bluuebunny/crossref_metadata_2025 huggingface dataset:
Esl for Students with Visual Impairments
Authors: Guinan H.
Published: July 2020

This article reviews the literature on teaching English as a second language (ESL) to, and research on the acquisition of first and second languages by, both sighted and visually impaired students. Although braille should be taught to students in their first language, the author offers suggestions for teaching students in a second language when instruction in a first language is not possible. She concludes that closer cooperation between vision teachers and ESL teachers is essential for children with limited proficiency in English and visual impairments to become fully literate and communicatively competent.
Integrating Industry 4.0 plans into regional innovation strategies
Authors: Lepore Dominique , Spigarelli Francesca
Published: July 2020

The article aims to shed light on why and how Smart Specialization Strategies in European countries can promote the development of Industry 4.0 actions in the next programming period 2021–2027. Smart Specialization Strategies could hold a strategic function in the adoption of Industry 4.0 by supporting technological innovation based on the potential of each territory. An integration of Smart Specialization Strategies and Industry 4.0 could be achieved by leveraging on the common collaborative approaches of the two policies, which call for the involvement of multiple stakeholders in their definition and implementation, as national and regional institutions, academia, firms and user. In order to identify enablers that can favour the integration of the two policies, empirical evidence is retrieved from selected technical reports, events and news press from the Smart Specialization platform. Based on the findings, future directions for guiding the revision of the Smart Specialization Strategies towards effectively embedding Industry 4.0 are presented.
Elevated, sustained, and yet reversible biotoxicity effects of lead on cessation of exposure: Melatonin is a potent therapeutic option
Authors: Adeyemi Wale Johnson , Abdussalam Tahir Ahmad , Abdulrahim Amin , Olayaki Luqman Aribidesi
Published: July 2020

Melatonin (Mel) is known to prevent and mitigate lead (Pb)-induced gonadotoxicity. However, there is no report in literature on the endogenous levels of different biomarkers after the cessation of Pb exposure, with or without treatment with Mel. Fifty adult male Wistar rats were divided into five groups ( N = 10), which included control ((vehicle (normal saline) - treated) − 0.1 ml/day); lead chloride (PbCl2) untreated (3 weeks vehicle + 3 weeks Pb); Pb recovery (3 weeks Pb + 3 weeks vehicle); Pb + Mel (3 weeks Pb + 3 weeks Mel); and Mel (3 weeks vehicle + 3 weeks Mel) groups. Pb and Mel were administered at 50 and 10 mg/kg B.W. ( p.o.), respectively. The results showed that Pb caused significant decreases in total bilirubin (TB), phospholipids (PLP), superoxide dismutase (SOD), catalase (CAT), and total antioxidant capacity (TAC), but significant elevations in alkaline phosphatase (ALP), aspartate aminotransferase (AST), triglyceride (TG), and malondialdehyde (MDA). Although the adverse effects of Pb on TB, ALP, AST, SOD, MDA, and TAC were sustained after the cessation of exposure, a reversal was observed in total cholesterol (TC), TG, PLP, CAT, and c-reactive protein (CRP) results. Nevertheless, the detrimental effects of Pb on alanine aminotransferase (ALT), albumin, and globulin were only expressed post-exposure. Treatment with Mel caused no significant effect on TB and albumin levels. However, unlike TAC and CRP, the hormone significantly reduced ALP, AST, ALT, TC, low-density lipoprotein cholesterol, PLP, SOD, CAT, MDA, and globulin to levels comparable to the control group. In conclusion, following the cessation of Pb exposure, alterations in physiological balance could be elevated, sustained, or reversible. However, Mel enhanced the reestablishment homeostatic status after Pb administration.
Alcohol Misuse and Women’s Use of Aggression in Intimate Relationships: The Mediating Role of Motivations for Using Aggression
Authors: Nelson-Aguiar Rebecca J. , Weiss Nicole H. , Swan Suzanne C. , Sullivan Tami P.
Published: July 2020

The relationship between alcohol misuse and women’s use of intimate partner violence (IPV) aggression has been well studied; however, there has been no research to date on women’s self-reported motivations for use of IPV aggression (e.g., self-defense, control) as an underlying mechanism explaining this link. Accordingly, this study aims to examine whether the effects of alcohol misuse on IPV aggression vary as a function of women’s motivations for using aggression. Participants were 412 ethnically diverse community women, between the ages of 18 and 65, in intimate relationships characterized by bidirectional IPV. The Motives and Reasons for IPV Scale was used to assess women’s reasons for using IPV aggression. Results revealed that the tough guise motive (i.e., wanting to appear tough, intimidating, and willing to harm one’s partner) explained the relationship between alcohol misuse and physical and sexual IPV aggression. Findings suggest the utility of incorporating the assessment of women’s motivations for IPV aggression in an effort to provide better informed intervention addressing the underlying reasons women use IPV aggression.
From authoritarian development to totalist urban reordering: The Daxing forced evictions case
Authors: Pils Eva
Published: July 2020

