Call for Better Data and Greater Understanding of Cancer Outcomes in All Ethnic Groups
Authors: Vyas Paresh
Published: March 2021

In this issue of Cancer Discovery, Bhatnagar and colleagues show that Black patients in the United States with acute myeloid leukemia have a shorter survival compared with white patients. This is an important paper as it addresses an under researched issue: the complex interaction of race, tumor genetics, socioeconomic factors, and access to treatment in defining treatment outcomes for a devastating cancer.

See related article by Bhatnagar et al., p. 626.
Genetic Ancestry Correlations with Driver Mutations Suggest Complex Interactions between Somatic and Germline Variation in Cancer
Authors: Gomez Felicia , Griffith Malachi , Griffith Obi L.
Published: March 2021

Carrot-Zhang and colleagues describe associations between Native American ancestry and the somatic mutational landscape in lung cancer, including tumor mutation burden and specific driver mutations in EGFR, KRAS, and STK11. Local ancestry analysis suggests that specific germline loci, and not environment, underlie these associations.

See related article by Carrot-Zhang et al., p. 591.
Rents and entitlements: reassessing Africa’s urban pasts and futures
Authors: Brennan James R.
Published: March 2021

This article considers recent literature on contemporary urbanization in Africa that is united in its ‘post-normative’ orientation, firmly discarding the ‘expectations’ of modernization that so deeply shaped twentieth-century research on African cities. Best typified by the work of urban anthropologists such as Abdoumaliq Simone, this scholarship instead focuses on the ‘vernacularization’ of urban structures and strategies in Africa. While such work has developed a host of new insights into the idiosyncratic nature of African urbanization, it has largely eschewed comparative analysis of enduring economic strategies that lie at the heart of the massive growth of African cities. By focusing on the longer-term historical role of such processes – namely urban rents and urban price regulations – this article suggests a more comparative framework for the study of urban Africa that still accounts for the otherwise seemingly hyper-local and idiosyncratic forms of urban livelihoods and strategies.
Women’s participation in decentralized local governance: the case of pastoral and non-pastoral women in Kondoa local authority, Tanzania
Authors: Misafi Haidari Pascal
Published: March 2021

This summary of my PhD thesis explains the reasons behind and the effects of pastoral and non-pastoral women’s participation in decentralized local governance in Tanzania. A body of knowledge exists on participation and gender in Tanzania. However, beyond plain statistics, there is limited information on women’s experiences in participation within decentralized local governance in the country. Two main theoretical streams exist in literature concerning participation and gender. One stream of literature argues that women’s descriptive participation leads to substantive women’s participation. The other stream argues that it is important to focus on what specific actors do to represent women’s concerns and not solely on women’s descriptive participation. The data analysed in this report were collected in Kondoa Local Authority, Tanzania. Within Kondoa, the two dominant women groups – pastoral women and non-pastoral women- were selected as case studies. Based on observations, interviews and focus group discussions, I have found that despite the presence of pastoral and non-pastoral women in governance, the quality of women participation is low. Both case studies reveal that women’s participation is mainly limited to their physical presence or the nominal level. Similarly, I have shown that the dynamics of women’s participation determine women’s descriptive and substantive participation in governance. Additionally, I have found that incentives, access to information and power relations significantly determine women’s presence in and contributions to governance. Moreover, women’s interest in local governance and their knowledge of the Kiswahili language are also determining factors behind their substantial participation in decision-making. Furthermore, I have found that women in governance have no impact on policy changes concerning women. A general conclusion in this report is that there is a mismatch between women in governance and participation. I argue that having women in governance does not guarantee participation. These results challenge both the women’s descriptive representation and women’s substantive representation theoretical perspectives. I therefore recommend that: (1) policies regarding women’s participation should be reconstructed to ensure not only an increase in women in governance but also that women in that position are able to act for women; (2) a holistic approach is required to understand underlying forces that determine the level and quality of women’s participation in governance; (3) interventions for enhancing women’s participation in governance should take into consideration unique dichotomies and peculiarities among women.
Filles déscolarisées et apprentissage des « métiers masculins » dans la ville de Kinshasa : quelle image sociale?
Authors: Alokpo Dieudonné Musa
Published: March 2021

