bluuebunny/crossref_metadata_2025 huggingface dataset:
Age Takes Hold of Us by Surprise: Conceptualizing Vulnerabilities in Aging as the Timing of Adverse Events
Authors: Vanhoutte Bram
Published: July 2019

Objectives: Aging in the public eye can be distilled to a limited number of adverse events, such as loss of health, partnership and wealth. While these events are a constitutive part of “normal aging,” they do not occur uniformly at the same time point in the life course. This study investigates to what extent bereavement, functional health loss, and onset of poverty are adequate markers of aging, and illustrates inequalities in their timing according to cohort, gender, class, education, and ethnicity.

Methods: The English Longitudinal Study of Ageing (ELSA), collected over seven waves (2002–2016) (n = 7,890) is examined in an event history framework. Cox proportional hazard models are used with the Andersen Gill extension in case of multiple failures per respondent.

Results: Persistent associations of lower occupational class, lower education, and having a black or minority ethnic background are found with increased hazards of functional health loss and wealth loss. Earlier born cohorts have lower hazards for functional health loss, wealth loss, and bereavement. Women have higher hazards for bereavement, and lower hazards for wealth loss.

Discussion: The timing of adverse events is a crucial gateway through which existing social inequalities are transferred into unequal aging pathways.
“… Above All, It’s a Matter of  This Person’s Quality of Life”: Health Care Professionals’ Perspectives on Deprescribing in Older Patients With Limited Life Expectancy
Authors: Lundby Carina , Graabæk Trine , Ryg Jesper , Søndergaard Jens , Pottegård Anton , Nielsen Dorthe Susanne
Published: July 2019

Background and Objectives

Deprescribing may be particularly relevant in older people with limited life expectancy. In order to effectively carry out deprescribing in this population, it is important to understand the perspectives of the full spectrum of health care professionals (HCPs) involved in the management of these patients’ medication. Thus, we aimed to explore different HCPs’ perspectives on deprescribing in older patients with limited life expectancy.

Research Design and Methods

Six qualitative focus group interviews were conducted using a semistructured approach. The groups comprised HCPs from both primary and secondary care, including family physicians (FPs), geriatricians, clinical pharmacologists, clinical pharmacists, nurses, and health care assistants. Interviews were audio recorded and transcribed verbatim. Results were analyzed using systematic text condensation.

Results

A total of 32 HCPs participated in the study (median age of 40.5 years; 22% male). The analysis elicited three main themes related to HCPs’ perspectives on deprescribing in older patients with limited life expectancy: (a) Approaching deprescribing, (b) Taking responsibility, and (c) Collaboration across professions. Within themes, subthemes were identified and analyzed.

Discussion and Implications

Our results imply that different groups of HCPs consider deprescribing an essential aspect of providing good care for older people with limited life expectancy and find that all HCPs play a crucial role in the deprescribing process, with FPs having the primary responsibility. In order to facilitate deprescribing among this population, however, the collaboration between different HCPs should be improved.
A physically based model for the electrical conductivity of water-saturated porous media
Authors: Duy Thanh Luong , Jougnot Damien , Van Do Phan , Van Nghia A Nguyen
Published: July 2019

Electrical conductivity is one of the most commonly used geophysical method for reservoir and environmental studies. Its main interest lies in its sensitivity to key properties of storage and transport in porous media. Its quantitative use therefore depends on the efficiency of the petrophysical relationship to link them. In this work, we develop a new physically based model for estimating electrical conductivity of saturated porous media. The model is derived assuming that the porous media is represented by a bundle of tortuous capillary tubes with a fractal pore-size distribution. The model is expressed in terms of the porosity, electrical conductivity of the pore liquid and the microstructural parameters of porous media. It takes into account the interface properties between minerals and pore water by introducing a surface conductivity. Expressions for the formation factor and hydraulic tortuosity are also obtained from the model derivation. The model is then successfully compared with published data and performs better than previous models. The proposed approach also permits to relate the electrical conductivity to other transport properties such as the hydraulic conductivity.
Removing mantle lithosphere under orogens: delamination versus convective thinning
Authors: Lei Tian , Li Zhong-Hai , Liu Mian
Published: July 2019

Thinning of the lithosphere under continental collisional orogens is often attributed to delamination or convective thinning. Both processes remove part or all of the mantle lithosphere that has become denser and gravitationally unstable. Previous studies mostly focused on the different thermomagmatic consequences of these two processes; the dynamic links between them, and the critical conditions for one or the other process to dominate lithosphere thinning, remain uncertain. Here, we used high-resolution thermomechanical models with various rheology (linear viscous, power-law viscous and/or the extended Drucker–Prager plasticity) to systematically investigate the dynamics of delamination and convective thinning under collisional orogens. Our results show that convective thinning is favoured in models of linear (Newtonian) viscous rheology and low viscosity $({10^{19}}\!-\! {10^{20}}\,\,{\rm{Pa}} \, {\rm{s}})$. Power-law viscous rheology promotes strain localization, which reduces the effective viscosity and may lead to localized rising of the asthenosphere to the crustal base, thus triggering delamination. Further strain localization and stronger delamination are predicted with inclusion of plastic rheology in the model. These results indicate that convective thinning and delamination are dynamically linked and can occur in the same orogeny. Their relative dominance during orogenesis may be distinguished by the resulting spatiotemporal evolutions of thermal perturbation, magmatism and elevation changes. We applied the models to show that the evolution of the Central Anatolian Plateau is consistent with the dominance of convective thinning, whereas delamination played a major role in thinning the mantle lithosphere under central-northern Tibetan Plateau.
Upper-mantle density structure in the Philippine Sea and adjacent region and its relation to tectonics
Authors: Liang Qing , Chen Chao , Kaban Mikhail K , Thomas Maik
Published: July 2019