The forced eviction campaign in the wake of a fire in Daxing District in Beijing in November 2017 provides some evidence signalling a shift from a technocratic-utilitarian model to a more assertive, image-conscious and totalist model of spatial control and population governance. Yet, although it was not possible for anyone to mount effective legal or political resistance to the campaign, protests in its wake suggest that faced with even harsher forms of control, citizens might solidarize in novel ways, articulating their legal rights and shared political identity as Chinese citizens across social barriers.
Effect of cavitation and free-gas entrainment on the hydraulic performance of a centrifugal pump
Authors: Wang Cong , Zhang Yongxue , Zhu Jianjun , Yuan Zhiyi , Lu Bohui
Published: July 2020

An experimental study on gas–liquid two-phase flow characteristics in a low-specific-speed centrifugal pump is presented via employing multiple investigation techniques, such as visualization observation, measurements of acoustic emission and vibration, etc. Specially, three different flow conditions were inspected, namely gas locking initiation, critical cavitation with/without free-gas presence, etc. For gas locking, the drastic deterioration of the pump performance and the disrupted balance of shaft were observed. Especially, at low rotational speeds, the gas locking accompanied with intermittent or churn flow can be triggered by even lower inlet gas volumetric fractions. When it came to the cavitation flow, a small amount of gas entrainment could induce the rapid deterioration of cavitation and stimulate much higher amplitude in low-frequency band of shaft rotation. The relationship between the gas bubble trajectory and the vibration level under the backflow is discussed. The results reveal that the combined effect of the free-gas entrainment and cavitation on the pump instability is much stronger than that under natural cavitation or free-gas entrainment flow, whose fault diagnosis can be determined by the data manifested in different spectral segments.
Intraday Variability and Trading Volume: Evidence from National Stock Exchange
Authors: Sampath Aravind , Gopalaswamy Arun Kumar
Published: July 2020

In this article, we investigate patterns in returns, volume and volatility and analyse the volume–return relationship using tick-by-tick data from the Indian equity market. Based on descriptive measures and regression frameworks, we document three important findings. First, we report unusually high volatility, trading volume and number of trades during the opening and closing minutes of the market depicting a ‘U’-shaped curve, implying high market activity during these periods. Second, while accounting for trading volume, we observe that volatility is not significantly different between mid-day period and evening period as compared to the normal ‘U’ curve. Finally, we document a significant positive relationship between intraday volume and price movements controlling for microstructure effects. The impact of positive returns on trading volume is higher than the impact of negative returns, implying the presence of return–volume asymmetry in the Indian market.

JEL Codes: G12, G15
Assessing the Effects of Anti-corruption Law on Entrepreneurial Finance: Evidence from Latin America
Authors: Battaglia Francesca , Carboni Marika , Cicchiello Antonella Francesca , Monferrà Stefano
Published: July 2020

Corruption normally causes distrust among investors and can negatively affect investments. Particularly in Latin America, decline of investments is one of the most significant problems. In such a context, anti-corruption laws can both fight corruption and promote business, restoring investors’ trust. In this article, we ask whether the introduction of an anti-corruption framework affecting both the public and private spheres is able to increase investors’ confidence in a new form of investment, that is, equity crowdfunding. By using a unique database, with combined information from different platforms in Brazil, Chile and Mexico, we study the population of 492 projects between 2013 and 2017. Implementing a set of linear probability regressions, we find that the new Mexican anti-corruption law has increased the probability of success of equity crowdfunding projects in this country, compared to Brazilian and Chilean projects, suggesting the existence of a causal relation between anti-corruption rules and investments in a highly perceived corrupt environment further characterised by a low level of investor protection.

JEL Classification: G23, G28, K22, L26
Fulfilling the Process Promise: A Review and Agenda for New Venture Creation Process Research
Authors: Davidsson Per , Gruenhagen Jan Henrik
Published: July 2020

We review new venture creation process research in leading journals over the past 30 years, applying a broad view of “process.” While we find a rich and varied literature with significant quantitative and qualitative growth, the review reveals considerable room for future contributions in this important area of entrepreneurship research. In an agenda building on review results, exemplary articles, and theory development advice from other sources, we discuss several types of such future contributions. We hope that our efforts can inspire emerging scholars, colleagues, research leaders, and institutional actors to contribute to a bright future for this core domain of entrepreneurship research.
Evaluation of autoignition models for production control of a spark-assisted compression ignition engine
Authors: Robertson Dennis , Prucka Robert
Published: July 2020

The drive to improve performance and efficiency of internal combustion engines has greatly expanded the degrees of freedom of engine systems. As efficiency objectives exceed the capability of traditional combustion strategies, advanced combustion modes are more attractive for production. These advanced combustion strategies typically add sensors, actuators, and degrees of freedom to the combustion process itself. Spark-assisted compression ignition is an efficient production-viable advanced combustion mode characterized by a spark-ignited flame propagation that triggers autoignition in the remaining unburned gas. This research focuses on autoignition modeling for spark-assisted compression ignition combustion phasing control. This work comprehensively evaluates several autoignition model structures and identifies the real-time production control implications of each. The candidate models include four ignition delay correlations, an ignition delay lookup, three polynomial regressions, and an artificial neural network. All are computationally feasible using production controllers, but the artificial neural network model represents autoignition phasing significantly better than the other options evaluated. The polynomial regressions were similar in error and exceeded the accuracy of ignition delay models. The low performance of the induction time integral–based models stems primarily from the exclusion of low-temperature heat release. The regression models are also exercised on an experimental engine dataset to identify the impact of engine phenomenon such as charge stratification on the performance of each model structure. The trends in the model performance as well as the magnitude of the error were similar when evaluated on both spark-assisted compression ignition simulation data and homogeneous charge compression ignition experimental data.
Are the Effects of Adverse Childhood Experiences on Violent Recidivism Offense-Specific?
Authors: Craig Jessica M. , Zettler Haley R.
Published: July 2020

