bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term (20-year) real-world outcomes of intravenous chemotherapy (chemoreduction) for retinoblastoma in 964 eyes of 554 patients at a single centre
Authors: Shields Carol L , Bas Zeynep , Tadepalli Sameeksha , Dalvin Lauren A , Rao Raksha , Schwendeman Rachel , Lally Sara E , Shields Jerry A , Shah Amish , Leahey Ann
Published: February 2020

Background

Intravenous chemotherapy (IVC) remains an important globe salvage therapy for retinoblastoma.

Methods

Evaluation of long-term globe salvage at 5, 10, 15 and 20 years following frontline IVC for retinoblastoma.

Results

Of 994 eyes, comparison by International Classification of Retinoblastoma group (A vs B vs C vs D vs E) revealed more advanced group with older mean age at presentation (8 vs 7 vs 10 vs 11 vs 15 months, p<0.001). By clinical features, more advanced group demonstrated greater mean tumour diameter (3.2 vs 6.8 vs 9.4 vs 14.3 vs 16.4, p<0.001) and thickness (2.0 vs 3.7 vs 4.4 vs 7.3 vs 9.3, p<0.001), and greater frequency of vitreous seeds ≥1 quadrant (0% vs 0% vs 44% vs 42% vs 57%, p<0.001) and subretinal seeds (0% vs 0% vs 22% vs 65% vs 54%, p<0.001). By outcomes, less advanced group demonstrated greater tumour control (without need for enucleation or external beam radiotherapy (EBRT)) by year 2 (96% vs 91% vs 91% vs 71% vs 32%, p<0.001), and with minimal change up to 20 years. In order to achieve globe salvage, additional intra-arterial chemotherapy (IAC) or plaque radiotherapy was employed by year 2 (5% vs 26% vs 28% vs 27% vs 19%, p<0.001), with little further need up to 20 years. Pinealoblastoma (2%), metastasis (2%) and death (1%) were infrequent.

Conclusion

Frontline IVC (plus additional IAC and/or plaque radiotherapy) for retinoblastoma provided complete tumour control for groups A (96%), B (91%), C (91%), D (71%) and E (32%), avoiding enucleation or EBRT and was lasting for up to 20 years.
Normative patterns and factors associated with presbyopia progression in a multiethnic Asian population: the Singapore Epidemiology of Eye Diseases Study
Authors: Majithia Shivani , Wong Kah Hie , Chee Miao Li , Soh Zhi-Da , Thakur Sahil , Fang Xiao Ling , Teo Zhen Ling , Sabanayagam Charumathi , Tham Yih Chung , Cheng Ching-Yu
Published: February 2020

Background/Aim

To investigate normative patterns and factors associated with presbyopia progression in a multiethnic Asian population.

Methods

Malay, Indian and Chinese participants aged 40–80 years who had baseline and 6-year follow-up examinations with subjective refraction data were recruited from the Singapore Epidemiology of Eye Diseases Study. Presbyopia progression was defined as an increase in near addition power of ≥+0.50 dioptre (D) from baseline to follow-up visit. Modified Poisson regression analyses were used to determine baseline factors associated with presbyopia progression.

Results

From the eligible 3974 eyes, 2608 eyes were included for final analysis after excluding eyes with a history of cataract surgery (929 eyes) and best-corrected distance visual acuity worse than 20/40 (342 eyes). Overall the mean near addition power change over 6 years was +0.25 D; Malays showed greater change (+0.37 D) compared with Indians (+0.23 D) and Chinese (+0.16 D). After adjusting for baseline age, gender, body mass index, hypertension, cataract, refractive error and daily hours of reading and writing, Malays were more likely to have presbyopia progression compared with Chinese (RR (relative risk)=1.67; 95% CI 1.43 to 1.95; p<0.001) and Indians (RR=1.45; 95% CI 1.25 to 1.68; p<0.001). Individuals aged 60–69 years (RR=0.77; p=0.006) and ≥70 years (RR=0.51; p<0.001) were less likely to progress in presbyopia compared with those aged 40–49.

Conclusion

In this Asian population, the near addition power change over 6 years was lower than the current near addition prescription guidelines (+0.25 D vs +0.60 D). Our findings may help update near addition prescription guidelines that can be more tailored to Asians.
Comparison of risk factor associations in UK Biobank against representative, general population based studies with conventional response rates: prospective cohort study and individual participant meta-analysis
Authors: Batty G David , Gale Catharine R , Kivimäki Mika , Deary Ian J , Bell Steven
Published: February 2020

Objective

To compare established associations between risk factors and mortality in UK Biobank, a study with an exceptionally low rate of response to its baseline survey, against those from representative studies that have conventional response rates.

Design

Prospective cohort study alongside individual participant meta-analysis of other cohort studies.

Setting

United Kingdom.

Participants

Analytical sample of 499 701 people (response rate 5.5%) in analyses in UK Biobank; pooled data from the Health Surveys for England (HSE) and the Scottish Health Surveys (SHS), including 18 studies and 89 895 people (mean response rate 68%). Both study populations were linked to the same nationwide mortality registries, and the baseline age range was aligned at 40-69 years.

Main outcome measure

Death from cardiovascular disease, selected malignancies, and suicide. To quantify the difference between hazard ratios in the two studies, a ratio of the hazard ratios was used with HSE-SHS as the referent.