The evolution of the Philippine Sea Plate (PSP) since Jurassic is one of the key issues in the dynamics of lithosphere and mantle. The related studies benefited mostly from seismic tomography which provides velocity structures in the upper mantle. However, the upper-mantle structure is not well resolved compared to the continental areas due to the lack of seismic data in the Philippine Sea. We employ a 3-D gravity inversion constrained by an initial model based on the S-wave tomography (SL2013sv; Schaeffer & Lebedev 2013) to image the density structure of the upper mantle of the PSP and adjacent region. The resulting model shows a three-layer pattern of vertical high-low-high density variation in the upper mantle under the PSP. The thin high-density layer evidences for strong oceanic lithosphere in the West Philippine Sea. The relatively low dense mantle located below the PSP possibly originates from the asthenosphere. The PSP differs from the Pacific and the Indian-Australian plates in the whole depth range, while its structure is similar to the eastern Eurasian and Sunda plates. In the depth range, 200–300 km, the relative high-density zone beneath PSP extends to the Sunda Plate and to the eastern Eurasian Plate. We further estimated the conversion factor of our density model and the velocity model (SL2013sv; Schaeffer & Lebedev 2013) in order to locate the changes of compositional effects in the upper mantle. The negative conversion factor indicates that the compositional changes primarily affect the density anomalies beneath the PSP. We, therefore, describe the layered density structures as ‘sandwich’ pattern, which is unique and different from adjacent regions.
Semirational design and engineering of grapevine glucosyltransferases for enhanced activity and modified product selectivity
Authors: Joshi Rakesh , Trinkl Johanna , Haugeneder Annika , Härtl Katja , Franz-Oberdorf Katrin , Giri Ashok , Hoffmann Thomas , Schwab Wilfried
Published: July 2019

Uridine diphosphate-dependent glycosyltransferases (UGTs) catalyze the transfer of a diversity of sugars to several acceptor molecules and often exhibit distinct substrate specificity. Modulation of glycosyltransferases for increased catalytic activity and altered substrate or product specificity are the key manipulations for the biotechnological use of glycosyltransferases in various biosynthetic processes. Here, we have engineered the binding pocket of three previously characterized Vitis vinifera glycosyltransferases, UGT88F12, UGT72B27 and UGT92G6, by structure-guided in silico mutagenesis to facilitate the interactions of active site residues with flavonol glucosides and thus modify substrate specificity and activity. Site-directed mutagenesis at selected sites, followed with liquid chromatography–mass spectrometry based activity assays, exhibited that mutant UGTs were altered in product selectivity and activity as compared to the wild-type enzymes. Mutant UGTs produced larger amounts of flavonol di-monosaccharide glucosides, which imply that the mutations led to structural changes that increased the volume of the binding pocket to accommodate a larger substrate and to release larger products at ease. Mutants showed increased activity and modified product specificity. Thus, structure-based systematic mutations of the amino acid residues in the binding pocket can be explored for the generation of engineered UGTs for diverse biotechnological applications.
Financial protection and equity of access to health services with the free maternal and child health initiative in Lao PDR
Authors: Nagpal Somil , Masaki Emiko , Pambudi Eko Setyo , Jacobs Bart
Published: July 2019

Though Lao People’s Democratic Republic (Lao PDR) has made considerable progress in improving maternal and child health (MCH), significant disparities exist nationwide, with the poor and geographically isolated ethnic groups having limited access to services. In its pursuit of universal health coverage, the government introduced a Free MCH initiative in 2011, which has recently been subsumed within the new National Health Insurance (NHI) programme. Although this was a major national health financing reform, there have been few evaluations of the extent to which it improved equitable access to MCH services. We analyse surveys that provide information on demand-side and supply-side factors influencing access and utilization of free MCH services, especially for vulnerable groups. This includes two rounds of household surveys (2010 and 2013) in southern Lao PDR involving, respectively 2766 and 2911 women who delivered within 24 months prior to each survey. These data have been analysed according to the socio-economic status, geographic location and ethnicity of women using the MCH services as well as any associated out-of-pocket expenses and structural quality of these services. Two other surveys analysed here focused on human resources for health and structural quality of health facilities. Together, these data point to persistent large inequities in access and financial protection that need to be addressed. Significant differences were found in the utilization of health services by both economic status and ethnicity. Relatively large costs for institutional births were incurred by the poor and did not decline between 2010 and 2013 whereby there was no significant impact on financial protection. The overall benefit incidence of the universal programme was not pro-poor. The inequity was accentuated by issues related to distribution and nature of human resources, supply-side readiness and thus quality of care provided across different geographical areas.
How to do (or not to do) … using the standardized patient method to measure clinical quality of care in LMIC health facilities
Authors: King Jessica J C , Das Jishnu , Kwan Ada , Daniels Benjamin , Powell-Jackson Timothy , Makungu Christina , Goodman Catherine
Published: July 2019