A growing body of literature has found that exposure to child maltreatment and other forms of family dysfunction, often conceptualized as Adverse Childhood Experiences (ACEs), are associated with delinquent and criminal behavior. Recent research has indicated that the effects of ACEs on offending may differ not only by offense type but also by sex and race/ethnicity. However, no study to-date has investigated the effects of ACEs on violent-specific recidivism, nor how these effects differ by sex- and racial/ethnic-specific subgroups. The current study seeks to address this gap by examining a large, diverse sample of serious delinquents institutionalized in a large southern state. The results indicated that while ACEs increased the likelihood of being rearrested for any violent felony, the effects were particularly strong for domestic violence and sexual offenses among white females and minority males. A discussion of these findings are presented, along with the limitations of the study.
Ectopic uterine scar pregnancy: A case report
Authors: Satyam  , Swarup M Sarthak , Garg Anju
Published: July 2020

Introduction

Implantation of a gestational sac in a previous Caesarean section scar of the lower uterine segment is a rare form of ectopic pregnancy.

Case report

We report a case of Caesarean scar ectopic pregnancy in a 25-year-old female, diagnosed by ultrasonography and confirmed by magnetic resonance imaging. We present the clinical details, imaging findings, and management of the patient.

Discussion

Imaging plays an important role in the diagnosis of ectopic pregnancy and ultrasonography is the modality of choice. Ultrasonography features of scar ectopic pregnancy include empty uterus and cervix with normal endometrium and endocervical canal, gestational sac (with embryo and/or yolk sac) in the anterior part of the lower uterine segment in the region of the Caesarean scar with a thin myometrial layer between the bladder wall and gestational sac. Magnetic resonance imaging may be used as an adjunct imaging modality in cases with inconclusive or equivocal sonographic findings. Termination of pregnancy in the first trimester should be considered and treatment options should be individualized as there is no universal agreement on the best or most preferred treatment modality.

Conclusion

Awareness of specific ultrasound features of scar ectopic pregnancy is crucial for early recognition, correct diagnosis, and initiating prompt management to prevent complications.
Complexity of postural sway affects affordance perception of reachability in virtual reality
Authors: Masoner Hannah , Hajnal Alen , Clark Joseph D , Dowell Catherine , Surber Tyler , Funkhouser Ashley , Doyon Jonathan , Legradi Gabor , Samu Krisztian , Wagman Jeffrey B
Published: July 2020

Visual perception of whether an object is within reach while standing in different postures was investigated. Participants viewed a three-dimensional (3D) virtual reality (VR) environment with a stimulus object (red ball) placed at different egocentric distances. Participants reported whether the object was reachable while in a standard pose as well as in two separate active balance poses (yoga tree pose and toe-to-heel pose). Feedback on accuracy was not provided, and participants were not allowed to attempt to reach. Response time, affordance judgements (reachable and not reachable), and head movements were recorded on each trial. Consistent with recent research on perception of reaching ability, the perceived boundary occurred at approximately 120% of arm length, indicating overestimation of perceived reaching ability. Response times increased with distance, and were shortest for the most difficult pose—the yoga tree pose. Head movement amplitude increased with increases in balance demands. Unexpectedly, the coefficient of variation was comparable in the two active balance poses, and was more extreme in the standard control pose for the shortest and longest distances. More complex descriptors of postural sway (i.e., effort-to-compress) were predictive of perception while in the tree pose and the toe-to-heel pose, as compared with control stance. This demonstrates that standard measures of central tendency are not sufficient for describing multiscale interactions of postural dynamics in functional tasks.
Inertial stresses of national and international motorcycle circuit racing riders
Authors: D’Artibale Emanuele , Neville Jonathon , Cronin John B
Published: July 2020

