bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients' and caregivers' knowledge and beliefs about mental illness in mainland China: A systematic review
Authors: Li Wenjing , Reavley Nicola
Published: September 2020

This review aimed to systematically investigate patients' and caregivers' knowledge and beliefs about mental illness in mainland China. A total of 48 eligible studies (N = 11 895) were retrieved from eight electronic databases. Prevalence statistics were computed for themes (eg, stress) under each construct relating to knowledge or belief about mental illness (eg, beliefs about causes). Effect size r was calculated for each correlation with an identified construct. We found that only 27.8% of patients recognized the symptoms of schizophrenia. Although 65% of caregivers declared that they knew the names of the disorders that their ill relatives had, depression (43.6%), schizophrenia (28.5%) and anxiety disorders (18.1%) had low recognition rates. Both caregivers and patients preferred psychosocial explanations of mental illness. Pharmacological interventions (eg, antipsychotics), non‐specific actives (eg, “getting out and learning more”), mental health professionals (eg, psychiatrists) and informal support (eg, family) were each considered helpful for different disorders by caregivers, whereas regular contact with mental health professionals was not highly rated as helpful by patients. Additionally, while more patients knew about the effects of the medications that they were taking, more caregivers emphasized the importance of medicine adherence. Psychosocial variables (eg, family burden) demonstrated significant effects on both groups' mental health literacy. The government should invest more in supporting caregivers of people with mental disorders and monitor the implementation of mental health policies.
Western Connections of Northeast Africa: The Garnet Evidence from Late Antique Nubia, Sudan
Authors: Then‐Obłuska J. , Gilg H. A. , Schüssler U. , Wagner B.
Published: September 2020

Outstanding garnet beads were found recently in an elite tumulus dated to the fourth century AD and located at the cemetery of Hagar el‐Beida in the Upper Nubian Nile Valley region. Whereas contacts of Northeast Africa with South Asia have just been proven through analysis of glass beads found in Nubia and dating to the time of intensive Indian Ocean trade, scientific evidence for Nubia's link with the regions to the west was lacking. Laser ablation‐inductively coupled plasma‐mass spectrometry (LA‐ICP‐MS) was used to determine the elemental composition of three garnet beads to gain information about their type and origin. Additionally, we analyzed twelve garnets from two nearby alluvial placer deposits. While the garnet beads are inclusion‐free Cr‐poor and Ti‐rich pyropes related to alkaline mafic volcanic rocks, the local garnet deposits are shown to be inclusion‐rich almandines and thus unrelated to the investigated Nubian beads. Detailed comparison of data from Merovingian cloisonné jewellery and all known sources of the Cr‐poor and Ti‐rich pyropes shows identical ranges of elemental contents. The source of raw materials for the beads found in Nubia has been not identified with certainty yet, but sources in Portugal and Nigeria are suggested and a connection is shown to similar garnets from Merovingian contexts.
Isolation of Cryptococcus neoformans var. grubii (serotype A) and C. magnus from the nasal lining of free‐ranging quokkas (Setonix brachyurus)
Authors: Martínez‐Pérez PA , Fleming PA , Hyndman TH
Published: September 2020

Cryptococcus species are environmental yeasts, with a worldwide distribution and remarkable environmental adaptation. Although many species do not cause disease, C. neoformans and C. gattii are causative agents of cryptococcosis, a life threatening infection and a significant public health problem worldwide. Infection especially affects immunocompromised animals and humans. In wildlife, cryptococcosis appears to be more prevalent in captive populations. The objective of this study was to assess whether apparently healthy quokkas (Setonix brachyurus) harbor Cryptococcus spp. Using cultural and molecular methods, we studied yeasts isolated from nasal swabs collected from 130 free‐ranging quokkas on Rottnest Island (RI, n = 97) and the mainland (n = 33) of Western Australia. Unspeciated Cryptococcus spp. (from four quokkas), C. neoformans var. grubii (serotype A) (two quokkas) and C. magnus (one quokka) were isolated from the nasal lining of apparently healthy quokkas from RI. Cryptococcus neoformans var. grubii was isolated from animals captured in a human‐populated area on RI. There was no significant effect of the presence of Cryptococcus on the results of haematology, blood chemistry, peripheral blood cell morphology or clinical examination. To the best of our knowledge, this is the first documented isolation of C. neoformans var. grubii (serotype A) and C. magnus in a free‐ranging macropod in Western Australia. The public health implications of this finding should be further explored.
Nature and frequency of prescription modifications in community pharmacies: A nationwide study in the Netherlands
Authors: van Loon W.E. (Ellen) , Borgsteede S.D. (Sander) , Baas G.W. (Gert) , Kruijtbosch M. (Martine) , Buurma H. (Henk) , De Smet P.A.G.M. Peter , Egberts A.C.G. (Toine) , Bouvy M. (Marcel) , Floor‐Schreudering A. (Annemieke)
Published: September 2020

Aims

To investigate the nature and frequency of prescription modifications in Dutch community pharmacies.

Methods

In this cross‐sectional study, Dutch community pharmacists documented prescription modifications in their pharmacy during 1 predetermined day. Pharmacists from all Dutch community pharmacies were invited to participate. A prescription modification was defined as any modification in a prescription for a medicine or other healthcare product because of an administrative problem, logistic issue or potential drug‐related problem (DRP). All documented modifications were assessed to establish the nature and frequency of prescription modifications.

