bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of a mass media campaign on breast cancer symptoms awareness and screening uptake in Malaysia: findings from a quasi-experimental study
Authors: Schliemann Désirée , Htay Mila Nu Nu , Dahlui Maznah , Paramasivam Darishiani , Cardwell Christopher R , Ibrahim Tamin Nor Saleha Binti , Somasundaram Saunthari , Donnelly Conan , Su Tin Tin , Donnelly Michael
Published: August 2020

Objective

To evaluate the impact of a mass media campaign in terms of improving breast cancer (BC) symptoms awareness and screening uptake.

Design

Before—and after—study with comparator groups.

Setting

Selangor State, Malaysia.

Participants

Malaysian women aged >40 years (n=676) from randomly selected households.

Intervention

A culturally adapted mass media campaign (TV, radio, print media and social media).

Primary and secondary outcome measures

The primary endpoint was BC symptoms awareness, which was assessed with the Breast Cancer Awareness Measure precampaign and postcampaign. Secondary outcomes included campaign reach, self-efficacy to notice BC symptoms and clinical outcomes. Clinical breast examination and mammogram screening data were collected from hospitals and clinics.

Results

Most participants recognised at least one of the campaign materials (65.2%). The odds of seeing the campaign were lowest for Chinese women (adjusted OR 0.25, 95% CI 0.15 to 0.40) compared with Malays and for women aged >70 years (adjusted OR 0.47, 95% CI 0.23 to 0.94) compared with younger women. Participants who recognised the campaign were significantly more likely to have improved awareness postcampaign compared with non-recognisers particularly for key symptoms such as ‘a lump or thickening in your breast’ (88.9% vs 62.1%) and ‘discharge or bleeding from nipple’ (79.7% vs 55.3%). Improvement in symptoms awareness scores was not associated with sociodemographic variables.

Conclusions

Implementation in Malaysia of an evidence-based mass media campaign from the UK that was culturally adapted appeared to lead to improved awareness about some BC symptoms, though various modes of media communication and perhaps other health education approaches may be required to extend the reach to diverse, multiethnic populations and all age groups.
Subjective experience of meningitis survivors: a transversal qualitative study using interpretative phenomenological analysis
Authors: Scanferla Elisabetta , Fasse Léonor , Gorwood Philip
Published: August 2020

Objectives

(1) To capture the subjective experience of meningitis survivors during adolescence and adulthood and (2) To explore how they give meaning to this specific experience.

Design

A qualitative study of in-depth interviews using interpretative phenomenological analysis.

Settings

Participants recruited through an association of persons affected by meningitis and their relatives.

Participants

Convenience sample of nine participants (seven women and two men) between the ages of 18 to 48 years (mean=28.3, SD=11.4), who personally experienced meningitis.

Results

Eight major themes and three main meaning-making processes in relation to the participants’ experiences of meningitis were identified: (1) the ability to rely on the testimony of others, (2) the impossibility of meaning-making and (3) the possibility of post-traumatic growth. We detailed here five major themes, which appear critical to answering the objective of the study.

Conclusions

This study provides a unique insight into the first-hand experience of surviving meningitis. Findings highlighted factors characterising the disease experience, the psychological adjustment of meningitis survivors and their meaning-making processes. These findings are important for both research and clinical practice, demonstrating the importance of direct involvement of meningitis survivors in identifying key aspects of care, which include the critical role of relatives, and the importance of investigating the need for training among healthcare providers on how to diagnose meningitis.
Adverse events associated with paediatric massage therapy: a systematic review
Authors: Karkhaneh Mohhamad , Zorzela Liliane , Jou Hsing , Funabashi Martha , Dryden Trish , Vohra Sunita
Published: August 2020

Introduction

Massage therapy (MT) is frequently used in children. No study has systematically assessed its safety in children and adolescents. We systematically review adverse events (AEs) associated with paediatric MT.

Methods

We searched seven electronic databases from inception to December 2018. We included studies if they (1) were primary studies published in a peer-reviewed journal, (2) involved children aged 0–18 years and (3) a type of MT was used for any indication. No restriction was applied to language, year of publication and study design. AEs were classified based on their severity and association to the intervention.