Results

Risk factor levels and mortality rates were typically more favourable in UK Biobank participants relative to the HSE-SHS consortium. For the associations between risk factors and mortality endpoints, however, close agreement was seen between studies. Based on 14 288 deaths during an average of 7.0 years of follow-up in UK Biobank and 7861 deaths over 10 years of mortality surveillance in HSE-SHS, for cardiovascular disease mortality, for instance, the age and sex adjusted hazard ratio for ever having smoked cigarettes (versus never) was 2.04 (95% confidence interval 1.87 to 2.24) in UK Biobank and 1.99 (1.78 to 2.23) in HSE-SHS, yielding a ratio of hazard ratios close to unity (1.02, 0.88 to 1.19). The overall pattern of agreement between studies was essentially unchanged when results were compared separately by sex and when baseline years and censoring dates were aligned.

Conclusion

Despite a very low response rate, risk factor associations in the UK Biobank seem to be generalisable.
Simple and non-invasive screening method for diabetes based on myoinositol levels in urine samples collected at home
Authors: Takakado Misaki , Takata Yasunori , Yamagata Fumio , Yaguchi Michiko , Hiasa Go , Sato Sumiko , Funada Jun-ichi , Kawazu Shoji , Osawa Haruhiko
Published: February 2020

Objective

To establish a simple screening method for diabetes based on myoinositol (MI) in urine samples collected at home.

Research design and methods

Initially, we evaluated the stability of urinary MI (UMI) at room temperature (RT; 25°C) and 37°C in 10 outpatients with type 2 diabetes. We then enrolled 115 volunteers without a current or history of diabetes. In all subjects, glucose intolerance was diagnosed by 75 g oral glucose tolerance test (75gOGTT). To assess the association between UMI or urine glucose (UG) and plasma glucose (PG), urine samples were also collected at 0 and 2 hours during 75gOGTT. All the subjects collected urine samples at home before and 2 hours after consuming the commercially available test meal. UMI levels at wake-up time (UMIwake-up), before (UMIpremeal) and 2 hours after the test meal (UMI2h-postprandial) were measured using an enzymatic method. ΔUMI was defined as UMI2h-postprandialminus UMIpremeal.

Results

Differing from UG, UMI was stable at RT and 37°C. UMI was increased linearly along with an increase in PG, and no threshold for UMI was observed. UMI was closely associated with blood glucose parameters obtained from a 75gOGTT and hemoglobin A1c (HbA1c) at hospital after adjustment for age, sex, body mass index and serum creatinine. UMIwake-up, UMIpremeal, UMI2h-postprandialand ΔUMI at home were higher in diabetic subjects than non-diabetic subjects even after the above adjustment. Receiver operating characteristics curve (ROC) analyses revealed that for the screening of diabetes, the area under the curve for ROC for UMI2h-postprandialand ΔUMI (0.83 and 0.82, respectively) were not inferior to that for HbA1c ≥48 mmol/mol, which is the American Diabetes Association (ADA) criteria for diabetes.

Conclusions

MI measurement in urine samples collected at home before and after the meal would be a simple, non-invasive and valuable screening method for diabetes.
Uncovering social and psychosocial health factors through participatory qualitative research with low-income adults in a suburb of Montreal, Quebec
Authors: Wang Caroline H-Y , Loignon Christine , Hudon Catherine
Published: February 2020

Objectives

The association between social status and health is well established, but the psychosocial factors and mechanisms underlying this association are not fully understood. This study aims to identify and describe social and psychosocial factors that may harm the health of low-income adults.

Design

Participatory qualitative research using a problem-posing method based on Freire’s pedagogy.

Setting

Community organisation in a low-income district in the metropolitan area of Montreal, in the province of Quebec, Canada.

Participants

Eight low-income adults using food bank services provided by the community organisation. Participants had to reside in the community organisation’s service area, have insufficient income to cover living expenses, be aged 18 years or older, and be able to participate in group sessions.

Methods

Eight weekly group sessions (average of 2.5 hours per session) were held using problem-posing method, which included activities such as presentation of representative stories or images and role-playing. Five additional sessions were held for thematic data analysis with participants.

Results

A main factor identified as harming the health of participants was the dissonance between perceived current circumstances and the ideal of circumstances conceived early in life. This dissonance follows a loss or a failure to achieve the ideal of circumstances and generates profound malaise. Other main factors identified were the current circumstances as a social trap and the lack of love and support from an early age.

Conclusions

This study identifies a new psychosocial factor, namely, the dissonance between perceived current circumstances and the ideal of circumstances conceived early in life. Larger studies should examine the influence of this factor on health.
Is administration of proton pump inhibitors in functional dyspepsia worth the risk of developing gastric cancer: a Markov model to bridge the gap between scientific evidence and clinical practice
Authors: Broide Efrat , Eindor-Abarbanel Adi , Shirin Haim , Richter Vered , Matalon Shay , Leshno Moshe
Published: February 2020

Objective

To formulate a decision analysis model based on recently published data that addresses the dilemma, whether improvement in quality of life rationalises continued proton pump inhibitors (PPI) use despite the risk of gastric cancer (GC) in patients with functional dyspepsia (FD).