Results

Pharmacists in 275 pharmacies completed the study. A modification was performed in 5.5% of all prescriptions. 1.3% of the prescriptions contained an administrative problem, of which insufficient specification of the dosing regimen was most common (63.1%). A modification was performed due to a logistic issue in 2.4% of the prescriptions. The most frequently recorded issues were unavailability of medication (40.9%) and obligatory product substitutions due to reimbursement policies (33.2%). A modification was performed in 1.8% of the prescriptions to solve or prevent potential DRPs. Of these, 69.2% was potentially clinically relevant according to the pharmacist concerned. The most frequently prevented potential DRP was an incorrect strength or dose (31.9%).

Conclusion

Dutch community pharmacists modified almost 1 in 20 prescriptions per pharmacy. The nature of the modifications reflects current community pharmacy practice, in which pharmacists frequently deal with logistic issues and intervene to solve or prevent for DRPs several times a day. The majority of the DRPs were considered to be potentially clinically relevant.
Semiparametric partial common principal component analysis for covariance matrices
Authors: Wang Bingkai , Luo Xi , Zhao Yi , Caffo Brian
Published: September 2020

We consider the problem of jointly modeling multiple covariance matrices by partial common principal component analysis (PCPCA), which assumes a proportion of eigenvectors to be shared across covariance matrices and the rest to be individual‐specific. This paper proposes consistent estimators of the shared eigenvectors in the PCPCA as the number of matrices or the number of samples to estimate each matrix goes to infinity. We prove such asymptotic results without making any assumptions on the ranks of eigenvalues that are associated with the shared eigenvectors. When the number of samples goes to infinity, our results do not require the data to be Gaussian distributed. Furthermore, this paper introduces a sequential testing procedure to identify the number of shared eigenvectors in the PCPCA. In simulation studies, our method shows higher accuracy in estimating the shared eigenvectors than competing methods. Applied to a motor‐task functional magnetic resonance imaging data set, our estimator identifies meaningful brain networks that are consistent with current scientific understandings of motor networks during a motor paradigm.
Whose Development? How Women Living Near the Yanacocha Mine, Peru, Envision Potential Futures
Authors: Boudewijn Inge A. M.
Published: September 2020

Among women opposing expansion of mining operations in Cajamarca, Peru, narratives of preferred alternatives diverge: from sustainable mining to alternative economic development, to more radical alternatives to ‘development’. In these accounts, both the women's relative powerlessness and agency become apparent. This article critically explores women's views of development and their imaginings of their region with or without mining. I argue that those who opposed mining show a continuing engagement with questions of development in the aftermath of conflict over natural resource extraction, highlighting a common thread of desires for bottom‐up initiatives embracing local knowledge, practice and history.
Performing the ‘India Permitida’: The Counter‐Gift of Indigenous Women Targeted by a Corporate Social Responsibility Programme (Chile)
Authors: Gajardo Anahy
Published: September 2020

Relying on ethnographic data, this article critically analyses the pro‐mining position adopted in Chile's Atacama Region by a group of Diaguita women who benefited from a corporate social responsibility (CSR) programme to revive indigenous culture. While the desire to escape from poverty (salir adelante, moving forward) appears as the main reason for participating, the benefits generated a sense of indebtedness resulting in allegiance to the company. The investigation also shows how this programme played a part in building a scenario in which indigenous females perform subjects apparently more suited than men to the neoliberal and multiculturalist governmentality of the Chilean State, whose politics favours mining.
Quantitative analysis of a footwall‐scarp degradation complex and syn‐rift stratigraphic architecture, Exmouth Plateau, NW Shelf, offshore Australia
Authors: Barrett Bonita J. , Hodgson David M. , Jackson Christopher A.‐L. , Lloyd Christopher , Casagrande Junia , Collier Richard E. Ll.
Published: September 2020

Interactions between footwall‐, hangingwall‐ and axial‐derived depositional systems make syn‐rift stratigraphic architecture difficult to predict, and preservation of net‐erosional source landscapes is limited. Distinguishing between deposits derived from fault‐scarp degradation (consequent systems) and those derived from long‐lived catchments beyond the fault block crest (antecedent systems) is also challenging, but important for hydrocarbon reservoir prospecting. We undertake geometric and volumetric analysis of a fault‐scarp degradation complex and adjacent hangingwall‐fill associated with the Thebe‐2 fault block on the Exmouth Plateau, NW Shelf, offshore Australia, using high resolution 3D seismic data. Vertical and headward erosion of the complex and fault throw are measured. Seismic‐stratigraphic and seismic facies mapping allow us to constrain the spatial and architectural variability of depositional systems in the hangingwall. Footwall‐derived systems interacted with hangingwall‐ and axial‐derived systems, through diversion around topography, interfingering or successive onlap. We calculate the volume of footwall‐sourced hangingwall fans (VHW) for nine quadrants along the fault block, and compare this to the volume of material eroded from the immediately up‐dip fault‐scarp (VFW). This analysis highlights areas of sediment bypass (VFW > VHW) and areas fed by sediment sources beyond the degraded fault scarp (VHW > VFW). Exposure of the border fault footwall and adjacent fault terraces produced small catchments located beyond the fault block crest that fed the hangingwall basin. One source persisted throughout the main syn‐rift episode, and its location coincided with: (a) an intra‐basin topographic high; (b) a local fault throw minimum; (c) increased vertical and headward erosion within the fault‐scarp degradation complex; and (d) sustained clinoform development in the immediate hangingwall. Our novel quantitative volumetric approach to identify through‐going sediment input points could be applied to other rift basin‐fills. We highlight implications for hydrocarbon exploration and emphasize the need to incorporate interaction of multiple sediment sources and their resultant architecture in tectono‐stratigraphic models for rift basins.
Carbon ion radiation therapy for sinonasal malignancies: Promising results from 2282 cases from the real world
Authors: Zhang Wenna , Hu Weixu , Hu Jiyi , Gao Jing , Yang Jing , Kong Lin , Lu Jiade J.
Published: September 2020