Results

Literature searches identified 12 286 citations, of which 938 citations were retrieved for full-text evaluation and 60 studies were included. In the included studies, 31 (51.6%) did not report any information on AEs, 13 (21.6%) reported that no AE occurred and 16 studies (26.6%) reported at least one AE after MT. There were 20 mild events (grade 1) that resolved with minimal intervention, 26 moderate events (grades 2–3) that required medical intervention, and 18 cases of severe AEs (grades 4–5) that resulted in hospital admission or prolongation of hospital stay; of these, 17 AEs were volvulus in premature infants, four of which were ultimately fatal events.

Conclusion

We identified a range of AEs associated with MT use, from mild to severe. Unfortunately, the majority of included studies did not report if an AE occurred or not, leading to publication bias. This review reports an association between abdominal massage with volvulus without malrotation in preterm infants; it is still to be defined if this is casual or not, but our findings warrant caution in the use of abdominal massage in preterm infants.
Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: a systematic review
Authors: Goley Stephanie Michele , Sakula-Barry Sidonie , Adofo-Ansong Nana , Isaaya Ntawunga Laurence , Tekyiwa Botchway Maame , Kelly Ann Horton , Wright Naomi
Published: August 2020

Background

Congenital anomalies are the fifth leading cause of under-5 mortality globally. The greatest burden is faced by those in low/middle-income countries (LMICs), where over 95% of deaths occur. Many of these deaths may be preventable through antenatal diagnosis and early intervention. This systematic literature review investigates the use of antenatal ultrasound to diagnose congenital anomalies and improve the health outcomes of infants in LMICs.

Methods

A systematic literature review was conducted using three search strings: (1) structural congenital anomalies; (2) LMICs; and (3) antenatal diagnosis. The search was conducted on the following databases: Medline, Embase, PubMed and the Cochrane Library. Title, abstract and full-text screening was undertaken in duplicate by two reviewers independently. Consensus among the wider authorship was sought for discrepancies. The primary analysis focused on the availability and effectiveness of antenatal ultrasound for diagnosing structural congenital anomalies. Secondary outcomes included neonatal morbidity and mortality, termination rates, referral rates for further antenatal care and training level of the ultrasonographer. Relevant policy data were sought.

Results

The search produced 4062 articles; 97 were included in the review. The median percentage of women receiving an antenatal ultrasound examination was 50.0% in African studies and 90.7% in Asian studies (range 6.8%–98.8%). Median detection rates were: 16.7% Africa, 34.3% South America, 34.7% Asia and 47.3% Europe (range 0%–100%). The training level of the ultrasound provider may affect detection rates. Four articles compared morbidity and mortality outcomes, with inconclusive results. Significant variations in termination rates were found (0%–98.3%). No articles addressed referral rates.

Conclusion

Antenatal detection of congenital anomalies remains highly variable across LMICs and is particularly low in sub-Saharan Africa. Further research is required to investigate the role of antenatal diagnosis for improving survival from congenital anomalies in LMICs.

PROSPERO registration number

CRD42019105620.
Adult palliative care 2004–2030 population study: estimates and projections in Malaysia
Authors: Yang Su Lan , Woon Yuan Liang , Teoh Cindy Cy Oun , Leong Chin Tho , Lim Richard Boon Leong
Published: August 2020

Objectives

To estimate past trends and future projection of adult palliative care needs in Malaysia.

Methods

This is a population-based secondary data analysis using the national mortality registry from 2004 to 2014. Past trend estimation was conducted using Murtagh’s minimum and maximum methods and Gómez-Batiste’s method. The estimated palliative care needs were stratified by age groups, gender and administrative states in Malaysia. With this, the projection of palliative care needs up to 2030 was conducted under the assumption that annual change remains constant.

Results

The palliative care needs in Malaysia followed an apparent upward trend over the years regardless of the estimation methods. Murtagh’s minimum estimation method showed that palliative care needs grew 40% from 71 675 cases in 2004 to 100 034 cases in 2014. The proportion of palliative care needs in relation to deaths hovered at 71% in the observed years. In 2030, Malaysia should anticipate the population needs to be at least 239 713 cases (240% growth from 2014), with the highest needs among age group ≥80-year-old in both genders. Sarawak, Perak, Johor, Selangor and Kedah will become the top five Malaysian states with the highest number of needs in 2030.