Design

A Markov model consisting of an initial decision regarding treatment with PPI (denoting it by PPI strategy) or any other treatment without PPI (denoting it by placebo strategy) was designed.

Data sources

Data from prospective cross-sectional studies indicating risk stratification for GC after the use of PPI, combined with a Markov model that comprised the following states: Live, GC stages 1–4, Death.

Outcome measures

The primary outputs included quality-adjusted life years (QALYs) and life expectancy (LE). The improvement in utility in FD without PPI as compared with PPI use was tested (PPI vs placebo strategies). Sensitivity analyses were performed to evaluate the robustness of the model and address uncertainty in the estimation of model parameters.

Setting

We considered only patients whose symptoms were relieved with PPIs and thus, had a better quality of life compared with patients who did not receive PPIs.

Results

The base case model showed that PPIs compared with placebo decreased LE by 58.4 days with a gain of 2.1 QALY. If utility (quality of life of patients with FD using PPI compared with patients with FD without PPI) improved by more than 0.8%, PPI use is considered better than placebo. Older patients benefited less from PPI treatment than did younger patients.

Conclusion

To bridge the gap between evidence and decision making, we found that even a small improvement in the QALY justified continuing PPI treatment.
Physician preferences for chemotherapy in the treatment of non-small cell lung cancer in China: evidence from multicentre discrete choice experiments
Authors: Sun Hui , Wang Huishan , Shi Lizheng , Wang Meifeng , Li Junling , Shi Jufang , Ni Ming , Hu Xianzhi , Chen Yingyao
Published: February 2020

Objective

To evaluate physician risk-benefit preferences and trade-offs when making chemotherapy decisions for patients with non-small cell lung cancer (NSCLC).

Design

A discrete choice experiment (DCE).

Settings

Tertiary hospitals in Beijing, Shanghai, Guangzhou and Chengdu of China.

Participants

The participants were 184 physicians (mean age of 37 years) with more than 1 year of NSCLC chemotherapy practice.

Outcomes

The DCE survey was constructed by six attributes: progression-free survival (PFS), disease control rate (DCR), risk of moderate side effects, risk of severe side effects, mode of administration and out-of-pocket costs. Physicians’ relative preferences and trade-offs in patient out-of-pocket costs for each attribute level were estimated using a mixed logit model, and interaction terms were added to the model to assess preferences variation among physicians with different sociodemographic factors.

Results

Physicians had the strongest preferences for improvements in PFS, followed by reducing the risk of severe side effects. The DCR, risk of moderate side effects and mode of administration were ranked in decreasing order of importance. There was little variation in preferences among physicians with different sociodemographic characteristics. Physicians were willing to trade $4814 (95% CI $4149 to $5480) of patient out-of-pocket costs per month for a chemotherapy that guaranteed 11 months of PFS, followed by $1908 (95% CI $1227 to $2539) for reducing the risk of severe side effects to 2%.

Conclusions

With regard to chemotherapy for patients with NSCLC, prolonging PFS, reducing severe and moderate side effects were primary considerations for physicians in China. The mode of administration and treatment costs significantly influenced physicians’ therapeutic decision. The current findings could add some evidence to inform NSCLC chemotherapy implementation and promote shared decision-making.
A double-blind randomised placebo-controlled trial of melatonin as an adjuvant agent in induction of labour (MILO): a study protocol
Authors: Swarnamani Kamala , Davies-Tuck Miranda , Wallace Euan , Mol Ben W , Mockler Joanne
Published: February 2020

Introduction

Induction of labour (IOL) is a common practice. In Australia, up to 40% of women undergoing labour induction will ultimately have a caesarean section. As a biological role for melatonin in the onset and progress of labour has been demonstrated, we aim to test the hypothesis that addition of melatonin will reduce the need for caesarean section.

Methods and analysis

This is a double-blind, randomised, placebo-controlled trial in women undergoing IOL at term. We plan to randomise 722 women (1:1 ratio) to receive either melatonin (four doses of 10 mg melatonin: first dose—in the evening at the time of cervical balloon or Dinoprostone PGE2vaginal pessary insertion, second dose—at time of oxytocin infusion commencement, third dose—6 hours after the second dose, fourth dose—6 hours after the third dose) or placebo (same dosing regime). Participants who are having artificial rupture of the membranes only as the primary means of labour induction will receive up to three doses of the trial intervention. The primary outcome measure will be the requirement for a caesarean section. Secondary outcomes will include duration of each stage of labour and time from induction to birth, total dose of oxytocin administration, epidural rate, indication for caesarean section, rate of instrumental deliveries, birth within 24 hours of induction commencement, estimated blood loss, Apgar score at 5 min, neonatal intensive care unit admissions and participant satisfaction. Maternal melatonin levels will be measured immediately before commencement of the oxytocin intravenous infusion and 3 hours after and at the time of birth in order to determine any differences between the two trial arms.

Ethics and dissemination

The study is conducted in accordance with the conditions of Monash Health HREC (RES-17-0000-168A). Findings from the trial will be disseminated through peer-reviewed publications and conference presentations.

Protocol version

V.7.0, 30 July 2019.