The aim of this study is to compare the effectiveness of carbon ion radiation therapy (CIRT), proton radiation therapy (PRT), and photon‐based intensity‐modulated radiation therapy (IMRT) in the treatment of sinonasal malignancies. We identified studies through systematic review and divided them into three cohorts (CIRT group/PRT group/IMRT group). Primary outcomes of interest were overall survival (OS) and local control (LC). We pooled the outcomes with meta‐analysis and compared the survival difference among groups using Chi2 (χ2) test. A representative sample of 2282 patients with sinonasal malignancies (911 in the CIRT group, 599 in the PRT group, and 772 in the IMRT group) from 44 observation studies (7 CIRT, 16 PRT, and 21 IMRT) was included. The pooled 3‐year OS, LC, distant metastasis–free survival, and progression‐free survival rates were 67.0%, 72.8%, 69.4%, and 52.8%, respectively. Through cross‐group analysis, the OS was significantly higher after CIRT (75.1%, 95% CI: 67.1%‐83.2%) than PRT (66.2%, 95% CI: 57.7%‐74.6%; χ2 = 13.374, P < .0001) or IMRT (63.8%, 95% CI: 55.3%‐72.3%; χ2 = 23.814, P < .0001). LC was significantly higher after CIRT (80.2%, 95% CI: 73.9%‐86.5%) than PRT (72.9%, 95% CI: 63.7%‐82.0%; χ2 = 8.955, P = .003) or IMRT (67.8%, 95% CI: 59.4%‐76.2%; χ2 = 30.955, P < .0001). However, no significant difference between PRT and IMRT for OS and LC was observed. CIRT appeared to provide better OS and LC for patients with malignancies of nasal cavity and paranasal sinuses. A prospective randomized clinical trial is needed to confirm the superiority of CIRT in the treatment of sinonasal tumors.
Safe environments—Through the eyes of 9‐year‐old schoolchildren from a socially vulnerable area in Sweden
Authors: Enskär Karin , Isma Gabriella E. , Rämgård Margaretha
Published: September 2020

Background

Children are more vulnerable than adults to environmental risks. Also, children have little control over their environment. Unlike adults, they may be both unaware of risks and unable to make choices to protect their health. Children living in especially vulnerable areas might be even more at risk due to socio‐economic factors, immigration and high crime rates. Therefore, the aim of this study was to describe the perceptions that schoolchildren from a socially vulnerable area have of safe environments.

Methods

Fifty‐two 9‐year‐old schoolchildren from a socially vulnerable area participated in this study. The data collection consisted of an environmental walk with photovoicing, followed by rating of the photos and a focus‐group discussion elaborating on the photos and ratings. Six focus groups, with six to eight children in each group, were conducted and analysed using inductive content analysis.

Results

The results show that, according to the children, places that they think are bright and beautiful, where they can do fun things with others and do not risk being exposed to danger, create safety. To increase safety, the children suggested cleaning up, making the environment beautiful with grass and flowers and painting it in nice colours. Furthermore, they suggested that building features that increase the opportunities to play and engage in activities together with others would improve safety and enhance protection and surveillance.

Conclusions

All children have the right to protection and safety. Therefore, it is important to create safe environments for all children by listening to children's own voices.
Changes in the hepatitis B surface antibody in childhood acute lymphocytic leukaemia survivors after treatment with the CCLG-ALL 2008 protocol
Authors: Wang L , Hu H , Zhang R , Zheng X , Li J , Lu J , Zhang Y , Qi P , Lin W , Wu Y , Yu J , Fan J , Peng Y , Zheng H
Published: September 2020

Antibody levels after hepatitis B virus (HBV) vaccination may be affected by suppression of the immune system due to cancer therapy. As such, childhood acute lymphocytic leukaemia (ALL) survivors are at risk of HBV infection due to immunosuppression secondary to chemotherapy. However, the hepatitis B surface antibody (HBsAb)-seropositive rate of childhood ALL survivors after chemotherapy is unknown, and the need to revaccinate HBsAb-seronegative ALL survivors is not appreciated in China. To assess the changes in HBsAb before and after chemotherapy, we retrospectively analyzed clinical data from 547 patients treated with the Chinese Children Leukaemia Group (CCLG)-ALL 2008 protocol from 1 April 2008 to 30 August 2019. The results revealed that 416 patients (76·1%) were HBsAb-seropositive at diagnosis, and at the time of the cessation of chemotherapy, 177 patients (32·4%) were HBsAb-seropositive and 370 patients (67·6%) were HBsAb-seronegative. Interestingly, 11 patients who were HBsAb-seronegative at diagnosis converted to seropositive at the time of the cessation of chemotherapy. HBsAb titres were decreased after chemotherapy (P < 0·0001). Further, patients with higher HBsAb titres at diagnosis were more likely to maintain protective antibody titres at the completion of chemotherapy (P < 0·0001). The loss of antibody was more remarkable in younger patients (≤ 10 years) both at diagnosis (P = 0·009) and at the completion of chemotherapy (P = 0·006). In summary, this study showed that 67·6% of patients were HBsAb-seronegative at the time of the cessation of chemotherapy, which indicates that ALL survivors are at high risk of HBV. As a result, HBV revaccination after chemotherapy should be highly valued in ALL survivors.
Comprehensive genotype‐phenotype correlation in AP‐4 deficiency syndrome; Adding data from a large cohort of Iranian patients
Authors: Beheshtian Maryam , Akhtarkhavari Tara , Mehvari Sepideh , Mohseni Marzieh , Fattahi Zohreh , Abedini Seyedeh Sedigheh , Arzhangi Sanaz , Fadaee Mahsa , Jamali Payman , Najafipour Reza , Kalscheuer Vera M. , Hu Hao , Ropers Hans‐Hilger , Najmabadi Hossein , Kahrizi Kimia
Published: September 2020