The forces on the human body associated with motorcycle racing are currently unpublished, and this study aimed at quantifying the negative and positive accelerations that circuit racers experience during real competitions via direct measurements in different classes of racing. Kinematical measurements of braking actions and corner exits during competitive laps were identified via GPS signal in 23 riders competing in 13 different circuits and categories (i.e. European Junior Cup 2016, national and world level 600 cc SuperSport). Fully equipped body mass of riders was measured and individual inertial forces were calculated. Riders in an entry-level class championship experienced 87 ± 11 brakes per race, while national and world SS600 class championships were found to have on average 144 ± 14 and 171 ± 28 brakes per race, respectively. For each braking action, the calculated inertial mean force acting on the rider centre of gravity was from 476 to 513 N on average, and peak forces doubling these values. Moreover, the mean inertial forces generated while accelerating to exit the corners were from 300 to 384 N on average, with the WSS class recording 33% larger accelerations compared to the entry category EJC. The findings of this study: suggest that international level riders experience positive and negative inertial loads considerable in volume, frequency and intensity; provide novel information enhancing the knowledge on the performance model for motorcycle circuit racing; and, offer a profile useful for the design of training programmes aiming at preparing riders for competition.
Severe Delayed-Onset Neutropenia Induced by Ocrelizumab
Authors: Baird-Gunning Jonatha , Yun James , Stevenson William , Ng Karl
Published: July 2020

Background:

Ocrelizumab is an anti-CD20 monoclonal antibody that has been shown to reduce disability progression in primary progressive multiple sclerosis (MS). The adverse event profile is still being determined through postmarketing surveillance and case reports.

Objective:

To report a case of severe late-onset neutropenia associated with ocrelizumab in a patient with primary progressive MS.

Methods:

Case report.

Result:

A 34-year-old male with primary progressive MS developed severe late-onset neutropenia 42 days after infusion of ocrelizumab, which necessitated hospital admission and administration of broad-spectrum antibiotics and granulocyte colony-stimulating factor.

Conclusion:

Late-onset neutropenia is a rare complication of ocrelizumab. Patients should be counseled to present for urgent evaluation if they develop fever.
Computer-Assisted Secondary Orbital Reconstruction
Authors: Singh Daman D. , Schorn Lara , Strong E. Bradley , Grant Michael , Schramm Alexander , Hufendiek Karsten , Gellrich Nils-Claudius , Rana Majeed
Published: July 2020

Study Design:

This study presents a case-control study of 33 patients who underwent secondary orbital reconstruction, evaluating techniques and outcome.

Objective:

Adequate functional and aesthetical appearance are main goals for secondary orbital reconstruction. Insufficient premorbid orbital reconstruction can result in hypoglobus, enophthalmos, and diplopia. Computer-assisted surgery and the use of patient-specific implants (PSIs) is widely described in the literature. The authors evaluate the use of selective laser-melted PSIs and hypothesize that PSIs are an excellent option for secondary orbital reconstruction.

Methods:

The sample was composed of 33 patients, previously treated with primary orbital reconstruction, presenting themselves with indications for secondary reconstruction (i.e. enophthalmos, diplopia, or limited eye motility). Computed tomography and/or cone beam data sets were assessed before and after secondary reconstruction comparing intraorbital volumes, infraorbital angles, and clinical symptoms. Clinical outcomes were assessed using a standardized protocol.

Results:

Results show a significant change in intraorbital volumes and a reduction of clinical symptoms after secondary reconstruction.

Conclusions:

Outcomes of this study suggest that secondary orbital reconstruction can be performed routinely using selective laser-melted PSIs and titanium spacers.
Effects of Body Orientation Relative to Gravity on Vection in Children and Adults
Authors: Oyamada Keisuke , Ujita Musashi , Imura Tomoko , Shirai Nobu
Published: July 2020

We investigated the effects of the interaction between the body and gravitational axes on vection (visually induced self-motion perception) in school-age children and adults. Experiment 1 was a pilot study of adults that was conducted to determine the appropriate experimental settings for the main experiment that included children and adults. The adult participants experienced vection in four different directions in the head-centered coordinate (forward, backward, upward, and downward) under two postural conditions: standing (in which the body and gravitational axes were consistent) and supine (in which the body orientation was orthogonally aligned to the gravitational axis). The adults reported more rapid and longer lasting vection when standing than when supine. In the main experiment (Experiment 2), we tested adults and school-age children under conditions similar to those of Experiment 1 and found that the reported vection was more rapid and longer lasting in children than in adults, whereas the reported vection tended to be more rapid and longer lasting under the standing condition than the supine condition for both age groups. Based on the similarities and differences between children and adults found in the present and previous vection studies, child-specific features of vection are discussed.
Effect of oxygen supplement during targeted temperature management on acute lung injury in the early stage of traumatic hemorrhagic shock
Authors: Rao Tai-Wen , Shen Ye-Hua , Zhao Xiao-Gang , Jiang Shou-Yin
Published: July 2020

Ideal concentrations of inhaled oxygen with regard to lung protection during early traumatic hemorrhagic shock (THS) remain unknown especially in the era of targeted temperature management (TTM). We speculated that a significant increase in oxygen supply in early stage of THS would magnify the protecting role of hypothermia in acute lung injury. Forty male New Zealand rabbits were randomly divided into four groups (n = 10): sham group, control group, group 1, and group 2. Except for sham group, all other animals were submitted to 30 min of uncontrolled THS and received limited fluid resuscitation for 60 min. During resuscitation, in addition to 34°C of TTM, animals in group 1 inhaled 21% oxygen while animals in group 2 inhaled 50% oxygen. Animals in control group inhaled room air and were kept normothermia. Oxidative stress, inflammation, and apoptosis parameters in the lung tissues were determined. THS induced higher expression of malondialdehyde, surfactant protein A, nuclear factor kappa B, and caspase 3 as well as lower expression of Bcl-2 mRNA and superoxide dismutase activity. Compared with inhalation of 21% oxygen, inhalation of 50% oxygen during TTM significantly improves oxidative stress, inflammation, apoptosis, and acute lung injury. Oxygen supplement during TTM therapy alleviated acute lung injury in the early stage of THS. Further studies are required to explore the ideal combination forms of TTM and oxygen supplement with the purpose of maximizing therapeutic effect while minimizing adverse effects.
Corrosion protection performance of titania nanoparticles filled poly(4-methyl-5-vinylthiazole) applied on mild steel in 3.5% sodium chloride solution
Authors: Pugazhenthi I , Ghouse S Mohammed
Published: July 2020