In the city of Kinshasa there has been a marked increase in the numbers of women expressing an interest in jobs traditionally thought of as male occupations. The case of the out-of-school girls learning mechanics is a good illustration of this new phenomenon. In a society in which access to employment in the formal sector is saturated, apprenticeships organized in non-formal educational centers offer out-of-school girls the opportunity to develop practical skills that can be used immediately, and so help them create their own employment opportunities. The choice to learn the 'male occupation' of mechanics contrasts with the cultural conceptions about the boundaries between the female and male oriented work. Considering such a contrast, and the recurring political discourse concerning gender equality, which encourages women to integrate into all spheres of social activity, it is interesting to question the inhabitants of Kinshasa about the relevance of the occupation choices of the out-of-school girls and about their skill levels in the “male jobs” arena. The survey showed that the inhabitants of Kinshasa are against the division of work along gender lines and remain in favor of the idea that men and women should be able to pursue jobs according to their skills rather than their sex.
Forced and Child Marriage at the Intersection of Health, Gender and Human Rights: Understanding the Determinants in Morocco and the Impact of the Migratory Context in Belgium
Authors: Sabbe Alexia
Published: March 2021

With over 650 million women alive today already suffering the consequences of child marriage, the practice of forced and child marriage disproportionally affects girls and women. Given its impact on physical and psychological wellbeing, it is a serious form of violence against women.

In view of the global magnitude of forced and child marriage, and the increasing numbers of international migrants, the general objective of this research is to ascertain the determinants of forced and child marriage in Morocco and the impact of the migratory context on the issue among Moroccan migrants in Belgium.

Our research analysed forced and child marriage in both settings from two angles. First, we studied policies and the socio-cultural context in a top-down perspective through the analysis of legislation, public debates and through expert/stakeholder interviews. Secondly, we investigated the determinants of forced and child marriage in both research settings from a bottom-up perspective through Focus Group Discussions and household interviews, as well as investigating the impact of legislative conditions and restrictions on migrants and their families.
Genomic analysis of circulating tumor DNA in 3,334 patients with advanced prostate cancer to identify targetable BRCA alterations and AR resistance mechanisms.
Authors: Tukachinsky Hanna , Madison Russell , Chung Jon , Dennis Lucas , Fendler Bernard , Morley Samantha , Zhong Lei , Graf Ryon , Ross Jeffrey S. , Alexander Brian M , Abida Wassim , Chowdhury Simon , Ryan Charles J. , Fizazi Karim , Golsorkhi Anthony A. , Watkins Simon Paul , Simmons Andrew , Loehr Andrea , Venstrom Jeffrey , Oxnard Geoffrey R.
Published: March 2021

25

Background: Comprehensive genomic profiling (CGP) by next-generation sequencing (NGS) of circulating tumor DNA (ctDNA) from plasma provides a minimally invasive method to identify targetable genomic alterations (GAs) and resistance mechanisms in patients with metastatic castration-resistant prostate cancer (mCRPC). The circulating tumor fraction in patients with mCRPC and the clinical validity of GAs detected in plasma remain unknown. We evaluated the landscape of GAs using ctDNA-based CGP and assessed concordance with tissue-based CGP. Methods: Plasma from 3,334 patients with advanced prostate cancer (including 1,674 mCRPC screening samples from the TRITON2/3 trials and 1,660 samples from routine clinical CGP) was analyzed using hybrid-capture-based gene panel NGS assays. Results were compared with CGP of 2,006 metastatic prostate cancer tissue biopsies. Concordance was evaluated in 837 patients with both tissue (archival or contemporaneous) and plasma NGS results. Results: 3,127 patients [94%] had detectable ctDNA. BRCA1/2 were mutated in 295 patients [8.8%]. In concordance analysis, 72/837 [8.6%] patients had BRCA1/2 mutations detected in tissue, 67 [93%] of whom were also identified by ctDNA, and 20 patients were identified using ctDNA but not tissue [23% of all patients identified using ctDNA]. ctDNA detected subclonal BRCA1/2 reversions in 10 of 1,660 [0.6%] routine clinical CGP samples. AR alterations, including amplifications and hotspot mutations, which were detected in 940/2,213 patients [42%]. Rare AR compound mutations, rearrangements, and novel in-frame deletions were identified. Altered pathways included PI3K/AKT/mTOR [14%], WNT/β-catenin [17%], and RAS/RAF/MEK [5%]. Microsatellite instability was detected in 31/2,213 patients [1.4%]. Conclusions: In the largest study of mCRPC plasma samples conducted to date, CGP of ctDNA recapitulated the genomic landscape detected in tissue biopsies, with a high level of agreement in detection of BRCA1/2 alterations. It also identified patients who may have gained somatic BRCA1/2 alterations since archival tissue was collected. ctDNA detected more acquired resistance GAs than tissue, including novel AR-activating variants. The large percentage of patients with rich genomic signal from ctDNA, and the sensitive, specific detection of BRCA1/2 alterations position liquid biopsy as a compelling clinical complement to tissue CGP for patients with mCRPC.
A phase II study of onvansertib in combination with abiraterone and prednisone in patients with metastatic castration-resistant prostate cancer (mCRPC).
Authors: Einstein David Johnson , Choudhury Atish Dipankar , Saylor Philip James , Patterson Jesse Christopher , Croucher Peter , Ridinger Maya , Erlander Mark G. , Yaffe Michael B. , Bubley Glenn
Published: March 2021