Standardized patients (SPs), i.e. mystery shoppers for healthcare providers, are increasingly used as a tool to measure quality of clinical care, particularly in low- and middle-income countries where medical record abstraction is unlikely to be feasible. The SP method allows care to be observed without the provider’s knowledge, removing concerns about the Hawthorne effect, and means that providers can be directly compared against each other. However, their undercover nature means that there are methodological and ethical challenges beyond those found in normal fieldwork. We draw on a systematic review and our own experience of implementing such studies to discuss six key steps in designing and executing SP studies in healthcare facilities, which are more complex than those in retail settings. Researchers must carefully choose the symptoms or conditions the SPs will present in order to minimize potential harm to fieldworkers, reduce the risk of detection and ensure that there is a meaningful measure of clinical care. They must carefully define the types of outcomes to be documented, develop the study scripts and questionnaires, and adopt an appropriate sampling strategy. Particular attention is required to ethical considerations and to assessing detection by providers. Such studies require thorough planning, piloting and training, and a dedicated and engaged field team. With sufficient effort, SP studies can provide uniquely rich data, giving insights into how care is provided which is of great value to both researchers and policymakers.
Client perspectives on an outreach approach for HIV prevention targeting Indonesian MSM and transwomen
Authors: Nugroho Adi , Erasmus Vicki , Krier Sarah E , Reviagana Kusnindyah P , Laksmono Pipiet A , Widihastuti Asti , Richardus Jan Hendrik
Published: July 2019

This study explored clients’ perspective on an outreach approach to promote HIV testing in Indonesia targeting men who have sex with men (MSM) and transgender women (transwomen or waria). Semi-structured qualitative interviews were conducted with 32 individuals (21 MSM and 11 waria) who had received services from outreach workers (OWs) in five cities in Indonesia. Participants in this study reported positive experiences with the outreach approach and perceived OWs as their motivators in accessing HIV testing as well as HIV care and treatment. OWs provided easy-to-understand HIV information. Clients expected OWs to be well-trained and more creative in performing outreach. They perceived that the Internet and social media have helped them considerably to stay in touch with OWs. Yet, they expressed that such virtual contacts could not simply replace the face-to-face contact, especially for waria. Furthermore, clients suggested outreach to be delivered in a more appealing manner, for example through activities that may facilitate clients learning professional or life skills. They also asserted that as an HIV prevention approach, outreach needs to use more positive framing and go beyond HIV and health contents, chiefly for the youth. Future outreach programmes should facilitate OWs in providing tailored services based on the level and type of support that the clients need, and in applying varied proportion and levels of sophistication in the use of online and virtual platforms for outreach.
Synapse diversity and synaptome architecture in human genetic disorders
Authors: Grant Seth G N
Published: July 2019

Over 130 brain diseases are caused by mutations that disrupt genes encoding the proteome of excitatory synapses. These include neurological and psychiatric disorders with early and late onset such as autism, schizophrenia and depression and many other rarer conditions. The proteome of synapses is highly complex with over 1000 conserved proteins which are differentially expressed generating a vast, potentially unlimited, number of synapse types. The diversity of synapses and their location in the brain are described by the synaptome. A recent study has mapped the synaptome across the mouse brain, revealing that synapse diversity is distributed into an anatomical architecture observed at scales from individual dendrites to the whole systems level. The synaptome architecture is built from the hierarchical expression and assembly of proteins into complexes and supercomplexes which are distributed into different synapses. Mutations in synapse proteins change the synaptome architecture leading to behavioral phenotypes. Mutations in the mechanisms regulating the hierarchical assembly of the synaptome, including transcription and proteostasis, may also change synapse diversity and synaptome architecture. The logic of synaptome hierarchical assembly provides a mechanistic framework that explains how diverse genetic disorders can converge on synapses in different brain circuits to produce behavioral phenotypes.
Pax7, Pax3 and Mamstr genes are involved in skeletal muscle impaired regeneration of dy2J/dy2J mouse model of Lama2-CMD
Authors: Yanay Nurit , Elbaz Moran , Konikov-Rozenman Jenya , Elgavish Sharona , Nevo Yuval , Fellig Yakov , Rabie Malcolm , Mitrani-Rosenbaum Stella , Nevo Yoram
Published: July 2019