Conclusion

The need for palliative care in Malaysia will continue to rise and surpass its service provision. This trend demands a stepped-up provision from the national health system with advanced integration of palliative care services to narrow the gap between needs and supply.
Telehealth in the time of COVID-19
Authors: Joshi Aditi U. , Lewiss Resa E
Published: August 2020

Telehealth or using technology for a remote medical encounter has become an efficient solution for safe patient care during the severe acute respiratory syndrome coronavirus 2 or COVID-19 pandemic. This medium allows patient immediate healthcare access without the need for an in-person visit. We designed a time-sensitive, practical, effective and innovative scale-up of telehealth services as a response to the demand for COVID-19 evaluation and testing. As more patients made appointments through the institution’s telehealth programme, we increased the number of clinicians available. JeffConnect, the acute care telehealth programme, was expanded to increase staffing from a standing staff of 37–187 doctors within 72 hours. Telehealth care clinicians primarily trained in emergency medicine, internal medicine and family medicine followed a patient decision pathway to risk stratify patients into three groups: home quarantine no testing, home quarantine with outpatient COVID-19 testing and referral for in-person evaluation in the ED, for symptomatic and potentially unstable patients.
The management of adult patients with severe chronic small intestinal dysmotility
Authors: Nightingale Jeremy M D , Paine Peter , McLaughlin John , Emmanuel Anton , Martin Joanne E , Lal Simon
Published: August 2020

Adult patients with severe chronic small intestinal dysmotility are not uncommon and can be difficult to manage. This guideline gives an outline of how to make the diagnosis. It discusses factors which contribute to or cause a picture of severe chronic intestinal dysmotility (eg, obstruction, functional gastrointestinal disorders, drugs, psychosocial issues and malnutrition). It gives management guidelines for patients with an enteric myopathy or neuropathy including the use of enteral and parenteral nutrition.
COVID-19, smoking and inequalities: a study of 53 002 adults in the UK
Authors: Jackson Sarah E , Brown Jamie , Shahab Lion , Steptoe Andrew , Fancourt Daisy
Published: August 2020

Background

This study aimed to examine associations between smoking and COVID-19 relevant outcomes, taking into account the influence of inequalities and adjusting for potential confounding variables.

Methods

Cross-sectional data were used from an online study of adults in the UK (n=53 002). Main outcome measures were confirmed and suspected COVID-19, worry about catching or becoming seriously ill from COVID-19 and adherence to protective behaviours. Covariates included age, sex, ethnicity, education (post-16 qualifications: yes/no), key worker status and comorbid health conditions.

Results

Compared with never smokers (0.26% (95% CI 0.21% to 0.33%)), prevalence of confirmed COVID-19 was higher among current (0.56% (0.41% to 0.75%)) but not ex-smokers (0.19% (0.13% to 0.28%)). Associations were similar before (current: OR=2.14 (1.49–3.08); ex-smokers: OR=0.73 (0.47–1.14)) and after (current: OR=1.79 (1.22–2.62); ex-smokers: OR=0.85 (0.54–1.33)) adjustment. For current smokers, this was moderated by socio-economic position, with higher rates only seen in those without post-16 qualifications (OR=3.53 (2.04–6.10)). After including suspected cases, prevalence was higher among current smokers (11.2% (10.6% to 11.9%), OR=1.11 (1.03–1.20)) and ex-smokers (10.9% (10.4% to 11.5%), OR=1.07 (1.01–1.15)) than never smokers (10.2% (9.9% to 10.6%)), but remained higher only among ex-smokers after adjustment (OR=1.21 (1.13–1.29)). Current and ex-smokers had higher odds than never smokers of reporting significant stress about becoming seriously ill from COVID-19 (current: OR=1.34 (1.27–1.43); ex-smokers: OR=1.22 (1.16–1.28)). Adherence to recommendations to prevent spread of COVID-19 was high (96.3% (96.1% to 96.4%)), but lower among current than never smokers (OR=0.70 (0.62–0.78)).