Mutations in adaptor protein complex‐4 (AP‐4) genes have first been identified in 2009, causing a phenotype termed as AP‐4 deficiency syndrome. Since then several patients with overlapping phenotypes, comprised of intellectual disability (ID) and spastic tetraplegia have been reported. To delineate the genotype‐phenotype correlation of the AP‐4 deficiency syndrome, we add the data from 30 affected individuals from 12 out of 640 Iranian families with ID in whom we detected disease‐causing variants in AP‐4 complex subunits, using next‐generation sequencing. Furthermore, by comparing genotype‐phenotype findings of those affected individuals with previously reported patients, we further refine the genotype‐phenotype correlation in this syndrome. The most frequent reported clinical findings in the 101 cases consist of ID and/or global developmental delay (97%), speech disorders (92.1%), inability to walk (90.1%), spasticity (77.2%), and microcephaly (75.2%). Spastic tetraplegia has been reported in 72.3% of the investigated patients. The major brain imaging findings are abnormal corpus callosum morphology (63.4%) followed by ventriculomegaly (44.5%). Our result might suggest the AP‐4 deficiency syndrome as a major differential diagnostic for unknown hereditary neurodegenerative disorders.
Predictive value of changes in the level of carbohydrate antigen 19‐9 in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy
Authors: Zheng Z. , Wang X. , Huang Y. , Lu X. , Chi P.
Published: September 2020

Aim

The aim of this work was to explore the predictive value of changes in the level of carbohydrate antigen 19‐9 (CA19‐9) after neoadjuvant chemoradiotherapy (nCRT) and after surgery in patients with locally advanced rectal cancer (LARC).

Method

Patients with LARC who underwent nCRT and radical surgery (between 2011 and 2016) were divided into three groups according to pre‐nCRT and post‐nCRT CA19‐9 levels as follows: normal pre‐nCRT CA19‐9 (normal CA19‐9 group), elevated pre‐nCRT and normal post‐nCRT CA19‐9 (normalized group) and elevated pre‐nCRT and elevated post‐nCRT CA19‐9 (nonnormalized group). The pathological nCRT response criteria included ypCR and downstaging (ypStages 0–I). Recurrence‐free survival (RFS) and overall survival (OS) were analysed.

Results

A total of 721 patients were identified. The normal CA19‐9 group was significantly associated with ypCR (n = 159) and downstaging (n = 347) (P < 0.05). The normalized group (n = 76) had worse RFS and OS than the normal CA19‐9 group (n = 622) and better RFS and OS than the nonnormalized group (n = 23) (5‐year RFS 47.0% vs 66.9% vs 81.5%, P < 0.001; 5‐year OS 47.0% vs 75.4% vs 85.0%, P < 0.001). In multivariate analysis, CA19‐9 group and ypTNM stage were independent predictors of RFS and OS. Moreover, for the 23 patients with elevated post‐nCRT CA19‐9 levels, the RFS and OS of patients with normalized postoperative CA19‐9 levels were significantly better than those of patients with elevated postoperative CA19‐9 levels (P < 0.05).

Conclusion

Following nCRT, changes in the CA19‐9 level are a strong prognostic marker for long‐term survival, and they may be helpful in the selection of patients who prefer more conservative surgery after chemoradiotherapy.
Effect of Combination Therapy of Hydroxychloroquine and Azithromycin on Mortality in Patients With COVID‐19
Authors: Lauriola Marinella , Pani Arianna , Ippoliti Giovanbattista , Mortara Andrea , Milighetti Stefano , Mazen Marjieh , Perseghin Gianluca , Pastori Daniele , Grosso Paolo , Scaglione Francesco
Published: September 2020

Conflicting evidence regarding the use of hydroxychloroquine (HCQ) and azithromycin for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection do exist. We performed a retrospective single‐center cohort study including 377 consecutive patients admitted for pneumonia related to coronavirus disease 2019 (COVID‐19). Of these, 297 were in combination treatment, 17 were on HCQ alone, and 63 did not receive either of these 2 drugs because of contraindications. The primary end point was in‐hospital death. Mean age was 71.8 ± 13.4 years and 34.2% were women. We recorded 146 deaths: 35 in no treatment, 7 in HCQ treatment group, and 102 in HCQ + azithromycin treatment group (log rank test for Kaplan–Meier curve P < 0.001). At multivariable Cox proportional hazard regression analysis, age (hazard ratio (HR) 1.057, 95% confidence interval (CI) 1.035–1.079, P < 0.001), mechanical ventilation/continuous positive airway pressure (HR 2.726, 95% CI 1.823–4.074, P < 0.001), and C reactive protein above the median (HR 2.191, 95% CI 1.479–3.246, P < 0.001) were directly associated with death, whereas use of HCQ + azithromycin (vs. no treatment; HR 0.265, 95% CI 0.171–0.412, P < 0.001) was inversely associated. In this study, we found a reduced in‐hospital mortality in patients treated with a combination of HCQ and azithromycin after adjustment for comorbidities. A large randomized trial is necessary to confirm these findings.
Important Pharmacogenetic Information for Drugs Prescribed During the SARS‐CoV‐2 Infection (COVID‐19)
Authors: Zubiaur Pablo , Koller Dora , Saiz‐Rodríguez Miriam , Navares‐Gómez Marcos , Abad‐Santos Francisco
Published: September 2020