Congenital muscular dystrophy type-1A (Lama2-CMD) and Duchenne muscular dystrophy (DMD) result from deficiencies of laminin-α2 and dystrophin proteins, respectively. Although both proteins strengthen the sarcolemma, they are implicated in clinically distinct phenotypes. We used RNA-deep sequencing (RNA-Seq) of dy2J/dy2J, Lama2-CMD mouse model, skeletal muscle at 8 weeks of age to elucidate disease pathophysiology. This study is the first report of dy2J/dy2J model whole transcriptome profile. RNA-Seq of the mdx mouse model of DMD and wild-type (WT) mouse was carried as well in order to enable a novel comparison of dy2J/dy2J to mdx. A large group of shared differentially expressed genes (DEGs) was found in dy2J/dy2J and mdx models (1834 common DEGs, false discovery rate [FDR] < 0.05). Enrichment pathway analysis using ingenuity pathway analysis showed enrichment of inflammation, fibrosis, cellular movement, migration and proliferation of cells, apoptosis and necrosis in both mouse models (P-values 3E-10–9E-37). Via canonical pathway analysis, actin cytoskeleton, integrin, integrin-linked kinase, NF-kB, renin–angiotensin, epithelial–mesenchymal transition, and calcium signaling were also enriched and upregulated in both models (FDR < 0.05). Interestingly, significant downregulation of Pax7 was detected in dy2J/dy2J compared to upregulation of this key regeneration gene in mdx mice. Pax3 and Mamstr genes were also downregulated in dy2J/dy2J compared to WT mice. These results may explain the distinct disease course and severity in these models. While the mdx model at that stage shows massive regeneration, the dy2J/dy2J shows progressive dystrophic process. Our data deepen our understanding of the molecular pathophysiology and suggest new targets for additional therapies to upregulate regeneration in Lama2-CMD.
CFAP70 mutations lead to male infertility due to severe astheno-teratozoospermia. A case report
Authors: Beurois Julie , Martinez Guillaume , Cazin Caroline , Kherraf Zine-Eddine , Amiri-Yekta Amir , Thierry-Mieg Nicolas , Bidart Marie , Petre Graciane , Satre Véronique , Brouillet Sophie , Touré Aminata , Arnoult Christophe , Ray Pierre F , Coutton Charles
Published: July 2019

The use of high-throughput sequencing techniques has allowed the identification of numerous mutations in genes responsible for severe astheno-teratozoospermia due to multiple morphological abnormalities of the sperm flagella (MMAF). However, more than half of the analysed cases remain unresolved suggesting that many yet uncharacterised gene defects account for this phenotype. Based on whole-exome sequencing data from a large cohort of 167 MMAF-affected subjects, we identified two unrelated affected individuals carrying a homozygous deleterious mutation in CFAP70, a gene not previously linked to the MMAF phenotype. One patient had a homozygous splice variant c.1723-1G>T, altering a consensus splice acceptor site of CFAP70 exon 16, and one had a likely deleterious missense variant in exon 3 (p.Phe60Ile). The CFAP70 gene encodes a regulator protein of the outer dynein arms (ODA) strongly expressed in the human testis. In the sperm cells from the patient carrying the splice variant, immunofluorescence (IF) experiments confirmed the absence of the protein in the sperm flagellum. Moreover, IF analysis showed the absence of markers for the ODAs and the central pair complex of the axoneme. Interestingly, whereas CFAP70 staining was present in sperm cells from patients with mutations in the three other MMAF-related genes ARMC2, FSIP2 and CFAP43, we observed an absence of staining in sperm cells from patients mutated in the WDR66 gene, suggesting a possible interaction between two different axonemal components. In conclusion, this work provides the first evidence that loss of CFAP70 function causes MMAF and that ODA-related proteins may be crucial for the assembly and/or stability of the flagellum axoneme in addition to its motility.
Deep neural networks for analysis of fisheries surveillance video and automated monitoring of fish discards
Authors: French Geoff , Mackiewicz Michal , Fisher Mark , Holah Helen , Kilburn Rachel , Campbell Neil , Needle Coby
Published: July 2019

We report on the development of a computer vision system that analyses video from CCTV systems installed on fishing trawlers for the purpose of monitoring and quantifying discarded fish catch. Our system is designed to operate in spite of the challenging computer vision problem posed by conditions on-board fishing trawlers. We describe the approaches developed for isolating and segmenting individual fish and for species classification. We present an analysis of the variability of manual species identification performed by expert human observers and contrast the performance of our species classifier against this benchmark. We also quantify the effect of the domain gap on the performance of modern deep neural network-based computer vision systems.
Effect of postoperative haemoglobin variation on major cardiopulmonary complications in high cardiac risk patients undergoing anatomical lung resections
Authors: Patella Miriam , Mongelli Francesco , Minerva Eleonora Maddalena , Previsdomini Marco , Perren Andreas , Saporito Andrea , La Regina Davide , Gavino Lorenzo , Inderbitzi Rolf , Cafarotti Stefano
Published: July 2019

OBJECTIVES

Recent evidence shows that permissive anaemia strategies are safe in different surgical settings. However, effects of variations in haemoglobin (Hb) levels could have a negative impact in high-risk patients. We investigated the combined effect of postoperative Hb concentration and cardiac risk status on major cardiopulmonary complications after anatomical lung resections.

METHODS

We retrospectively analysed the records, collected in a prospective clinical database, of 154 consecutive patients undergoing anatomical lung resections at our institution (February 2017–February 2019). Hb levels were displayed as preoperative concentration, nadir Hb level before onset of complications and delta Hb (ΔHb). Cardiac risk was stratified according to the Thoracic Revised Cardiac Risk Index (ThRCRI). Univariable and multivariable logistic regression analyses were used to test the associations between patients, surgical variables and cardiopulmonary complications according to the European Society of Thoracic Surgeons definitions.