Trial registration number

ACTRN12616000311459, Universal trial number: (UTN) U1111-1195-3515.
Education as a strategy for managing occupational-related musculoskeletal pain: a scoping review
Authors: Palsson Thorvaldur Skuli , Boudreau Shellie , Høgh Morten , Herrero Pablo , Bellosta-Lopez Pablo , Domenech-Garcia Victor , Langella Francesco , Gagni Nicolo , Christensen Steffan Wittrup , Villumsen Morten
Published: February 2020

Background

Musculoskeletal (MSK) pain is the primary contributor to disability worldwide. There is a growing consensus that MSK pain is a recurrent multifactorial condition underpinned by health and lifestyle factors. Studies suggest that education on work-related pain and individualised advice could be essential and effective for managing persistent MSK pain.

Objective

The objective of this scoping review was to map the existing educational resources for work-related MSK (WRMSK) pain, and the effects of implementing educational strategies in the workplace on managing WRMSK pain.

Methods

This scoping review assessed original studies that implemented and assessed education as a strategy to manage WMSK pain. Literature search strategies were developed using thesaurus headings (ie, MeSH and CINAHL headings) and free-text search including words related to MSK in an occupational setting. The search was carried out in PubMed, CINAHL, Cochrane Library and Web of Science in the period 12–14 February 2019.

Results

A total of 19 peer-reviewed articles were included and the study design, aim and outcomes were summarised. Of the 19 peer-reviewed articles, 10 randomised controlled trial (RCT) studies assessed the influence of education on work-related MSK pain. Many studies provided a limited description of the education material and assessed/used different methods of delivery. A majority of studies concluded education positively influences work-related MSK pain. Further, some studies reported additive effects of physical activity or ergonomic adjustments.

Conclusions

There is a gap in knowledge regarding the best content and delivery of education of material in the workplace. Although beneficial outcomes were reported, more RCT studies are required to determine the effects of education material as compared with other interventions, such as exercise or behavioural therapy.
Athena SWAN and gender diversity: a UK-based retrospective cohort study
Authors: Xiao Yunyu , Pinkney Edward , Au Terry Kit Fong , Yip Paul Siu Fai
Published: February 2020

Objectives

To promote gender diversity and equity in higher education, Athena Scientific Women’s Academic Network (SWAN) supports and recognises higher education institutions (HEI) in advancing the careers of women through charter commitment, awards, training and advocacy since 2005. Most evaluation studies, however, are based on qualitative assessments. This study sought to (1) examine the relationship between Athena SWAN accreditation/awards in the UK and gender diversity of leaders and senior academics using quantitative data from 2012/2013 to 2016/2017, and (2) explore the associations between Athena SWAN awards and university performance as measured by overall scores in global ranking systems.

Design

Retrospective cohort study based on the UK HEIs.

Setting

Higher education sector in the UK provided by the Higher Education Statistics Agency.

Participants

148 HEIs who provided employment data on female-to-male ratios (55% complete data) for each academic year between 2012/2013 and 2016/2017.

Primary and secondary outcome measures

Gender diversity, defined as female representation rates of positions in managerial leadership (eg, heads of institutions, department heads) and professors. The Quacquarelli Symonds (QS) World University Rankings scores, an indicator of research, teaching, employability and internationalisation, were collected to measure university performance.

Results

Gender diversity of managerial leaders and non-managerial professors at all levels of Athena SWAN status has improved over the 5 years. Linear mixed effects models identified that Athena SWAN awardees had lower female representation than non-awardees in managerial leadership positions (p<0.05), while the gap was narrowed among Silver awardees over time. Athena SWAN Charter members had increasingly higher female representation than those not in the Charter (p<0.05). Silver-award institutions ranked higher in QS rankings than Bronze-award institutions (β=11.80, p<0.05).

Conclusions

There are overall rising trends in gender diversity from 2012/2013 to 2016/2017. Athena SWAN members showed greater and faster growth in female representations. Silver awardees had greater university performance than Bronze awardees.
Priorities of patients with multimorbidity and of clinicians regarding treatment and health outcomes: a systematic mixed studies review
Authors: Sathanapally Harini , Sidhu Manbinder , Fahami Radia , Gillies Clare , Kadam Umesh , Davies Melanie J , Khunti Kamlesh , Seidu Samuel
Published: February 2020

Objectives

To identify studies that have investigated the health outcome and treatment priorities of patients with multimorbidity, clinicians or both, in order to assess whether the priorities of the two groups are in alignment, or whether a disparity exists between the priorities of patients with multimorbidity and clinicians.

Design

Systematic review.

Data sources

MEDLINE, EMBASE, CINHAL and Cochrane databases from inception to May 2019 using a predefined search strategy, as well as reference lists containing any relevant articles, as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane guidelines.

Eligibility criteria

We included studies reporting health outcome and treatment priorities of adult patients with multimorbidity, defined as suffering from two or more chronic conditions, or of clinicians in the context of multimorbidity or both. There was no restriction by study design, and studies using quantitative and/or qualitative methodologies were included.

Data synthesis

We used a narrative synthesis approach to synthesise the quantitative findings, and a meta-ethnography approach to synthesise the qualitative findings.

Results

Our search identified 24 studies for inclusion, which comprised 12 quantitative studies, 10 qualitative studies and 2 mixed-methods studies. Twelve studies reported the priorities of both patients and clinicians, 10 studies reported the priorities of patients and 2 studies reported the priorities of clinicians alone. Our findings have shown a mostly low level of agreement between the priorities of patients with multimorbidity and clinicians. We found that prioritisation by patients was mainly driven by their illness experiences, while clinicians focused on longer-term risks. Preserving functional ability emerged as a key priority for patients from across our quantitative and qualitative analyses.