In December 2019, the severe acute respiratory syndrome virus‐2 pandemic began, causing the coronavirus disease 2019. A vast variety of drugs is being used off‐label as potential therapies. Many of the repurposed drugs have clinical pharmacogenetic guidelines available with therapeutic recommendations when prescribed as indicated on the drug label. The aim of this review is to provide a comprehensive summary of pharmacogenetic biomarkers available for these drugs, which may help to prescribe them more safely.
Exploring views on alcohol consumption and digital support for alcohol reduction in UK‐based Punjabi‐Sikh men: A think aloud and interview study
Authors: Taak Karamjeet , Brown Jamie , Perski Olga
Published: September 2020

Introduction and Aims

We aimed to explore UK‐based Punjabi‐Sikh men's views on: (i) alcohol consumption within the community; (ii) available support for alcohol reduction; and (iii) an evidence‐informed alcohol reduction app.

Design and Methods

Semi‐structured interviews and a think aloud method were employed. Participants (n = 15) were male, aged 18–27 years, identified as Punjabi‐Sikh, were hazardous or harmful drinkers (i.e. had an Alcohol Use Disorders Identification Test‐Consumption score of ≥5) and interested in using an app to reduce drinking. Interviews were audio‐recorded, transcribed verbatim and analysed with inductive thematic analysis.

Results

Six themes were developed: (i) fear of drinking to cope; (ii) clash between religious and cultural norms (i.e. an internal conflict between important values); (iii) stigmatisation of mental health issues and lack of knowledge as barriers to help seeking; (iv) perceived usefulness of goal setting, monitoring and feedback (i.e. beliefs about the utility of the app's components for reducing drinking); (v) concerns about accessibility of the app within the Punjabi‐Sikh community; and (vi) desire for human support for continued app engagement.

Discussion and Conclusions

Among UK‐based, Punjabi‐Sikh men, clashing religious and cultural norms give rise to internal conflict about drinking. Stigmatisation of mental health issues and lack of knowledge of available support leads to reduced help seeking. Respondents believed an evidence‐informed alcohol reduction app could be useful, but were concerned about accessibility within the wider community and wanted an element of human support. The potential for a combination of digital and face‐to‐face support should be explored.
Hybrid governance and disaster management in Freetown, Sierra Leone, Monrovia, Liberia, and Dar es Salaam, Tanzania
Authors: Clark‐Ginsberg Aaron , Blake Jonathan S. , Patel Karishma V.
Published: September 2020

This paper introduces a hybrid governance—referring to situations where state and non‐state actors collectively provide key services—perspective to disaster management. It contends that hybridity is often the norm rather than the exception in disaster management, particularly in developing countries where the state is frequently weak and may be unable or unwilling to supply essential services. In these instances, risks are addressed by state and non‐state entities, ranging from citizens and non‐governmental organisations to customary authorities. Given their important role in risk reduction, the disruption of hybrid processes by attempting to bring them within the remit of the state may create rather than diminish risk. To make this argument, the paper first outlines the key tenants of hybridity and their applicability to disasters before illustrating hybridity through three case studies of hybrid risk management in three cities in Africa: Freetown, Sierra Leone; Monrovia, Liberia; and Dar es Salaam, Tanzania.
Pre‐treatment high‐sensitivity troponin T for the short‐term prediction of cardiac outcomes in patients on immune checkpoint inhibitors
Authors: Petricciuolo Serena , Delle Donne Maria Grazia , Aimo Alberto , Chella Antonio , De Caterina Raffaele
Published: September 2020

Background

Immune checkpoint inhibitors (ICIs) are an emerging option for several advanced metastatic cancers, but may have cardiotoxic effects. The prognostic value of high‐sensitivity troponin T (hs‐TnT) before treatment start has never been investigated.

Materials and methods

Thirty consecutive patients underwent measurement of hs‐TnT before starting ICI therapy (pembrolizumab, 23%; nivolumab, 12%; atezolizumab, 6%; durvalumab, 5%). The primary endpoint of cardiovascular death, stroke or transient ischaemic attack, pulmonary embolism and new‐onset heart failure, and the secondary endpoint of progression of cardiac involvement according to the CARDIOTOX classification were evaluated after 3 months from the first cycle.

Results

Patients (median age 68 years, 77% men, 13% with coronary artery disease, 90% current or former smokers, 67% overweight or obese and 43% hypertensive) had a median hs‐TnT of 12 ng/L (interquartile interval 8‐23). The primary endpoint occurred only in patients with hs‐TnT ≥ 14 ng/L at baseline. Therefore, only patients who had hs‐TnT ≥ 14 ng/L before the first cycle died had a stroke/TIA or new‐onset HF. Furthermore, nine out of 13 patients with the secondary endpoint (progression of cardiac disease) had hs‐TnT ≥ 14 ng/L before the first cycle (P = .012). AUC values were 0.909 for the primary endpoint and 0.757 for the secondary endpoint. The best cut‐off was 14 ng/L for both the primary (100% sensitivity, 73% specificity) and secondary endpoints (sensitivity 75%, specificity 77%).