Conclusions

In a population sample, current smoking was independently associated with self-reported confirmed COVID-19 infection. There were socio-economic disparities, with the association only apparent among those without post-16 qualifications. Smokers reported lower adherence to guidelines despite being more worried than non-smokers about catching or becoming seriously ill from COVID-19.
Research on optimized design of road space in mixed sections of historical district: a case study of Xi’an, China
Authors: Wang Qiuping , Yan Yuehong , Wang Kai
Published: August 2020

To solve the problems existing in most Chinese historic districts, such as incomplete traffic network planning and unreasonable spatial layout, this paper analyzes the spatial characteristics of motor vehicles in the mixed road section of a historical district and summarizes the application conditions and shortcomings of the model for calculating the Bolankerf lane width and re-calibrates the parameters of the model with the survey data, to determine the formula for calculating the width of motor lanes in different sections of roads. Furthermore, this paper establishes a game model of road space optimization for mixed sections of motor vehicles and non-motor vehicles with the goal of minimizing the generalized travel cost. Finally, by taking the Xiangzimiao historic district as the verification object, this paper draws from the Bolankerf model and the game model to determine the most reasonable road space division plan within blocks.
Fermionic cosmological model with gauge and Schutz couplings: Classical and quantum analysis
Authors: Ribas Marlos O. , Devecchi Fernando P. , Kremer Gilberto M.
Published: August 2020

A cosmological model for the early universe is investigated where a Schutz fluid and a fermionic field coupled to a gauge field are the sources of the gravitational field. The determination of the scale factor in the classical analysis follows from the Hamiltonian formulation together with Dirac’s method for constrained systems. The expectation value of the scale factor in the quantum analysis is determined from the Wheeler–DeWitt equation. The singularity in the classical solution for the scale factor is avoided in the quantum solution where a bouncing from a minimum value of the scale factor is present. It is shown that: (i) the minimum value of the scale factor depends on the ratio of the fermionic coupling constant and the mass of the vectorial field; (ii) the classical and quantum solutions coincide for large values of the conformal time due to a dilution of the quantum effects with the time evolution; (iii) the behavior of the wave function probability density confirms that the maximum probability occurs when the scale factor has its minimum value equal to its expectation value; (iv) the quantum potential in the Bohmian formulation goes to infinity when the scale factor tends to zero avoiding the singularity at this point.
On n-algebraic structures in the Calogero model
Authors: Zhang Chun-Hong , Wang Rui
Published: August 2020

We construct two realizations of the [Formula: see text] algebra in the classical Calogero model based on the [Formula: see text] constraints for the Hermitian one-matrix model. We also discuss the quantum Calogero model and construct the new operators which yield the closed [Formula: see text][Formula: see text]-algebra. The super [Formula: see text][Formula: see text]-algebra is derived for the supersymmetric quantum Calogero model.
Random coxeter groups
Authors: Deibel Angelica
Published: August 2020

Much is known about random right-angled Coxeter groups (i.e., right-angled Coxeter groups whose defining graphs are random graphs under the Erdös–Rényi model). In this paper, we extend this model to study random general Coxeter groups and give some results about random Coxeter groups, including some information about the homology of the nerve of a random Coxeter group and results about when random Coxeter groups are [Formula: see text]-hyperbolic and when they have the FC-type property.
When the Case Creates a Competitive Advantage
Authors: Talukdar Mohammad Rafiqul Islam
Published: August 2020

When academics talk about the case method of teaching, it sounds great. Most of the leading business schools in the world have adopted the case method of learning and teaching. The rest of the world’s business schools also appreciate the outcome of such a pedagogical approach. In reality, some deeprooted challenges are evident concerning the case method of teaching. For instance, the literature on case method pedagogy and on how to write a robust teaching or business case is limited or outdated. Secondly, many of the business schools that embraced the case method of teaching have few faculty members trained on the use of the case method in teaching or they invest little for faculty capacity building in this regard comparing to the set expectations. Thirdly, most of the available business cases seem to be boring, which fail either to build compelling angel or to get substantial attention to the class. Considering such contextual reality, the paper focuses on the methodological aspects of writing and analyzing a good business case, and justifies the competitive advantage of case method schooling.
Mathematical modeling and qualitative analysis of viscoelastic conductive fluids
Authors: Tan Zhong , Wang Yong , Wu Wenpei
Published: August 2020