Mild steel materials have wide applications in marine construction, because they are low cost, available and easy to handle. However, they have to be protected from corrosive media by coating with polymer hybrid materials. This paper focuses on the anticorrosive properties of poly(4-methyl-5-vinylthiazole) PVTZ coatings on mild steel. Further the coating resistance is enhanced by incorporating Titania Nano particles (TiO2NPs). The nanoparticles were evaluated using X-ray diffraction studies (XRD) and transmission electron microscopy (TEM). PVTZ and its TiO2 nanocomposite were coated on mild steel. Their anticorrosive behavior was analyzed by potentiodynamic polarization and electrochemical impedance spectroscopy in 3.5% (w/v) NaCl.
Identification of candidate genes for milk production traits by RNA sequencing on bovine liver at different lactation stages
Authors: Li Qian , Liang Ruobing , Li Yan , Gao Yanxia , Li Qiufeng , Sun Dongxiao , Li Jianguo
Published: July 2020

Background

RNA-sequencing was performed to explore the bovine liver transcriptomes of Holstein cows to detect potential functional genes related to lactation and milk composition traits in dairy cattle. The bovine transcriptomes of the nine liver samples from three Holstein cows during dry period (50-d prepartum), early lactation (10-d postpartum), and peak of lactation (60-d postpartum) were sequenced using the Illumina HiSeq 2500 platform.

Results

A total of 204, 147 and 81 differentially expressed genes (DEGs, p < 0.05, false discovery rate q < 0.05) were detected in early lactation vs. dry period, peak of lactation vs. dry period, and peak of lactation vs. early lactation comparison groups, respectively. Gene ontology and KEGG pathway analysis showed that these DEGs were significantly enriched in specific biological processes related to metabolic and biosynthetic and signaling pathways of PPAR, AMPK and p53 (p < 0.05). Ten genes were identified as promising candidates affecting milk yield, milk protein and fat traits in dairy cattle by using an integrated analysis of differential gene expression, previously reported quantitative trait loci (QTL), data from genome-wide association studies (GWAS), and biological function information. These genes were APOC2, PPP1R3B, PKLR, ODC1, DUSP1, LMNA, GALE, ANGPTL4, LPIN1 and CDKN1A.

Conclusion

This study explored the complexity of the liver transcriptome across three lactation periods in dairy cattle by performing RNA sequencing. Integrated analysis of DEGs and reported QTL and GWAS data allowed us to find ten key candidate genes influencing milk production traits.
Objective validation of YouTube™ educational videos for the instruction of regional anesthesia nerve blocks: a novel approach
Authors: Tewfik George L. , Work Adam N. , Shulman Steven M. , Discepola Patrick
Published: July 2020

Background

YouTube™ (“YouTube”) is often used as an educational tool to instruct anesthesia providers on regional anesthesia nerve blocks. However, there is no current objective standard to assess the educational quality of these user-uploaded videos. A new approach was used to objectively validate these videos by comparing them to high quality educational sources for the seven most commonly used nerve blocks.

Objective

We sought to evaluate the educational quality of user-uploaded videos when compared to the highest quality anesthesia society websites (NYSORA, ACEP, USRA).

Methods

After reviewing the instructional material available for the seven most frequently conducted nerve blocks on high-quality reference websites, we documented the educational characteristics present including such things as indications, volume, anatomy, etc. Next we reviewed the five most popular videos on YouTube for each block (by views) and documented the presence or absence of these educational characteristics.

Results

Eighteen educational characteristics were documented in the “high-quality” anesthesia society reference material. Correlation was sought between this material and YouTube videos. Although there were varying degrees of correlation between the high quality sources and the videos, rarely did YouTube videos contain as high a percentage of these educational characteristics as the well-established sources. Some videos contained very few of these important educational characteristics.

Conclusion

Although YouTube has been used an educational tool, we recommend that only high quality sources be used to teach or illustrate regional anesthesia nerve blocks.
Patient and caregiver perspectives on early identification for advance care planning in primary healthcare settings
Authors: Kendell Cynthia , Kotecha Jyoti , Martin Mary , Han Han , Jorgensen Margaret , Urquhart Robin
Published: July 2020

Background

As part of a broader study to improve the capacity for advance care planning (ACP) in primary healthcare settings, the research team set out to develop and validate a computerized algorithm to help primary care physicians identify individuals at risk of death, and also carried out focus groups and interviews with relevant stakeholder groups. Interviews with patients and family caregivers were carried out in parallel to algorithm development and validation to examine (1) views on early identification of individuals at risk of deteriorating health or dying; (2) views on the use of a computerized algorithm for early identification; and (3) preferences and challenges for ACP.