Conclusions

In patients on ICIs, baseline hs‐TnT predicts a composite cardiovascular endpoint and the progression of cardiac involvement at 3 months, with 14 ng/L as the best cut‐off.
Rehabilitation of a patient with mini‐implants after avulsion of the upper incisors: A 13‐year follow up
Authors: Giannetti Luca , Apponi Roberto , Murri Dello Diago Alberto , Mintrone Francesco
Published: September 2020

Treatment following avulsion of a tooth in the growing patient requires a complex multidisciplinary therapeutic approach for the clinical team. The literature offers different therapeutic solutions following the avulsion of one or more teeth, but unfortunately all of them have negative repercussions on the patients' life quality, they involve long treatment plans, they are not always feasible, and they have limits. Alternatively, a new treatment concept that uses mini‐implants can be considered and is presented with its rationale, clinical steps and 13 years of follow up of one case.
Genetic structuring across alternative life‐history tactics and small spatial scales in brown trout (Salmo trutta)
Authors: Rodger Jessica R. , Honkanen Hannele M. , Bradley Caroline R. , Boylan Patrick , Prodöhl Paulo A. , Adams Colin E.
Published: September 2020

Facultative migration occurs when, in response to prevailing conditions, individuals in a population may (or may not) undertake a migration. The brown trout (Salmo trutta) is a species that exhibits facultative migration, where some individuals within populations may move to mainstem rivers (fluvial–adfluvial migration), lakes (lacustrine–adfluvial migration), estuaries (partial anadromy) or sea (anadromy) to feed, while others remain resident. This study attempts to separate two alternative hypotheses for the population structuring that underpins the expression of facultative migration in this species: (a) that anadromous and nonanadromous fish comprise two gene pools; (b) that individual genetic variation or individual variation in gene–environment interactions is responsible for the expression of different life‐history tactics within the same gene pool. The study design involved sampling and analyses of anadromous and nonanadromous brown trout from three independent tributary rivers known to produce (sea‐run) trout within the same catchment. Results indicate that, in all cases, population genetic divergence was linked to geographical location and not to life‐history tactics. Two genetically distinct coexisting population pairs were identified in two separate tributaries. Despite similar environmental conditions in both tributaries, the frequency of each life‐history tactic (anadromy vs. nonanadromous) within these population pairs differed significantly. The results of this study support the hypothesis that facultative migration in brown trout is likely to be driven by a quantitative threshold trait, where the threshold value varies both among populations and among individuals within populations.
Hemodynamic modeling of long‐term aspirin effects on blood oxygenated level dependent responses at 7 Tesla in patients at cardiovascular risk
Authors: Do Cao‐Tri , Manjaly Zina‐Mary , Heinzle Jakob , Schöbi Dario , Kasper Lars , Pruessmann Klaas P. , Stephan Klaas Enno , Frässle Stefan
Published: September 2020

Aspirin is considered a potential confound for functional magnetic resonance imaging (fMRI) studies. This is because aspirin affects the synthesis of prostaglandin, a vasoactive mediator centrally involved in neurovascular coupling, a process underlying blood oxygenated level dependent (BOLD) responses. Aspirin‐induced changes in BOLD signal are a potential confound for fMRI studies of at‐risk individuals or patients (e.g. with cardiovascular conditions or stroke) who receive low‐dose aspirin prophylactically and are compared to healthy controls without aspirin. To examine the severity of this potential confound, we combined high field (7 Tesla) MRI during a simple hand movement task with a biophysically informed hemodynamic model. We compared elderly individuals receiving aspirin for primary or secondary prophylactic purposes versus age‐matched volunteers without aspirin medication, testing for putative differences in BOLD responses. Specifically, we fitted hemodynamic models to BOLD responses from 14 regions activated by the task and examined whether model parameter estimates were significantly altered by aspirin. While our analyses indicate that hemodynamics differed across regions, consistent with the known regional variability of BOLD responses, we neither found a significant main effect of aspirin (i.e., an average effect across brain regions) nor an expected drug × region interaction. While our sample size is not sufficiently large to rule out small‐to‐medium global effects of aspirin, we had adequate statistical power for detecting the expected interaction. Altogether, our analysis suggests that patients with cardiovascular risk receiving low‐dose aspirin for primary or secondary prophylactic purposes do not show strongly altered BOLD signals when compared to healthy controls without aspirin.
Pathways Linking Parental Relationship Changes, Depressive Symptoms, and Parenting Behaviors to Young Children's Development
Authors: Barnett Melissa A. , Paschall Katherine W. , Kopystynska Olena , Warren Shannon M. , Curran Melissa A.
Published: September 2020

Objective

The current study examined how parental relationship changes were linked to observed parenting behaviors, parental depressive symptoms, and 3‐year‐old children's social–emotional development.

Background

Parental relationship changes may present risks to young children's well‐being. The specific processes linking these changes to child development, however, remain unclear because these changes are often confounded with other family risks. We applied an adapted family stress model to identify family‐based pathways conferring risk to children among predominantly low‐income unmarried families.

Method

Data are from 2,575 families who participated in the Building Strong Families study, which included primarily unmarried, low‐income couples transitioning to parenthood. Parental relationship changes were measured as overall changes in parents' romantic relationship status with each other and with new partners and multipartner fertility. Structural equation models (SEM) were estimated to link these changes directly and indirectly, via mothers' and fathers' parenting behaviors and depressive symptoms, to children's behavior problems and effortful control.