TPS186

Background: Metastatic CRPC remains a leading cause of cancer-related deaths worldwide. Although abiraterone + prednisone (abi) in either the castration-sensitive or castration-resistant setting increases survival, resistance is universal and generally occurs within 9-16 months of initiating treatment. Polo-like kinase 1 (PLK1) is a serine/threonine protein kinase that regulates mitotic functions and progression, and it is highly upregulated in prostate cancer following castration. Onvansertib is an oral and highly-selective PLK1 inhibitor that demonstrated safety and tolerability in a Phase 1 trial. Preclinical studies showed that PLK1 inhibition enhanced abi efficacy in cell line models and in patient-derived tumor xenografts via an AR-independent mechanism. Transcriptomic analyses revealed that abi induced mitosis-related gene sets in cells synergistic for abi + onvansertib, and identified an abi-onvansertib synergy gene signature. Methods: The goal of this phase 2 study (NCT03414034) is to observe the effects of onvansertib in combination with abi on disease control, as assessed by prostate-specific antigen (PSA) decline or stabilization after 12 weeks of study treatment, in subjects with mCRPC and early resistance to abi. Patients are enrolled at time of PSA progression while on standard abi. Patients with prior treatment with enzalutamide or apalutamide are excluded. Three onvansertib dosing schedules are tested in noncomparative arms: arm A (24 mg/m2 on days 1-5 of a 21-day cycle), arm B (18 mg/m2 on days 1-5 of a 14-day cycle), and arm C (12 mg/m2 on days 1-14 of a 21-day cycle). The 3 arms have completed their safety-lead phases and expansion phases are ongoing. With 32 patients in each arm, there will be 90% power to detect a change in disease-control rate from 10% (null) to 30% (alternative). Based on a Simon’s two-stage optimal design, the study will terminate early if < 2 of the first 13 patients in each arm achieve disease control. Exploratory analyses include evaluation of the presence of the androgen receptor variant 7 (AR-V7) in circulating tumor cells and targeted genomic profiling of circulating tumor DNA to assess associations between genomic alterations and response to treatment. Additionally, transcriptomic analysis of archived tumor tissue will be performed to determine whether enrichment for gene expression signatures, such as the abi-onv synergy signature identified in preclinical models, could be used to predict clinical response. Clinical trial information: NCT03414034.
A single-blinded, multicenter, randomized controlled trial to evaluate NeuroSAFE robotic-assisted radical prostatectomy (RARP) versus standard robotic-assisted radical prostatectomy (RARP) in men with localized prostate cancer: NeuroSAFE PROOF—Trial in progress.
Authors: Dinneen Eoin , Grierson Jack , Haider Aiman , Freeman Alex , Aning Jonathan , Persad Rajendra , Oakley Neil , Ahmad Imran , Dutto Lorenzo , Shaw Greg ,   NeruoSAFE PROOF Research Group
Published: March 2021