Methods

Fourteen participants were recruited from two Canadian provinces. Participants included individuals aged 65 and older with declining health and self-identified caregivers of individuals aged 65 and older with declining health. Semi-structured interviews were conducted via telephone. A qualitative descriptive analytic approach was employed, which focused on summarizing and describing the informational contents of the data.

Results

Participants supported the early identification of patients at risk of deteriorating health or dying. Early identification was viewed as conducive to planning not only for death, but for the remainder of life. Participants were also supportive of the use of a computerized algorithm to assist with early identification, although limitations were recognized. While participants felt that having family physicians assume responsibility for early identification and ACP was appropriate, questions arose around feasibility, including whether family physicians have sufficient time for ACP. Preferences related to the content of and approach to ACP discussions were highly individualized. Required supports during ACP include informational and emotional supports.

Conclusions

This work supports the role of primary care providers in the early identification of individuals at risk of deteriorating health or death and the process of ACP. To improve ACP capacity in primary healthcare settings, compensation systems for primary care providers should be adjusted to ensure appropriate compensation and to accommodate longer ACP appointments. Additional resources and more established links to community organizations and services will also be required to facilitate referrals to relevant community services as part of the ACP process.
The alpha-fetoprotein serum is still reliable as a biomarker for the surveillance of hepatocellular carcinoma in Indonesia
Authors: Jasirwan Chyntia Olivia Maurine , Fahira Alessa , Siregar Lianda , Loho Imelda
Published: July 2020

Background and aims

Hepatocellular carcinoma (HCC), the most common type of liver cancer, is one of the leading causes of cancer-related death worldwide with an inferior prognosis. In Indonesia, the average life expectancy is less than 5 months, with most patients being in an advanced stage wherein the survival rate is very low. Early detection through surveillance program is very crucial. HCC guidelines worldwide have provided surveillance recommendation through the examination of α-fetoprotein (AFP) and ultrasound for patients at risk in developing HCC. However, there have been some controversies regarding the usage of AFP concerning its low sensitivity and specificity in detecting HCC. Therefore, the effectiveness of AFP in the surveillance of HCC patients and identifying the parameters most associated with the increase of AFP ≥ 10 ng/ml in Indonesia should be evaluated.

Methods

We analyzed medical records of HCC patients and those at high risk of developing HCC through cross-sectional study, including patients with cirrhosis and hepatitis B and C, from 2015 to 2017 who underwent treatment at the Cipto Mangunkusumo National General Hospital and Dharmais National Cancer Hospital, Indonesia.

Results

The sensitivity and specificity of AFP in the surveillance of HCC in Indonesia with a cut-off of 10 ng/ml were 82.6 and 71.2%, respectively. The parameters most associated with the increase of AFP ≥10 ng/ml according to multivariate analysis were the etiology of hepatitis B, the stage of Barcelona Clinic Liver Cancer (BCLC) B and C, and the presence of cirrhosis, respectively.

Conclusion

AFP can still be used in the surveillance of HCC in Indonesia for its high sensitivity value.
Influence of blood group, Glucose-6-phosphate dehydrogenase and Haemoglobin genotype on Falciparum malaria in children in Vihiga highland of Western Kenya
Authors: Ahmed Jafaralli Sande , Guyah Bernard , Sang’ David , Webale Mark Kilongosi , Mufyongo Nathan Shaviya , Munde Elly , Ouma Collins
Published: July 2020

Background

Genetic diversity of ABO blood, glucose-6-phosphate dehydrogenase (G6PD) deficiency and haemoglobin type and their ability to protect against malaria vary geographically, ethnically and racially. No study has been carried out in populations resident in malaria regions in western Kenya.

Method

A total of 574 malaria cases (severe malaria anaemia, SMA = 137 and non-SMA = 437) seeking treatment at Vihiga County and Referral Hospital in western Kenya, were enrolled and screened for ABO blood group, G6PD deficiency and haemoglobin genotyped in a hospital-based cross-sectional study.

Result

When compared to blood group O, blood groups A, AB and B were not associated with SMA (P = 0.380, P = 0.183 and P = 0.464, respectively). Further regression analysis revealed that the carriage of the intermediate status of G6PD was associated with risk to SMA (OR = 1.52, 95%CI = 1.029–2.266, P = 0.035). There was, however, no association between AS and SS with severe malaria anaemia. Co-occurrence of both haemoglobin type and G6PD i.e. the AA/intermediate was associated with risk to SMA (OR = 1.536, 95%CI = 1.007–2.343, P = 0.046) while the carriage of the AS/normal G6PD was associated with protection against SMA (OR = 0.337, 95%CI = 0.156–0.915, P = 0.031).