Conclusion

Recognising that there may be a disparity in prioritisation and understanding the reasons for why this might occur, can facilitate clinicians in accurately eliciting the priorities that are most important to their patients and delivering patient-centred care.

PROSPERO registration number

CRD42018076076.
Physical activity interventions for adults who are visually impaired: a systematic review and meta-analysis
Authors: Sweeting Joanna , Merom Dafna , Astuti Putu Ayu Swandewi , Antoun Michael , Edwards Kate , Ding Ding
Published: February 2020

Objectives

Compared with sighted individuals, people with visual impairment have a higher prevalence of chronic conditions and lower levels of physical activity. This review aims to systematically review physical activity interventions for those with a visual impairment and to assess their effectiveness.

Design

A systematic review of articles reporting physical activity interventions in visually impaired individuals was conducted. Medline, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Physiotherapy Evidence Database were searched in August 2018. Meta-analyses were conducted on randomised controlled trials with the same outcome measure.

Setting

Most interventions were conducted in a group setting, with some including an at-home, self-directed component.

Participants

Following identification of a recent systematic review of physical activity interventions in children, our review focused on adults aged 18 years and older with a visual impairment.

Primary and secondary outcome measures

Outcomes included measures of balance, mobility, mental well-being (eg, quality of life), number of falls, muscle strength, flexibility and gait.

Results

Eighteen papers from 17 studies met inclusion criteria. Physical activity components include falls prevention and/or balance-based activities, walking, tai chi, Alexander Technique, Yoga, dance, aerobics and core stability training. Significant results in favour of the intervention were reported most commonly in measures of functional capacity (9/17 studies) and in falls/balance-related outcomes (7/13 studies). The studies identified were generally small and diverse in study design, and risk of bias was high across several categories for most studies. Meta-analyses indicated non-significant effects of the included interventions on the Timed Up and Go, Chair Sit Test and Berg Balance Scale.

Conclusions

Physical activity interventions in individuals with visual impairment incorporating activities such as tai chi, Yoga and dance can have positive results, particularly in physical measures such as mobility and balance. However, when performing a meta-analysis of randomised controlled trials, the evidence for effectiveness is less clear. More studies with larger sample sizes, stronger designs and longer follow-up periods are needed.

PROSPERO registration number

CRD42018103638.
Patient priorities in relation to surgery for gastric cancer: qualitative interviews with gastric cancer surgery patients to inform the development of a core outcome set
Authors: Alkhaffaf Bilal , Blazeby Jane M , Bruce Iain A , Morris Rebecca L
Published: February 2020

Objective

The reporting of outcomes in surgical trials for gastric cancer is inconsistent. The GASTROS study (GAstric CancerSurgeryTRialsReportedOutcomeStandardisation) aims to address this by developing a core outcome set (COS) for use in all future trials within this field. A COS should reflect the views of all stakeholders, including patients. We undertook a series of interviews to identify outcomes important to patients which would be considered for inclusion in a COS.

Setting

All interviews took place within the UK. Interviews were carried out face-to-face at hospitals and cancer support centres or via the telephone.

Participants

Twenty participants at varying stages of recovery following surgery for gastric cancer with curative intent.

Design

Qualitative design using semistructured interviews, supported by an interview guide which was iteratively modified; thematic analysis was used to explore patient priorities.

Results

Six themes enveloping 38 outcomes were identified; surviving and controlling cancer, technical aspects of surgery, adverse events from surgery, recovering from surgery, long-term problems following surgery and long-term life impact of surgery. The ‘most important’ patient priority was to be ‘cured of cancer’.

Conclusion

Surgical trials for gastric cancer should consider broader priorities of patients when choosing which outcomes to report. This study highlighted the importance of longer-term outcomes such as cancer survival. Outcomes identified in this study will be used to inform an international Delphi survey to develop a COS in this field.
Management of hepatitis B in the era of checkpoint inhibition
Authors: Dutcher Janice
Published: February 2020

Hepatitis B virus (HBV) is a major global health concern, affecting more than 350 million people worldwide. Its management in the setting of cancer treatment can be problematic, particularly with the use of immunological treatment modalities, but also with chemotherapy. Immunological perturbations by chemo or immunotherapy have the potential to permit viral hepatitis reactivation and acute hepatic failure. HBV management algorithms have evolved, based on host tumor factors, viral serological factors, and the specific antitumor agents planned. As new agents enter the antitumor armamentarium, their impact on HBV infection needs to be defined. Zhanget alprovide data on the utility of antiviral therapy in the management of HBV antigen positive patients receiving checkpoint inhibitors (CPIs) in preventing hepatitis reactivation, and offers guidance for such management in endemic areas, suggesting that prophylaxis is highly effective in preventing reactivation. This is pertinent to Western cancer therapy also, as a recent study has documented the silent existence of positive hepatitis antigenemia among newly diagnosed cancer patients. Whereas antigen and viral DNA screening is standard of care in Asia and Western Pacific oncology practice, evaluation for latent hepatitis may become a necessary part of management worldwide as CPIs continue to expand their role.
T lymphocyte-targeted immune checkpoint modulation in glioma
Authors: Kelly William James , Giles Amber Jin , Gilbert Mark
Published: February 2020