Results

Parental relationship changes were directly associated with paternal depressive symptoms and children's internalizing behaviors. Mothers' and fathers' parenting behaviors were independently associated with children's behavior problems and effortful control.

Conclusion

The findings point to the value of simultaneously considering the observed parenting behaviors and depressive symptoms of mothers and fathers within the context of parent relationship changes.

Implications

Interventions aimed at strengthening low‐income unmarried families should focus on the quality of mothers' and fathers' parenting to bolster young children's development because these parenting behaviors were more closely associated with child development than were parental relationship changes.
Conditioned place preference for cocaine and methylphenidate in female mice from lines selectively bred for high voluntary wheel‐running behavior
Authors: Schmill Margaret P. , Cadney Marcell D. , Thompson Zoe , Hiramatsu Layla , Albuquerque Ralph L. , McNamara Monica P. , Castro Alberto A. , Kay Jarren C. , Buenaventura Darrius G. , Ramirez Jocelyn L. , Rhodes Justin S. , Garland Theodore
Published: September 2020

Behavioral addictions can come in many forms, including overeating, gambling and overexercising. All addictions share a common mechanism involving activation of the natural reward circuit and reinforcement learning, but the extent to which motivation for natural and drug rewards share similar neurogenetic mechanisms remains unknown. A unique mouse genetic model in which four replicate lines of female mice were selectively bred (>76 generations) for high voluntary wheel running (High Runner or HR lines) alongside four non‐selected control (C) lines were used to test the hypothesis that high motivation for exercise is associated with greater reward for cocaine (20 mg/kg) and methylphenidate (10 mg/kg) using the conditioned place preference (CPP) test. HR mice run ~three times as many revolutions/day as C mice, but the extent to which they have increased motivation for other rewards is unknown. Both HR and C mice displayed significant CPP for cocaine and methylphenidate, but with no statistical difference between linetypes for either drug. Taken together, results suggest that selective breeding for increased voluntary running has modified the reward circuit in the brain in a way that increases motivation for running without affecting cocaine or methylphenidate reward.
Exist or exit? Women business‐owners in Bangladesh during COVID‐19
Authors: Jaim Jasmine
Published: September 2020

Within the unique context of COVID‐19, this feminist research provides novel insights on how gender‐specific issues are articulated in the experiences of women concerning their small businesses in a patriarchal developing nation. Based on the interviews of women business‐owners in Bangladesh, this research reveals the diversified gendered experiences of women in private and public spheres in continuing their business operations during the pandemic period. It also unveils patriarchal practices regarding women's discontinuing or closing down ventures due to the COVID‐19 crisis. Thus, the research substantially advances the understanding on the influence of gender on women's continuing or discontinuing or even closing down their businesses in a highly patriarchal developing nation during the pandemic period. It further offers important suggestions for policy practitioners in supporting women business‐owners of patriarchal developing nations during the COVID‐19 pandemic.
Effect of pemafibrate on fatty acid levels and liver enzymes in non‐alcoholic fatty liver disease patients with dyslipidemia: A single‐arm, pilot study
Authors: Seko Yuya , Yamaguchi Kanji , Umemura Atsushi , Yano Kota , Takahashi Aya , Okishio Shinya , Kataoka Seita , Okuda Keiichiroh , Moriguchi Michihisa , Okanoue Takeshi , Itoh Yoshito
Published: September 2020

Aim

Dyslipidemia (DL) is commonly associated with non‐alcoholic fatty liver disease (NAFLD). Pemafibrate, a selective peroxisome proliferator activated receptor α modulator (SPPARMα), has been shown to improve liver function among patients with DL. The aim of this single‐arm prospective study is to evaluate the efficacy of pemafibrate in NAFLD patients with DL.

Methods

Twenty NAFLD patients with DL who received pemafibrate (0.1 mg) twice a day for 12 weeks were prospectively enrolled in this study. The primary end‐point was change in serum alanine aminotransferase (ALT) levels from baseline to week 12.

Results

Serum ALT levels decreased from 75.1 IU/L at baseline to 43.6 IU/L at week 12 (P = 0.001). Significant improvements in triglyceride, high‐density lipoprotein cholesterol, total fatty acid, saturated fatty acid (SFA), and unsaturated fatty acid were also noted. The serum level of remnant‐like protein cholesterol, SFA, and polyunsaturated / saturated fatty acid ratio (PUFA / SFA ratio) at baseline were correlated with change in ALT level (r = −0.53, r = −0.57, and r = 0.46, respectively). Change in PUFA and change in PUFA / SFA ratio were negatively correlated with change in ALT level (r = −0.49 and r = −0.53). No hepatic or renal adverse events were reported.

Conclusions

Selective peroxisome proliferator activated receptor α could be a promising novel agent for treatment of NAFLD patients with DL by regulating fatty acid composition. A further long‐term large‐scale trial is warranted to confirm the efficacy of SPPARMα on NAFLD with DL.
A multicentre analytical comparison study of inter‐reader and inter‐assay agreement of four programmed death‐ligand 1 immunohistochemistry assays for scoring in triple‐negative breast cancer
Authors: Noske Aurelia , Ammann Johannes U , Wagner Daniel‐Christoph , Denkert Carsten , Lebeau Annette , Sinn Peter , Kreipe Hans‐Heinrich , Sommer Ulrich , Baretton Gustavo , Steiger Katja , Kiechle Marion , Hieke‐Schulz Stefanie , Flores Mike , Roth Wilfried , Weichert Wilko
Published: September 2020

Aims

Studies in various cancer types have demonstrated discordance between results from different programmed death‐ligand 1 (PD‐L1) assays. Here, we compare the reproducibility and analytical concordance of four clinically developed assays for assessing PD‐L1‐positivity in tumour‐infiltrating immune cells in the tumour area (PD‐L1‐IC‐positivity) in triple‐negative breast cancer (TNBC).