Conclusion

Results demonstrate that blood group genotypes do not have influence on malaria disease outcome in this region. Children in Vihiga with blood group O have some protection against malaria. However, the intermediate status of G6PD is associated with risk of SMA. Further, co-inheritance of sickle cell and G6PD status are important predictors of malaria disease outcome. This implies combinatorial gene function in influencing disease outcome.
Parvovirus B19 infection and kidney injury: report of 4 cases and analysis of immunization and viremia in an adult cohort of 100 patients undergoing a kidney biopsy
Authors: Kauffmann Maëlis , Bobot Mickaël , Daniel Laurent , Torrents Julia , Knefati Yannick , Moranne Olivier , Burtey Stéphane , Zandotti Christine , Jourde-Chiche Noémie
Published: July 2020

Background

The seroprevalence of human Parvovirus B19 (PVB19) is 70–85% in adults worldwide. PVB19 is the etiologic agent of the fifth disease, is a cause of aplastic anemia, and can be associated with kidney injury. We aimed to describe the cases of 4 patients with kidney injury related to PVB19 primary infection, and to evaluate the seroprevalence of PVB19 and the incidence of PVB19 primary infection in patients undergoing a native kidney biopsy.

Methods

Cases of PVB19 infection with kidney injury were reviewed from the archives of the department of Nephrology. A systematic screening of anti-PVB19 IgG and IgM antibodies and viral DNA was performed in sera from 100 consecutive patients with a kidney biopsy in 2017–2018.

Results

The 4 patients with PVB19 infection-associated kidney disease displayed: one lupus-like glomerulonephritis (GN) without lupus auto-antibodies, one minimal change disease with tubular necrosis, one secondary hemolytic and uremic syndrome and one membrano-proliferative GN. In the 100 patients biopsied, 67 had elevated anti-PVB19 IgG, among whom 8 had elevated IgM, without circulating viral DNA, without any particular renal pathological pattern. One additional patient showed a seroconversion at the time of kidney biopsy, which revealed a class V lupus nephritis.

Conclusion

PVB19 primary infection can be associated with different kidney diseases. The seroprevalence of PVB19 among patients with a kidney biopsy is similar to the overall population, and primary infection is rarely documented (1%) after systematic screening. Whether PV19 is nephrotoxic, or triggers renal endothelial injury and immune activation, remains to be elucidated.
Relationship between aspirin use of esophageal, gastric and colorectal cancer patient survival: a meta-analysis
Authors: Lin Ju-Li , Lin Jian-Xian , Zheng Chao-Hui , Li Ping , Xie Jian-Wei , Wang Jia-bin , Lu Jun , Chen Qi-Yue , Cao Long-long , Lin Mi , Huang Chang-Ming
Published: July 2020

Background

Many studies have found that use of aspirin can lengthen survival in patients with gastrointestinal cancer. The aim of this study was to assess the survival benefit of aspirin use compared with non-aspirin use for patients with esophageal, gastric or colorectal cancer.

Methods

We searched online databases, including PubMed, the Cochrane Library, Embase and www.clinicaltrials.gov for studies that were conducted, before April 30th, 2020, to identify relevant studies. Overall survival and cancer-specific survival of esophageal, gastric and colorectal cancers among aspirin users were compared with those among non-aspirin users. Data extraction and quality evaluation were independently conducted by 2 investigators. A meta-analysis was performed to calculate the pooled risk ratios (RRs) for overall survival and cancer-specific survival by using either a fixed-effects model or a random-effects model.

Results

A total of 18 studies were included in this meta-analysis, with more than 74,936 patients. There were no significant differences between postdiagnosis aspirin use and overall survival for esophageal and gastric cancers. For colorectal cancer, a benefit that was associated with postdiagnosis aspirin use was observed for overall survival and cancer-specific survival [HR = 0.83, 95%CI(0.75, 0.9.);HR = 0.78, 95%CI(0.66, 0.92), respectively. However, a prediagnosis of aspirin use did not provide a benefit for overall or cancer-specific survival in colorectal cancer. HR values for overall and cancer-specific survival benefits for colorectal cancer associated with both prediagnosis and postdiagnosis aspirin were as follows: HR = 0.75, 95%CI(0.61, 0.92) and HR = 0.78, 95%CI(0.73, 0.85), respectively. In addition, the survival benefit of postdiagnosis aspirin use appeared to be confined to patients with mutated PIK3CA tumors [HR = 0.78, 95%CI(0.50, 0.99)] and was positive for PTGS2 (COX-2) expression [HR = 0.75, 95%CI(0.43, 1.30)].

Conclusions

These findings provide further indications that postdiagnosis aspirin use improves overall survival and cancer-specific survival in colorectal cancer, especially for patients who are positive for PTGS2 (COX-2) expression and PIK3CA-mutated tumors. However, aspirin therapy does not improve overall survival in esophageal and gastric cancers, although the meta-analysis was mainly limited to retrospective studies.
Thyroid cancer in Ecuador
Authors: López Gavilanez Enrique , Bautista Litardo Noemí , Navarro Chávez Manuel , Hernández Bonilla Mario , Segale Bajaña Angel
Published: July 2020

Background

The incidence of thyroid cancer is increasing worldwide. This is not accompanied by a corresponding increase in mortality. In contrast, in most populations’ thyroid cancer mortality has been decreasing in recent decades, although there are some notable exceptions.