RESULTS

Cardiopulmonary complications occurred in 63 patients (17%). In the fully adjusted multivariable model, higher values of ΔHb were associated with increased risk of complications [odds ratio (OR) 1.07; P < 0.001], along with higher ThRCRI classes (classes A–B versus C–D: OR 0.09; P < 0.001). Interaction terms with transfusion were not statistically significant, indicating that the harmful effect of ΔHb was independent. According to receiver operating characteristic curve analysis, a ΔHb of 29 g/l was found to be the best cut-off value for predicting complications.

CONCLUSIONS

In our series, ΔHb, rather than nadir Hb, was associated with an increased risk of complications, particularly in patients with higher cardiac risk. Restrictive transfusion strategies should be carefully applied in patients undergoing lung resections and balanced according to individual clinical status.
A study on CO2 absorption using hybrid solvents in packed columns
Authors: Kumar Ravinder , Ahmadi Mohammad Hossein , Rajak Dipen Kumar , Nazari Mohammad Alhuyi
Published: July 2019

Greenhouse gases emissions from large scale industries as well as gasoline based vehicles are mainly responsible for global warming since the 1980s. At present, it has triggered global efforts to reduce the level of GHG. The contribution of carbon dioxide (CO2) in polluting the environment is at a peak due to the excessive use of coal in power plants. So, serious attention is required to reduce the level of CO2 using advanced technologies. Carbon dioxide capture and storage may play an important role in this direction. In process industries, various carbon dioxide capture techniques can be used to reduce CO2 emissions. However, post-combustion carbon dioxide capture is on top priority. Nowadays the researcher is focusing their work on CO2 capture using hybrid solvent. This work highlights a review of carbon dioxide capture using various kind of hybrid solvent in a packed column. The various challenges for absorption efficiency enhancement and future direction are also discussed in the present work. It is concluded through the literature survey that hybrid solvent shows better efficiency in comparison to the aqueous solution used for CO2 capture.
On the Fourier Transform of Regularized Bessel Functions on Complex Numbers and Beyond Endoscopy Over Number Fields
Authors: Qi Zhi
Published: July 2019

In this article, we prove certain Weber–Schafheitlin-type integral formulae for Bessel functions over complex numbers. A special case is a formula for the Fourier transform of regularized Bessel functions on complex numbers. This is applied to extend the work of A. Venkatesh on Beyond Endoscopy for $\textrm{Sym}^2$ on $\textrm{GL}_2$ from totally real to arbitrary number fields.
The Contribution of the ILO’s International Labour Standards System to the European Court of Human Rights’ Jurisprudence in the Field of Non-Discrimination
Authors: Teklè Tzehainesh
Published: July 2019

This article examines the role played by International Labour Standards (ILS) of the International Labour Organisation (ILO) and the pronouncements of the ILO supervisory bodies in the development of the European Court of Human Rights (ECtHR)’s jurisprudence by focussing on the ECtHR’s case law on discrimination. This analysis is conducted against the background of the role that the ECtHR has been playing in making the European Convention of Human Rights (ECHR) an instrument that protects not only civil and political rights but also social and economic rights, and its consideration of the ECHR as a ‘living’ document. This study concludes with a reflection on the benefits of the ECtHR’s use of ILS and the work of the ILO supervisory bodies and challenges ahead.
Understanding profit margins of medical providers from prescription drugs: evidence from Taiwan
Authors:  Liu Ya-Ming
Published: July 2019

Background

This study empirically estimates the magnitude and associated determinants of profit margins that medical providers earn from prescription drugs based on Taiwan’s pharmaceutical market.

Methods

Our main data set is from the population-based claims data compiled by the National Health Insurance Research Database covering three waves of price adjustment: July–December 2004, October 2007–September 2008 and October 2009–September 2010. Only drugs whose reimbursement prices were adjusted using the R-zone formula were used as samples for this study. By calculating the difference between retail and wholesale prices for 796 pharmaceutical products, we can estimate the profit margin determinants using the regression model.

Results

We found evidence that suppliers of generic drugs tend to offer larger discounts to medical providers than suppliers of brand-name drugs. In addition, the countervailing power of wholesale pharmaceuticals, as measured by the discount rate offered by pharmaceutical manufacturers, is positively associated with the degree of competition within the pharmaceutical market and the size of the market itself.

Conclusions

Our findings imply that the profit-seeking behaviour exhibited by medical providers is the engine of competitive forces in Taiwan’s prescription drug market. This creates financial incentives for them, which in turn influences their choices of prescription drugs.
Does involving male partners in antenatal care improve healthcare utilisation? Systematic review and meta-analysis of the published literature from low- and middle-income countries
Authors: Suandi Dedih , Williams Pauline , Bhattacharya Sohinee
Published: July 2019

Background

Although in most low- and middle-income countries (LMICs) men are decision makers and control the household budget, their involvement in maternity care is limited. Reports from high-income countries indicate a beneficial effect of involving men in antenatal and delivery care on birth outcomes.

Methods

We conducted a systematic review to assess whether similar effects are observed in LMICs. We searched MEDLINE, PubMed, CINAHL, Embase, NCBI, PsycInfo and other relevant databases using a comprehensive search strategy to retrieve relevant articles. A total of 17 articles were included. Meta-analysis of extracted data was performed, using the generic inverse variance method where possible. All studies were conducted in South Asia and Africa.