Immunomodulatory therapies targeting inhibitory checkpoint molecules have revolutionized the treatment of solid tumor malignancies. Concerns about whether systemic administration of an immune checkpoint inhibitor could impact primary brain tumors were answered with the observation of definitive responses in pediatric patients harboring hypermutated gliomas. Although initial clinical results in patients with glioblastoma (GBM) were disappointing, recently published results have demonstrated a potential survival benefit in patients with recurrent GBM treated with neoadjuvant programmed cell death protein 1 blockade. While these findings necessitate verification in subsequent studies, they support the possibility of achieving clinical meaningful immune responses in malignant primary brain tumors including GBM, a disease in dire need of additional therapeutic options. There are several challenges involved in treating glioma with immune checkpoint modulators including the immunosuppressive nature of GBM itself with high inhibitory checkpoint expression, the immunoselective blood brain barrier impairing the ability for peripheral lymphocytes to traffic to the tumor microenvironment and the high prevalence of corticosteroid use which suppress lymphocyte activation. However, by simultaneously targeting multiple costimulatory and inhibitory pathways, it may be possible to achieve an effective antitumoral immune response. To this end, there are now several novel agents targeting more recently uncovered “second generation” checkpoint molecules. Given the multiplicity of drugs being considered for combination regimens, an increased understanding of the mechanisms of action and resistance combined with more robust preclinical and early clinical testing will be needed to be able to adequately test these agents. This review summarizes our current understanding of T lymphocyte-modulating checkpoint molecules as it pertains to glioma with the hope for a renewed focus on the most promising therapeutic strategies.
First clinical experience with the new Surpass Evolve flow diverter: technical and clinical considerations
Authors: Orru Emanuele , Rice Henry , De Villiers Laetitia , Klostranec Jesse M , Wakhloo Ajay K , Coon Alexander L , Radovanovic Ivan , Kortman Hans , Bhatia Kartik Dev , Krings Timo , Pereira Vitor M
Published: February 2020

Objective

To describe the results in patients treated with the Surpass Evolve (SE) device, the new generation of Surpass flow diverters.

Methods

Twenty-five consecutive patients (20 women, average age 58 years), with anterior or posterior circulation aneurysms treated with SEs in two early-user centers, were included. Device properties and related technical properties, imaging and clinical follow-up data, and intraprocedural, early (<30 days) and delayed (>30 days) neurological complications, further divided into minor (silent/non-permanent) and major (permanent) complications, were recorded and analyzed.

Results

Twenty-nine SEs were successfully implanted in all subjects to treat 26 aneurysms using an 0.027" microcatheter with an average of 1.2 stents per patient. No intraprocedural thromboembolic or hemorrhagic complications were seen. At clinical follow-up, 24/25 (96%) patients had a modified Rankin Score of 0–2. Mortality was 0%. Imaging follow-up, available in 22/25 (88%) patients (median follow-up time 4 months), showed a complete aneurysm occlusion in 13/23 (57%) imaged lesions. Minor, transitory neurological deficits were recorded in 5/25 (20%) patients. One (4%) major complication was seen in one patient (4%) with a left-sided hemispheric stroke on postprocedural day 4 due to an acute stent thrombosis.

Conclusions

Preliminary experience in patients demonstrates a good performance of the SE. This newly designed implant maintains the engineering characteristics of Surpass flow diverters, including precise placement due to its lower foreshortening and a high mesh density, yet can be deployed through a significantly lower-profile delivery system.
A minimalist electronic health record-based intervention to reduce standing lab utilisation
Authors: Chin Kuo-Kai , Krishnamurthy Amrita , Zubair Talhah , Ramaswamy Tara , Hom Jason , Maggio Paul , Shieh Lisa
Published: February 2020

Background

Repetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive.

Objective

To evaluate the effect of a minimally restrictive EHR-based intervention on utilisation.

Setting

One year before and after intervention at a 600-bed tertiary care hospital. 18 000 patients admitted to General Medicine, General Surgery and the Intensive Care Unit (ICU).

Intervention

Providers were required to specify the number of times each test should occur instead of being able to order them indefinitely.

Measurements

For eight tests, utilisation (number of labs performed per patient day) and number of associated orders were measured.

Results

Utilisation decreased for some tests on all services. Notably, complete blood count with differential decreased 9% (p<0.001) on General Medicine and 21% (p<0.001) in the ICU.

Conclusions

Requiring providers to specify the number of occurrences of labs changes significantly reduces utilisation in some cases.
Effect of inspiratory resistive training on diaphragm shear modulus and accessory inspiratory muscle activation
Authors: Ando Ryosuke , Ohya Toshiyuki , Kusanagi Kenta , Koizumi Jun , Ohnuma Hayato , Katayama Keisho , Suzuki Yasuhiro
Published: February 2020

This study aimed to elucidate changes in diaphragm and accessory inspiratory muscle (sternocleidomastoid (SCM) muscle and intercostal muscle (IC)) function after a 6-week training program. Nineteen male elite collegiate swimmers were assigned to either a control group (n = 9) or training group (n = 10). The subjects in the training group performed 30 maximum inspirations at a load resistance of 50% of maximum inspiratory mouth pressure (PImax) using an inspiratory muscle training device. These were conducted twice per day and 6 days per week. At baseline and after 6 weeks, PImax, shear modulus of the diaphragm, and electromyograms (EMG) of the SCM and IC during a maximal inspiratory maneuver were evaluated. Relative change in PImax was greater in the training group than in controls. The shear modulus during a PImax maneuver had increased significantly in both groups after 6 weeks. EMG amplitudes of the SCM increased in the training group after 6 weeks, but not in the control group. EMG amplitudes of the IC did not change after 6 weeks in either group. These results suggest that 6-week inspiratory resistive training significantly improves the activation of the SCM, which could be one of the major mechanisms behind increases in inspiratory muscle strength after resistive training.