Main body of the abstract

Relatively few studies focus on mortality and in Latin America we do not find evidence on the temporal trend of mortality. The study of the epidemiology of the thyroid cancer should be approached with a suitable methodology and with data based on the population. Trends should be expressed as an annual percentage of change and/or average annual rate of change. An appropriate method for analyzing trends in thyroid cancer mortality rates is the Joinpoint regression analysis. Previously published findings are described, and the methodology used is compared.

Short conclusion

At the global level, Ecuador is one of the countries with the highest incidence rate of thyroid cancer. However, mortality data are scarce and not rigorous. It is important to raise awareness of updated and reliable population-based data on the trend of thyroid cancer mortality in Eccuador.
Safety and efficacy of ripasudil in Japanese patients with glaucoma or ocular hypertension: 12-month interim analysis of ROCK-J, a post-marketing surveillance study
Authors: Tanihara Hidenobu , Kakuda Takahiko , Sano Tetsuro , Kanno Takashi , Gunji Ryoji
Published: July 2020

Background

Ripasudil is approved in Japan for glaucoma or ocular hypertension (OH) when other treatments are ineffective or cannot be administered. Its long-term safety and efficacy are being examined in a post-marketing surveillance study; 12-month data are described here.

Methods

This prospective, open-label, observational study enrolled patients with glaucoma or OH who started ripasudil during routine care. The key safety outcome was the incidence of adverse drug reactions (ADRs), focusing on allergy and/or inflammation-related ADRs such as blepharitis (including allergic) or conjunctivitis (including allergic). The primary efficacy endpoint was least squares mean (LSM) ± standard error (SE) change in intraocular pressure (IOP) from baseline to 12 months in all patients and in diagnostic groups. Secondary endpoints were change in IOP in groups stratified by treatment initiation pattern, number of concomitant drugs, and baseline IOP.

Results

Overall, 3359 patients (48% male, mean age ± standard deviation [SD] 69.1 ± 12.7 years) were evaluated for safety and 3323 for efficacy. Diagnoses were primary open-angle glaucoma (43.9%), normal-tension glaucoma (36.6%), secondary glaucoma (8.7%), OH (4.2%), and primary closed-angle glaucoma (2.4%). Mean ± SD observation period was 300.1 ± 122.4 days; 1010 patients (30.1%) discontinued ripasudil by 12 months. ADRs occurred in 626 patients (18.6%); the most common were conjunctival hyperemia and blepharitis. Allergy and/or inflammation-related ADRs occurred in 388 patients (11.6%), most commonly blepharitis (5.6%) and conjunctivitis (4.2%). IOP decreased significantly from a mean ± SD 18.1 ± 6.1 mmHg at baseline; the LSM ± SE IOP change throughout 12 months of ripasudil treatment was − 2.6 ± 0.1 mmHg (− 14.0 ± 0.4%; p < 0.001). A significant decrease in IOP at 12 months was seen in all categories of baseline IOP (p < 0.001), and all types of glaucoma (p < 0.001), except neovascular glaucoma. Ripasudil was associated with a significant reduction in IOP at 12 months whether initiated as monotherapy or in combination with ≤4 concomitant glaucoma therapies (p < 0.001).

Conclusions

Ripasudil was safe and effective in patients with glaucoma or OH during routine care. No new safety signals were identified, and significant reductions in IOP were maintained over 12 months.
A common variant of the NOTCH4 gene modulates functional connectivity of the occipital cortex and its relationship with schizotypal traits
Authors: Xie Xiaohui , Zu Meidan , Zhang Long , Bai Tongjian , Wei Ling , Huang Wanling , Ji Gong-Jun , Qiu Bensheng , Hu Panpan , Tian Yanghua , Wang Kai
Published: July 2020

Background

Schizotypal traits are considered as inheritable traits and the endophenotype for schizophrenia. A common variant in the NOTCH4 gene, rs204993, has been linked with schizophrenia, but the neural underpinnings are largely unknown.

Methods

In present study, we compared the differences of brain functions between different genotypes of rs204993 and its relationship with schizotypal traits among 402 Chinese Han healthy volunteers. The brain function was evaluated with functional connectivity strength (FCS) using the resting-state functional magnetic resonance image(rs-fMRI). The schizotypal traits were measured by the schizotypal personality questionnaire (SPQ).

Results

Our results showed that carriers with the AA genotype showed reduced FCS in the left occipital cortex when compared with carriers with the AG and GG genotypes, and the carriers with the AG genotype showed reduced FCS in the left occipital cortex when compared with carriers with the GG genotype. The FCS values in the left occipital lobe were negatively associated with the SPQ scores and its subscale scores within the carriers with the GG genotype, but not within the carriers with AA or AG genotype.

Conclusion

Our results suggested that the common variant in the NOTCH4 gene, rs204993, modulates the function of the occipital cortex, which may contribute to schizotypal traits. These findings provide insight for genetic effects on schizotypal traits and its potential neural substrate.