Results

We found that involving a male partner in antenatal care was associated with skilled birth attendance utilization (pooled OR 3.19 [95% CI 1.55 to 6.55]), having institutional delivery (OR 2.76 [95% CI 1.70 to 4.50]) and post-partum visit uptake (OR 2.13 [95% CI 1.45 to 3.13]). Mother’s knowledge of danger signs and modern contraception utilization were also positively affected. However, it had no significant impact on the number of antenatal visits.

Conclusions

Male involvement in antenatal care had a positive impact on the uptake of maternal health services. Further research needs to investigate whether this translates into improved maternal and newborn health in developing countries.
The effect of migration and the hukou registration system on psychosocial domains and family functioning of children in Shanghai, China
Authors: Wang Jian , Gu Shenbing , Ye Bo , Gao Junling , Wang Fan , Dai Junming , Fu Hua
Published: July 2019

Background

According to the 2017 China National Education Development Statistics Bulletin, there were 14.07 million rural–urban migrant children in the compulsory education stage. The mental health of migrant children in China has drawn increasing attention in research. The objective of this study was to compare subjective well-being, self-esteem, prosocial behaviour and family functioning of migrant children vs local children in Shanghai and to explore their relationship.

Methods

A survey was conducted among 2229 students (9–17 y of age; male 52.0%, female 48.0%) and their parents from grades 4 to 8 in four primary schools and four middle schools in Shanghai in 2016. The sample consisted of 1333 migrant children and 896 urban children in three migrant schools and five public schools. A total of 959 rural–urban migrant children and 374 urban hukou migrant children were recruited. The questionnaire for students included the Personal Well-Being Index – School Children (PWI-SC), Satisfaction with Life Scale (SWLS), Positive and Negative Affect Scale for Children, Rosenberg Self-Esteem Scale, Family APGAR Index and prosocial behaviour domain of the Strengths and Difficulties Questionnaire. In the questionnaire for parents, the Personal Well-Being Index and Social Support Rating Scale were used in addition to the sociodemographic characteristics. These data were analysed using one-way analysis of variance, correlation analysis and multiple linear regression.

Results

Rural–urban migrant children reported significantly lower PWI-SC, SWLS, positive affect, prosocial behaviour, self-esteem and Family APGAR Index scores and reported higher negative affect scores than local children (p<0.01). The prevalence rate of abnormal prosocial behaviour among rural–urban migrant children was 10%, which was higher than that of local children (5.9%; p<0.001). Compared with rural–urban migrant children in public schools, the SWLS, prosocial behaviour and Family APGAR Index scores of the children in migrant schools were higher and the prevalence rate of abnormal prosocial behaviour was lower (p<0.01). Multiple linear regression analysis indicated that the self-esteem and Family APGAR Index had predictive effects on subjective well-being and prosocial behaviour scores of rural–urban migrant children.

Conclusions

Rural–urban migrant children are susceptible to mental health problems. Additional public policy and interventions by practitioners are needed to support rural–urban migrant children.
Switching to bictegravir/emtricitabine/tenofovir alafenamide maintained HIV-1 RNA suppression in participants with archived antiretroviral resistance including M184V/I
Authors: Andreatta Kristen , Willkom Madeleine , Martin Ross , Chang Silvia , Wei Lilian , Liu Hui , Liu Ya-Pei , Graham Hiba , Quirk Erin , Martin Hal , White Kirsten L
Published: July 2019

Objectives

Studies 1878 and 1844 demonstrated non-inferior efficacy of switching suppressed HIV-1-infected adults to bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) versus continuing boosted PI-based triple regimens or dolutegravir/abacavir/lamivudine (DTG/ABC/3TC). Here, detailed analyses of pre-existing resistance in the two BIC/FTC/TAF switch studies and efficacy at week 48 are described.

Methods

Pre-existing resistance was assessed from historical genotypes (documented resistance to study drugs was excluded) and by retrospective baseline proviral archive DNA genotyping from whole blood. Outcomes were based on HIV-1 RNA at week 48 with missing values imputed using the last on-treatment observation carried forward method.

Results

Cumulative pre-existing resistance data from historical and proviral genotypes were obtained for 95% (543/570) of participants who switched to BIC/FTC/TAF. Altogether, 40% (217/543) had one or more pre-existing primary resistance substitutions in protease, reverse transcriptase and/or integrase. Pre-switch NRTI resistance was detected in 16% (89/543) of BIC/FTC/TAF-treated participants, with M184V or M184I detected by proviral genotyping in 10% (54/543). At week 48, 98% (561/570) of all BIC/FTC/TAF-treated participants versus 98% (213/217) with pre-existing resistance and 96% (52/54) with archived M184V/I had HIV-1 RNA <50 copies/mL. No BIC/FTC/TAF-treated participants developed treatment-emergent resistance to study drugs.