Novelty Six-week inspiratory resistive training increased diaphragm stiffness during maximal inspiration maneuver. Six-week inspiratory resistive training increased electromyogram amplitudes of the sternocleidomastoid during maximal inspiration maneuver.
Application of nanotechnology in pavement engineering: a review
Authors: Shah Peerzada Mosir , Mir Mohammad Shafi
Published: February 2020

Nanotechnology utilizes the research and technology established at the nuclear and molecular or macromolecular levels to comprehend the nanoscale phenomena. In road construction, the bituminous materials are used in enormous amounts. The macroscopic mechanical conduct of these materials still largely relies on microstructure and physical characteristics at a micro and nano scale level. For many years, scientists and engineers have been exploring nanotechnology in civil engineering, but nanotechnology use in this sector has been limited. Nanotechnology has caught the interest of experts and has progressively penetrated into the field of pavement engineering. The article reviews the published works carried out to study the use of nanomaterials in asphalt pavements and illustrates the technique used to enhance asphalt features by the use of these nanomaterials. In this review, multiple nanomaterials are discussed followed by characterization of these nanomaterials, preparation techniques of modified asphalt binder, and finally the effect of nanomaterials on the efficiency of base asphalt binder as well as the asphalt mixture. The primary focus continues on the use of nanotechnology in pavement engineering to achieve a better atmosphere for society based on recognized pavement engineering requirements and difficulties.
Soil quality assessment of vegetation restoration after a large forest fire in Daxing’anling, northeast China
Authors: Wang Lihong , Fu Qiang
Published: February 2020

Forest fires significantly change soil function and quality. Finding an effective way to accelerate the restoration of soil quality after forest fires is a major issue. This study investigated the soil quality index (SQI) during vegetation restoration after a fire in a Larix gmelinii plantation, throughout different restoration years. Fifteen physical, chemical, and biological properties of soil were examined using principal component analysis, and soil quality was assessed by SQI. The results revealed that soil physical properties, chemical properties, and enzyme activities showed the most improvement after 24 yr of restoration. Soil microbial biomass carbon content and microbial biomass nitrogen content increased with restoration years. Soil bulk density, microbial biomass nitrogen, sucrase, and catalase were retained in the minimum data set. After 24 yr of restoration, SQI was the highest, with a value of 0.52, followed by natural restoration, 21, 13, and 16 yr; the SQI after 3 yr of restoration was the lowest, with a value of 0.26. Artificial regeneration accelerated the recovery of soil quality after 24 yr. Soil quality should be monitored continuously in the study area.
Odd-frequency superconducting pairing in one-dimensional systems
Authors: Cayao Jorge , Triola Christopher , Black-Schaffer Annica M.
Published: February 2020

Odd-frequency superconductivity represents a truly unconventional ordered state which, in contrast to conventional superconductivity, exhibits pair correlations which are odd in relative time and, hence, inherently dynamical. In this review article we provide an overview of recent advances in the study of odd-frequency superconducting correlations in one-dimensional systems. In particular, we focus on recent developments in the study of nanowires with Rashba spin-orbit coupling and metallic edges of two-dimensional topological insulators in proximity to conventional superconductors. These systems have recently elicited a great deal of interest due to their potential for realizing one-dimensional topological superconductivity whose edges can host Majorana zero modes. We also provide a detailed discussion of the intimate relationship between Majorana zero modes and odd-frequency pairing. Throughout this review, we highlight the ways in which odd-frequency pairing provides a deeper understanding of the unconventional superconducting correlations present in each of these intriguing systems and how the study and control of these states holds the potential for future applications.
Formalization and Verification of TESAC Using CSP
Authors: Sun Dongzhen , Zhu Huibiao , Fei Yuan , Xiao Lili , Lu Gang , Yin Jiaqi
Published: February 2020

Cloud computing is an emerging computing paradigm in IT industries. The wide adoption of cloud computing is raising concerns about management of data in the cloud. Access control and data security are two critical issues of cloud computing. Time-efficient secure access control (TESAC) model is a new data access control scheme which can minimize many significant problems. This scheme has better performance than other existing models in a cloud computing environment. TESAC is attracting more and more attentions from industries. Hence, the reliability of TESAC becomes extremely important. In this paper, we apply Communication Sequential Processes (CSP) to model TESAC, as well as their security properties. We mainly focus on its data access mechanism part and formalize it in detail. Moreover, using the model checker Process Analysis Toolkit (PAT), we have verified that the TESAC model cannot assure the security of data with malicious users. For the purpose of solving this problem, we introduce a new method similar to digital signature. Our study can improve the security and robustness of the TESAC model.
FURTHER EXAMPLES OF PARAMETRIC ITERATIVE FUNCTION SYSTEMS FOR THE CONTINUUM GROWTH OF THE ATTRACTOR
Authors: GUTIÉRREZ-HERNÁNDEZ SEBASTIÁN , BORY-REYES JUAN
Published: February 2020