TPS262

Background: Robot-assisted radical prostatectomy (RARP) offers cure for localised prostate cancer but is associated with considerable toxicity. Potency and urinary continence are improved when the neurovascular bundles (NVBs) are preserved during a nerve-sparing (NS) RARP. The NeuroSAFE (intra-operative frozen section examination of the neurovascular structure adjacent prostate margin) seeks to promote optimal NS to maximise the opportunity for functional recovery without jeopardising oncological safety. The NeuroSAFE technique in RP has never been evaluated against a standard of care in an randomised controlled trial. Methods: This is a pragmatic, multicentre, single-blinded randomised controlled trial (RCT) in which men are allocated in a 1:1 ratio to NeuroSAFE RARP or standard RARP. Men in the NeuroSAFE RARP arm will undergo RARP with NS guided by the NeuroSAFE technique. Men in the standard RARP arm will undergo RARP with NS guided by standard current practice (prostate cancer clinical characteristics, multi-parametric magnetic resonance imaging (mpMRI) recommendations and digital rectal examination (DRE)). Eligible men will have operable localised prostate cancer, will be opting for RARP as primary treatment and will have good baseline erectile function (EF) (as defined by an Internatinoal Index of Erectile Function (IIEF)-5 score >21). The primary outcome is the proportion of men who achieve EF recovery at 12-months according to the IIEF. Oncological safety will be ensured by the independent DMC who will routinely review proportions of men with treatment failure (adjuvant therapy or biochemical recurrence (BCR)) in each arm. A sample size of 404 is estimated required. NeuroSAFE PROOF will continue to follow participant recovery for 5 years following treatment. Key secondary outcomes include patient-reported urinary continence recovery, sexual satisfaction, quality of life, and economic analyses. NeuroSAFE PROOF will be the first RCT of frozen section in radical prostatectomy (RP) in the world. Ethics and dissemination: Ethical approval was obtained from the National Research Ethics Committee North London (17/LO/1978). Results of this study will be disseminated through national and international papers, and to study participants. Clinical trial information: NCT03317990.
Features of the audit of accounting statements of organizations for 2020 in the context of the spread of coronavirus infection
Authors: Dmitrieva I. , Kharakoz Yu.
Published: March 2021

The article considers main aspects and features of the audit in terms of the spread of coronavirus infection, the normative and methodical materials on carrying out of audit of financial statements for 2020 are reviewed, the main risks of distortion of financial statements are identified.
Insider Trading, Competition, and Real Activities Manipulation
Authors: Chen Hui , Jorgensen Bjorn N.
Published: March 2021

We consider a setting where managers manipulate the firms’ real activities in anticipation of insider trading opportunities. Managers choose strictly higher production quantities than the quantities chosen absent insider trading, implying lower firm profit but higher consumer surplus. Through comparative statics, we show the overproduction is mitigated by the degree of competition in the industry, the manager’s current equity stake in the firm, and the precision of cost information. We also analyze the effects of insider trading in several extensions including asymmetric ownership structure, potential horizontal merger, and common market maker.

This paper was accepted by Shiva Rajgopal, accounting.
Non-surgical removal of milia: treatment and aftercare
Authors: Huntley Gillian
Published: March 2021

Although harmless, milia—small, white spots most commonly found near the eyes—are a cosmetic concern and must be removed safely by a trained professional. Gillian Huntley details the types of milia and explains how they are treated
Activities for resident wellbeing
Authors: Hong Chia Swee
Published: March 2021

Keeping residents active is critical to overall health, especially in times where their freedom of movement might be restricted. Chia Swee Hong provides the eighth instalment of his series on resident engagement.
In vitro analyses of Artemisia extracts on Plasmodium falciparum suggest a complex antimalarial effect
Authors: Gruessner Brian M. , Weathers Pamela J.
Published: March 2021