Conclusions

Pre-existing resistance substitutions, notably M184V/I, were unexpectedly common among suppressed participants who switched to BIC/FTC/TAF. High rates of virological suppression were maintained in the overall study population and in those with pre-existing resistance, including M184V/I, for up to 48 weeks of BIC/FTC/TAF treatment with no resistance development. These results indicate that BIC/FTC/TAF is an effective treatment option for suppressed patients, including those with evidence of archived NRTI resistance.
An unexpectedly high occurrence of aciclovir-induced neuropsychiatric symptoms in patients treated for herpesvirus CNS infection: a prospective observational study
Authors: Lindström Johan , Helldén Anders , Lycke Jan , Grahn Anna , Studahl Marie
Published: July 2019

Background

Aciclovir is effective in herpesvirus infections of the CNS. Aciclovir-induced neuropsychiatric symptoms (AINS) have been reported and are associated with high CSF concentrations of aciclovir metabolite 9-carboxymethoxymethylguanine (CMMG). Risk factors except for renal failure have not been explored, and disruption of the blood–brain barrier (BBB) in acute CNS infection may be of interest.

Objectives

To investigate the impact of risk factors on aciclovir and CMMG concentrations, and to relate the results to AINS.

Methods

We investigated 21 consecutively included, consenting patients treated with aciclovir or valaciclovir for herpesvirus CNS infection. Regression models were constructed to study the impact of risk factors including BBB disruption, as measured with CSF:serum albumin ratio, on CSF aciclovir and CMMG concentrations. Medical records were assessed retrospectively to identify patients with AINS.

Results

Increased CSF:serum albumin ratio, as well as decreased renal function and high aciclovir doses, was associated with increased aciclovir and CMMG concentrations in the CSF. We identified five patients with new neuropsychiatric symptoms; four of those were considered to have AINS and had increased CSF CMMG concentrations. Only one patient without suspicion of AINS had an increased CSF CMMG concentration.

Conclusions

In patients with herpesvirus CNS infections, BBB disruption is associated with increasing aciclovir and CMMG CSF concentrations. We also found an unexpectedly high number of patients with AINS. Evaluation of CSF:serum albumin ratios, renal function and CSF concentrations of aciclovir and CMMG may all contribute to the optimization of aciclovir dosing and avoidance of AINS.
Prognostic models will be victims of their own success, unless…
Authors: Lenert Matthew C , Matheny Michael E , Walsh Colin G
Published: July 2019

Predictive analytics have begun to change the workflows of healthcare by giving insight into our future health. Deploying prognostic models into clinical workflows should change behavior and motivate interventions that affect outcomes. As users respond to model predictions, downstream characteristics of the data, including the distribution of the outcome, may change. The ever-changing nature of healthcare necessitates maintenance of prognostic models to ensure their longevity. The more effective a model and intervention(s) are at improving outcomes, the faster a model will appear to degrade. Improving outcomes can disrupt the association between the model’s predictors and the outcome. Model refitting may not always be the most effective response to these challenges. These problems will need to be mitigated by systematically incorporating interventions into prognostic models and by maintaining robust performance surveillance of models in clinical use. Holistically modeling the outcome and intervention(s) can lead to resilience to future compromises in performance.
Cannabinoid Stability in Antemortem and Postmortem Blood
Authors: Meneses Vanessa , Mata Dani
Published: July 2019

In toxicological testing, drug stability is important when providing quantitative results and interpretation of findings, as well as when collecting correlation data. The goal of this study was to expand on previous stability studies and to evaluate other cannabinoids encountered in forensic toxicology. In this 6-month study, the stability of Δ-9-tetrahydrocannabinol (THC), 11-hydroxy-THC, 11-nor-9-carboxy-THC, Cannabinol and Cannabidiol in antemortem and postmortem blood was evaluated in refrigerated (4°C) and frozen (−4°C) storage conditions. Pooled antemortem and postmortem bloods were fortified at low and high concentrations and stored in untreated glassware. Over 6 months, samples were analyzed by automated extraction and liquid chromatography-mass spectrometry/mass spectrometry to evaluate the change in concentration over time. Samples in each storage condition were analyzed in triplicate 12 times over the 6-month period. Cannabinoids in antemortem blood were more stable in the refrigerated condition than in the frozen condition, with 11-hydroxy-THC, 11-nor-9-carboxy-THC and Cannabinol having more than 80% of the original concentration remaining at the end of the study. Cannabinoids in postmortem blood had improved stability in the frozen storage condition with THC, 11-hydroxy-THC, 11-nor-9-carboxy-THC and Cannabinol in the low concentration pool with more than 80% of the original concentration remaining. These data demonstrated that cannabinoids may decrease in concentration over time when stored in untreated glass vials. To ensure the most accurate determination of drug concentration, samples containing cannabinoids should be analyzed as soon as possible.
Acidic Drug Concentrations in Postmortem Vitreous Humor and Peripheral Blood
Authors: Hubbard Jacqueline A , Navarrete Aylmer L , Fitzgerald Robert L , McIntyre Iain M
Published: July 2019

Vitreous humor is a potential alternative matrix for postmortem toxicology drug screens when peripheral blood is unavailable. It is easily and reliably collected and may not suffer from the same postmortem redistribution as seen in blood. Here, we compared the concentrations of 7 acidic drugs (acetaminophen, ibuprofen, naproxen, salicylic acid, carbamazepine, phenobarbital and phenytoin) in peripheral blood and vitreous fluid collected in 89 autopsy cases. Analysis was done by high-performance liquid chromatography with diode-array detection. Overall, we found that vitreous drug concentrations were significantly lower than peripheral blood with median vitreous to peripheral blood (V/PB) ratios ranging from 0.0 to 0.6 (mean, 0.1–0.6). The correlations between the concentrations of over-the-counter analgesics in peripheral blood versus vitreous fluid were poor, with acetaminophen exhibiting the best linearity (R2 = 0.72). The antiepileptic drugs (carbamazepine, phenytoin and phenobarbital) exhibited good correlations between peripheral blood and vitreous humor, with all exhibiting an R2 ≥ 0.95. Overall, we have demonstrated the potential of vitreous fluid as an alternative matrix for the detection of select acidic drugs.
MicroRNA-449b-5p suppresses cell proliferation, migration and invasion by targeting TPD52 in nasopharyngeal carcinoma
Authors: Yin Wei , Shi Lei , Mao Yanjiao
Published: July 2019