We use an energetic variational approach to model the transport of compressible viscoelastic conductive fluids. Such a model can be called the three-dimensional compressible viscoelastic Navier–Stokes–Poisson equations. The global unique smooth solution to the Cauchy problem is obtained. In particular, we obtain the optimal time-decay rates of the solution and its higher-order spatial derivatives by using a pure energy method.
Do environmental taxes impede economic growth? A comparison between China and India
Authors: Ahmad Muhammad Ishfaq , Ur Rehman Ramiz , Naseem Muhammad Akram , Ali Rizwan
Published: August 2020

The aim of this study is to determine the direction of causality between economic growth and environmentally oriented taxes between two countries, China and India. Further, it investigates which country is leading in environmental protection race by imposing and collecting more environmental taxes. The novel element of this study is that this is the first study comparing two economic rivals by environment taxes. The dataset consists of environmental taxes and its proportion to GDP and total taxes, transportation taxes, GDP and adjusted net savings for China and India. The data are taken from the organization of Economic Cooperation and Development (OECD) data bank from 2009 to 2018. The study utilizes the Granger causality to test the causal relationship between environment taxes and economic growth. The findings of the study posit that the imposition of environmental taxes will not only make the big economies environmental friendly but with sustainable economic growth.
Becoming an 'adaptive' expert
Authors: Burke Quinn , Bailey Cinamon Sunrise
Published: August 2020

Investigating student knowledge transfer and metacognitive activities at college CS departments and at coding bootcamps.
Redacted letters to the other Korea
Authors: Min Lisa Sang-Mi
Published: August 2020

This forum highlights conversations at the intersection of design methods and social studies of technology. By highlighting a diversity of perspectives on design interventions and programs, we aim to forge new connections between HCI design and communication, science and technology studies, and media studies scholarship.
--- Daniela Rosner, Editor
A Class of
C
2
Interpolating Splines
Authors: Yuksel Cem
Published: August 2020

We present a class of non-polynomial parametric splines that interpolate the given control points and show that some curve types in this class have a set of highly desirable properties that were not previously demonstrated for interpolating curves before. In particular, the formulation of this class guarantees that the resulting curves have
C
2
continuity everywhere and local support, such that only four control points define each curve segment between consecutive control points. These properties are achieved directly due to the mathematical formulation used for defining this class, without the need for a global numerical optimization step. We also provide four example spline types within this class. These examples show how guaranteed self-intersection-free curve segments can be achieved, regardless of the placement of control points, which has been a limitation of prior interpolating curve formulations. In addition, they present how perfect circular arcs and linear segments can be formed by splines within this class, which also have been challenging for prior methods of interpolating curves.
Virtual collaboration in the age of the coronavirus
Authors: Marks Paul
Published: August 2020

Videoconferencing apps took off during the COVID-19 lockdowns, but more efficient ways to collaborate virtually are waiting in the wings.
Identifying Defects in Li-Ion Cells Using Ultrasound Acoustic Measurements
Authors: Robinson James B. , Owen Rhodri E. , Kok Matt D. R. , Maier Maximilian , Majasan Jude , Braglia Michele , Stocker Richard , Amietszajew Tazdin , Roberts Alexander J. , Bhagat Rohit , Billsson Duncan , Olson Jarred Z. , Park Juyeon , Hinds Gareth , Ahlberg Tidblad Annika , Brett Dan J. L. , Shearing Paul R.
Published: August 2020

Identification of the state-of-health (SoH) of Li-ion cells is a vital tool to protect operating battery packs against accelerated degradation and failure. This is becoming increasingly important as the energy and power densities demanded by batteries and the economic costs of packs increase. Here, ultrasonic time-of-flight analysis is performed to demonstrate the technique as a tool for the identification of a range of defects and SoH in Li-ion cells. Analysis of large, purpose-built defects across multiple length scales is performed in pouch cells. The technique is then demonstrated to detect a microscale defect in a commercial cell, which is validated by examining the acoustic transmission signal through the cell. The location and scale of the defects are confirmed using X-ray computed tomography, which also provides information pertaining to the layered structure of the cells. The demonstration of this technique as a methodology for obtaining direct, non-destructive, depth-resolved measurements of the condition of electrode layers highlights the potential application of acoustic methods in real-time diagnostics for SoH monitoring and manufacturing processes.
Greater α1-adrenergic-mediated vasoconstriction in contracting skeletal muscle of patients with type 2 diabetes
Authors: Bock Joshua M. , Hughes William E. , Ueda Kenichi , Feider Andrew J. , Hanada Satoshi , Kruse Nicholas T. , Iwamoto Erika , Casey Darren P.
Published: August 2020