We construct new examples of parametric iterated function systems converging to some fractal shapes. The main goal is the study of the continuous growth and the rate of change of the attractor of the corresponding parametrization.
Burnside rings for Real 2-representation theory: The linear theory
Authors: Rumynin Dmitriy , Young Matthew B.
Published: February 2020

This paper is a fundamental study of the Real [Formula: see text]-representation theory of [Formula: see text]-groups. It also contains many new results in the ordinary (non-Real) case. Our framework relies on a [Formula: see text]-equivariant Morita bicategory, where a novel construction of induction is introduced. We identify the Grothendieck ring of Real [Formula: see text]-representations as a Real variant of the Burnside ring of the fundamental group of the [Formula: see text]-group and study the Real categorical character theory. This paper unifies two previous lines of inquiry, the approach to [Formula: see text]-representation theory via Morita theory and Burnside rings, initiated by the first author and Wendland, and the Real [Formula: see text]-representation theory of [Formula: see text]-groups, as studied by the second author.
NAD+ precursors protect corneal endothelial cells from UVB-induced apoptosis
Authors: Zhao Can , Li Wenjing , Duan Haoyun , Li Zongyi , Jia Yanni , Zhang Songmei , Wang Xin , Zhou Qingjun , Shi Weiyun
Published: February 2020

Excessive exposure of the eye to ultraviolet B light (UVB) leads to corneal edema and opacification because of the apoptosis of the corneal endothelium. Our previous study found that nicotinamide (NIC), the precursor of nicotinamide adenine dinucleotide (NAD), could inhibit the endothelial-mesenchymal transition and accelerate healing the wound to the corneal endothelium in the rabbit. Here we hypothesize that NIC may possess the capacity to protect the cornea from UVB-induced endothelial apoptosis. Therefore, a mouse model and a cultured cell model were used to examine the effect of NAD+ precursors, including NIC, nicotinamide mononucleotide (NMN), and NAD, on the UVB-induced apoptosis of corneal endothelial cells (CECs). The results showed that UVB irradiation caused apparent corneal edema and cell apoptosis in mice, accompanied by reduced levels of NAD+ and its key biosynthesis enzyme, nicotinamide phosphoribosyltransferase (NAMPT), in the corneal endothelium. However, the subconjunctival injection of NIC, NMN, or NAD+ effectively prevented UVB-induced tissue damage and endothelial cell apoptosis in the mouse cornea. Moreover, pretreatment using NIC, NMN, and NAD+ increased the survival rate and inhibited the apoptosis of cultured human CECs irradiated by UVB. Mechanistically, pretreatment using nicotinamide (NIC) recovered the AKT activation level and decreased the BAX/BCL-2 ratio. In addition, the capacity of NIC to protect CECs was fully reversed in the presence of the AKT inhibitor LY294002. Therefore, we conclude that NAD+ precursors can effectively prevent the apoptosis of the corneal endothelium through reactivating AKT signaling; this represents a potential therapeutic approach for preventing UVB-induced corneal damage.
Vasoinhibin generation and effect on neuronal apoptosis in the hippocampus of late mouse embryos
Authors: Aroña Rodrigo M. , Arnold Edith , Macías Fernando , López-Casillas Fernando , Clapp Carmen , Martínez de la Escalera Gonzalo
Published: February 2020

Morphological and behavioral evidence suggests that vasoinhibin is present in the central nervous system (CNS), triggering neuroendocrine and behavioral responses to stress. Moreover, vasoinhibin reduces neuronal survival and differentiation of primary sensory neurons of the peripheral nervous system. To address the functional role played by vasoinhibin at the CNS, and to better understand the underlying mechanisms involved in its actions, we treated primary cultured hippocampal neurons obtained from embryonic day 16 (E16) mice with a human recombinant vasoinhibin. We examined the resulting cellular changes, focusing on neuronal cell death, and explored the local generation of vasoinhibin within the hippocampus. Our results show that vasoinhibin significantly reduced neuronal cell density and increased immunoreactive activated caspase-3 and TUNEL-positive staining at 72, 16, and 24 h, respectively. Furthermore, vasoinhibin increased the expression of proapoptotic genes BAX, BAD, BIM, and PUMA and decreased that of the antiapoptotic gene BCL-2 at 24 h, as assessed by quantitative real-time reverse transcription-polymerase chain reaction. Vasoinhibin effects were blocked by coincubation with a vasoinhibin antibody or with prolactin. Immunoreactive bands consistent with vasoinhibin were observed in hippocampal extracts by Western blot analysis, and a prolactin standard was cleaved to vasoinhibin by a hippocampal lysate in a heat- and cathepsin D inhibitor pepstatin A-dependent fashion. Taken together, these data support the notion that vasoinhibin is locally produced by cathepsin D within the embryonic mouse hippocampus, a brain region that plays a critical role in emotional regulation, resulting in decreased neuronal cell viability via the activation of the intrinsic apoptosis pathway.