Nasopharyngeal carcinoma (NPC) is an important type of head and neck malignant cancer with geographical distribution. MicroRNA-449b-5p (miR-449b-5p) is related to the development of various cancers, while its function in NPC remains unknown. The present study aimed to investigate the role and target gene of miR-449b-5p in NPC. Expressions of miR-449b-5p in NPC cell lines and clinical tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Cell proliferation was determined by MTT and colony formation assays. Migration and invasion abilities after different treatment were evaluated by wound healing and Transwell assays, respectively. Dual-luciferase reporter assay was performed to explore the relationship between miR-449b-5p and tumour protein D52 (TPD52). TPD52 expression was determined by qRT-PCR and western blot assay. miR-449b-5p was significantly downregulated in NPC cell lines and clinical tissues than the matched control. Overexpression of miR-449b-5p inhibited proliferation, migration and invasion of NPC cells. Dual-luciferase reporter assay indicated that miR-449b-5p directly targeted TPD52. Furthermore, shRNA-mediated downregulation of TPD52 rectified the promotion of cell migration and invasion by miR-449b-5p inhibition. In conclusion, the present study suggests that miR-449b-5p, as a novel tumour-suppressive miRNA against NPC, inhibits proliferation, migration and invasion of NPC cells via inhibiting TPD52 expression.
Genetic Variation in Anastrepha obliqua (Diptera: Tephritidae) in a Highly Diverse Tropical Environment in the Mexican State of Veracruz
Authors: Ruiz-Arce Raul , Islam Md-Sajedul , Aluja Martin , McPheron Bruce A
Published: July 2019

There has been considerable interest in understanding biological, ecological, historical, and evolutionary processes that contribute to the diversification of species and populations among tephritid fruit flies. Only a limited number of studies have examined the genetic diversity and population biology of species belonging to the genus Anastrepha considering fine-scale differentiations associated to locality as well as hosts over an entire fruiting season. To expand our understanding of population structure and genetic diversity in one of the critical Anastrepha fruit flies populations in a highly diverse tropical environment we analyzed Anastrepha obliqua (Macquart) (Diptera: Tephritidae) in the Mexican state of Veracruz from five host fruit species and 52 geographic collections using sequence data from mtDNA and microsatellite markers from nuclear DNA. Indeed, we examined the population structure of this pest in a micro-geographic region and report on relationships and historical processes for individuals collected within a small portion of the geographic range of its distribution. Analyses of 1055 bp mtDNA sequences from CO1and ND1genes across 400 individuals detected 34 haplotypes. Haplotype and nucleotide diversity was low, with 53% of the individuals exhibiting a single haplotype (OBV1). Host association and fine-scale differentiation at 17 microsatellite markers across 719 individuals from 32 of the 52 geographic collections reveal fragmented A. obliqua populations. These findings have important implications for the implementation of the Sterile Insect Technique (SIT) and other pest management programs used to control this pestiferous fruit fly.
For a Human Rights Approach to Reforming the American Penal State
Authors: Simon Jonathan
Published: July 2019

Economic arguments seem to be the most promising avenue for driving reform of America’s bloated penal state in the aftermath of mass incarceration. Raising human rights concerns has limited appeal beyond cultural elites and, on occasion, courts, but today reform is coming from elected branches. Talk of human rights for criminals, or human dignity for prisoners, can risk backlash as happened around the death penalty in the 1970s. This essay challenges this conventional account in three ways. First, I argue that historical conditions make the potential for backlash limited. Second, that economic arguments will always be limited by the political and institutional frameworks that define the current meanings of criminal justice; only a human rights approach can drive a truly abolitionist reform agenda, one aimed at rethinking the institutions themselves, not just their budgets. Third, human rights campaigns can, if properly conceived, expand the constituency for deep criminal justice reform.
Nonparametric Dynamic Conditional Beta
Authors: Maheu John M , Shamsi Zamenjani Azam
Published: July 2019

This article derives a dynamic beta representation using a Bayesian semiparametric multivariate generalized autoregressive conditional heteroskedasticity (GARCH) model. The conditional joint distribution of excess stock returns and market excess returns is modeled as a countably infinite mixture of normals. This allows for deviations from the elliptic family of distributions. Empirically, we find the time-varying beta of a stock nonlinearly depends on the expected value of excess market returns. The nonlinear dependence is robust to different GARCH specifications as well as more factors in the model. In highly volatile markets, beta is almost constant, while in stable markets, the beta coefficient can depend asymmetrically on the expected market excess return. We extend the model to several factors and find empirical support for a three-factor model with nonlinear factor sensitives.