Dried-leaf Artemisia annua L. (DLA) antimalarial therapy was shown effective in prior animal and human studies, but little is known about its mechanism of action. Here IC50s and ring-stage assays (RSAs) were used to compare extracts of A. annua (DLAe) to artemisinin (ART) and its derivatives in their ability to inhibit and kill Plasmodium falciparum strains 3D7, MRA1252, MRA1240, Cam3.11 and Cam3.11rev in vitro. Strains were sorbitol and Percoll synchronized to enrich for ring-stage parasites that were treated with hot water, methanol and dichloromethane extracts of DLA, artemisinin, CoArtem™, and dihydroartemisinin. Extracts of A. afra SEN were also tested. There was a correlation between ART concentration and inhibition of parasite growth. Although at 6 hr drug incubation, the RSAs for Cam3.11rev showed DLA and ART were less effective than high dose CoArtem™, 8 and 24 hr incubations yielded equivalent antiparasitic results. For Cam3.11, drug incubation time had no effect. DLAe was more effective on resistant MRA-1240 than on the sensitive MRA-1252 strain. Because results were not as robust as observed in animal and human studies, a host interaction was suspected, so sera collected from adult and pediatric Kenyan malaria patients was used in RSA inhibition experiments and compared to sera from adults naïve to the disease. The sera from both age groups of malaria patients inhibited parasite growth ≥ 70% after treatment with DLAe and compared to malaria naïve subjects suggesting some host interaction with DLA. The discrepancy between these data and in-vivo reports suggested that DLA’s effects require an interaction with the host to unlock their potential as an antimalarial therapy. Although we showed there are serum-based host effects that can kill up to 95% of parasites in vitro, it remains unclear how or if they play a role in vivo. These results further our understanding of how DLAe works against the malaria parasite in vitro.
The interplay of sleep duration, working hours, and obesity in Korean male workers: The 2010–2015 Korea National Health and Nutrition Examination Survey
Authors: Eum Mi-Jung , Jung Hye-Sun
Published: March 2021

The purpose of this study was to clarify the odds ratio for association between working hours and obesity in Korean male wage workers and investigate the role of sleep duration. This study is a cross-sectional one using large-scale national data from the Korea National Health and Nutrition Examination Survey collected between 2010 and 2015 to evaluate 2,592 male wage workers (between the ages of 19 and 60 years). Obesity was defined as 25kg/m2 or more and working hours per week were categorized into <40, 40–49, 50–59, and ≥60 hours. Multiple regression analysis was performed to examine the odds ratio for association between working hours and obesity, after controlling for age, education, income, marital status, smoking, drinking, physical activity, daily energy intake, sleep duration, hypertension, diabetes, dyslipidemia, work schedule, and job category. Next, to study the mediating effect of sleep duration on the association between working hours and obesity, an analysis was performed using the Baron and Kenny method and the Sobel test. Results showed that workers with 50 to 59 hours had 1.4 times higher odds (odds ratio [OR] = 1.4, confidence interval [CI]: 1.11–1.85) of obesity and workers with 60 hours or more had 1.4 times higher odds (OR = 1.4, CI: 1.06–1.90) of obesity than workers with less than 40 hours. Sleep was found to have a mediating effect on the association between working time and body mass index. Therefore, the results of this analysis suggest that practitioners should identify potential factors such as working time and sleeping time when preventing work-related obesity.
Rare Case of Unilateral Disc Oedema Secondary to Idiopathic Intracranial Hypertension
Authors: Kiran Kher Praveena , Motwani Jigna Mukesh , Daigavane Sachin Vishwanath
Published: March 2021

Majority of idiopathic intracranial hypertension (IIH) cases present with bilateral papilloedema. Unilateral papilloedema is a rare condition in IIH. This is a report of one such unusual case. Papilloedema is clinically defined as swelling of the optic nerve head secondary to raised intracranial pressure.1 Disc oedema is a non-specific term that includes papilloedema but also refers to a disc swollen from other causes. Classically, presence of papilloedema is most commonly due to an intracranial space occupying lesion leading to raised intracranial pressure; however, it may be caused due to other aetiologies such as hydrocephalus, shunt failures, idiopathic intracranial hypertension and drugs.2 Idiopathic intracranial hypertension, also known as pseudotumour cerebri, is a disorder characterised by increased intracranial pressure of unclear pathogenesis in the absence of other structural and obstructive lesions. This is a case of acute established unilateral disc oedema secondary to idiopathic intracranial hypertension.