Methods and results

Primary TNBC resection specimens (n = 30) were selected based on their PD‐L1‐IC‐positivity per VENTANA SP142 (<1%: 15 cases; 1–5%: seven cases; >5%: eight cases). Serial histological sections were stained for PD‐L1 using VENTANA SP142, VENTANA SP263, DAKO 22C3 and DAKO 28‐8. PD‐L1‐IC‐positivity and tumour cell expression (≥1 versus <1%) were scored by trained readers from seven sites using online virtual microscopy. The adjusted mean of PD‐L1‐IC‐positivity for SP263 (7.8%) was significantly higher than those for the other three assays (3.7–4.9%). Differences in adjusted means were statistically significant between SP263 and the other three assays (P < 0.0001) but not between the three remaining assays when excluding SP263 (P = 0.0961–0.6522). Intra‐class correlation coefficients revealed moderate‐to‐strong inter‐reader agreement for each assay (0.460–0.805) and poor‐to‐strong inter‐assay agreement for each reader (0.298–0.678) on PD‐L1‐IC‐positivity.

Conclusions

In this first multicentre study of different PD‐L1 assays in TNBC, we show that PD‐L1‐IC‐positivity for SP142, 22C3 and 28‐8 was reproducible and analytically concordant, indicating that these three assays may be analytically interchangeable. The relevance of the higher PD‐L1‐IC‐positivity for SP263 should be further investigated.
Isomaltodextrin strengthens model starch gels and moderately promotes starch retrogradation
Authors: Fang Fang , Hayes Anna M.R. , Watanabe Hikaru , Higashiyama Takanobu , Campanella Osvaldo H. , Hamaker Bruce R.
Published: September 2020

Isomaltodextrin (IMD) is a novel highly branched α‐glucan with emerging applications in foods due to its nutritional functionalities. In this study, the impact of IMD on the viscoelasticity and microstructure of starch gels and starch retrogradation were investigated. IMD solutions displayed typical Newtonian behaviour. Their viscosities had a positive correlation with concentration and a negative correlation with temperature. When maintained at relative humidity of 95%, IMD absorbed 40% water of its original weight. The addition of IMD to normal corn starch increased strength of gels as indicated by higher storage moduli (G′) and resulted in a denser and smaller pore structure, but there were no changes in elasticity. Upon storage for 7 days, addition of IMD at high concentration (starch: IMD = 2:1) significantly increased the degree of starch retrogradation. This study provided perspectives underlying applications of IMD in starchy foods as a novel ingredient with textural functionality.
Date fruit: a review of the chemical and nutritional compounds, functional effects and food application in nutrition bars for athletes
Authors: Ibrahim Salam A. , Ayad Amira A. , Williams Leonard L. , Ayivi Raphael D. , Gyawali Rabin , Krastanov Albert , Aljaloud Sulaiman O.
Published: September 2020

Date fruit is an excellent source of nutritional and health benefits. The chemical composition of dates includes carbohydrates, dietary fibre, proteins, fats, minerals and vitamins, enzymes, phenolic acid and carotenoids, all of which are directly linked to nutritional and health benefits for consumers. A number of studies have also confirmed the therapeutic effects of dates and their efficacy in the treatment of many disease conditions. As a result, a number of food products such as date syrup, date juice and date paste have been developed in order to harness the nutritional potential of dates. Adequate sources of nutrition are important for all consumers, especially for active lifestyle individuals such as athletes and sportspeople. As the goal of every athlete is to enhance athletic performance and prevent energy deficit, the use of dietary supplements has been highly recommended as a solution in this regard. For example, nutrition bars are one source of high energy and nutrients that can provide the required energy for enhanced athletic performance, and date fruits could be valorised into nutrition bars in order to help athletes to achieve their performance and nutritional goals. In this paper, we review the chemical composition and health benefits of date fruit, its food application and consequently its formulation in nutrition bars for athletes.
Acid‐induced aggregation and gelation of heat‐treated chia proteins
Authors: López Débora N. , Ingrassia Romina , Busti Pablo , Wagner Jorge , Boeris Valeria , Spelzini Darío
Published: September 2020

This work studied for the first time the acid‐induced aggregation and gelation of heat‐treated chia protein isolates obtained by extraction at pH 10 or 12 (CPI10 and CPI12, respectively). The aggregation state of proteins was modified during acidification. The size of the aggregates was reduced for both samples when the pH decreased but below pH 4.5 further protein aggregation took place for CPI12. Gelation of CPI12 was completed after about 30 min of acidification with glucone‐δ‐lactone. By contrast, this period was not enough to reach a constant value in G′ for CPI10. When gelation was ensured, confocal laser scanning micrographs from those gels revealed a coarse and irregular structure with large pores (median size of diameters: 30 μm). Instead, micrographs from CPI12 cold gels showed a more regular and interconnected network, with smaller pores (median size of diameters: 9 μm). These differences are consistent with a higher elastic behaviour ( = 13.6 ± 0.1 Pa).