Findings presented in this article are the first to show patients with type 2 diabetes mellitus have blunted hyperemic and vasodilatory responses to dynamic handgrip exercise. Moreover, we illustrate greater α1-adrenergic-mediated vasoconstriction may contribute to our initial observations. Collectively, these data suggest patients with type 2 diabetes may have impaired functional sympatholysis, which can contribute to their reduced exercise capacity.
The Significance of Circular RNA DDX17 in Prostate Cancer
Authors: Lin Qi , Cai Jian , Wang Qin-Quan
Published: August 2020

Circular RNA DDX17 (circDDX17) has been demonstrated as a tumor suppressor in colorectal cancer. However, mechanisms underlying circDDX17 effects in cases of prostate cancer (PCa) are not well understood. Thus, herein, we determined measures of circDDX17 expression by use of the TCGA database. Expression of circDDX17 in prostate cancer‐afflicted tissue samples was determined by qRT‐PCR. Functionally, circDDX17 induced remarkable inhibition of cell colonizing ability, invasion, and epithelial‐mesenchymal transition (EMT) progression in vitro. Mechanistically, dual‐luciferase reporter assays, RNA immunoprecipitation, and RNA pull‐down experiments helped verify interactions between circDDX17 and miR‐346. Low expression of circDDX17 occurred in TCGA PCa samples. Furthermore, circDDX17 expression was downregulated significantly in PCa. These results suggested that circDDX17 suppressed PC cell mobility, proliferation, and invasion. Mechanistic experiments indicated that circDDX17 might serve as a ceRNA of miR‐346 to relieve repressive effects of miR‐346 upon phospholysine phosphohistidine inorganic pyrophosphate phosphatase (LHPP). LHPP expression itself was downregulated in TCGA PCa samples. Overall, our findings indicated that the circDDX17/miR‐346/LHPP pathway inhibited the progression of prostate cancer and that circDDX17 may be a new potential therapeutic or diagnostic target for treating and diagnosing prostate cancer. As our study also demonstrated for the first time that LHPP might act as an anticancer gene in prostate cancer, the findings could have wide‐ranging implications for the treatment of this affliction.
Effect of Weather on COVID-19 Transmission and Mortality in Lagos, Nigeria
Authors: Ogaugwu Christian , Mogaji Hammed , Ogaugwu Euphemia , Nebo Uchechukwu , Okoh Hilary , Agbo Stanley , Agbon Andrew
Published: August 2020

The novel coronavirus disease 2019 (COVID-19) has become a global pandemic with more than 4 million confirmed cases and over 280,000 confirmed deaths worldwide. Evidence exists on the influence of temperature and humidity on the transmission of related infectious respiratory diseases, such as influenza and severe acute respiratory syndrome (SARS). This study therefore explored the effects of daily temperature and humidity on COVID-19 transmission and mortality in Lagos state, the epicenter of COVID-19 in Nigeria. Correlation analysis was performed using incidence data on COVID-19 and meteorological data for the corresponding periods from 9th March to 12th May, 2020. Our results showed that atmospheric temperature has a significant weak negative correlation with COVID-19 transmission in Lagos. Also, a significant weak negative correlation was found to exist between temperature and cumulative mortality. The strength of the relationship between temperature and the disease incidence increased when 1 week and 2 weeks’ predetection delays were put into consideration. However, no significant association was found between atmospheric humidity and COVID-19 transmission or mortality in Lagos. This study contributes more knowledge on COVID-19 and will benefit efforts and decision-making geared towards its control.
Development of a 100 mW-Class 94 GHz High-Efficiency Single-Series Rectifier Feed by Finline for Micro-UAV Application
Authors: Matsui Kosumo , Komurasaki Kimiya , Hatakeyama Waku , Shimamura Kohei , Fujiwara Kohei , Yamaoka Hidehiko
Published: August 2020

Wireless power transfer (WPT) is one solution to realize long flight times and accommodate various missions of micro-uncrewed aerial vehicles (MAVs). Reducing the constraint of power transmission distance and realizing high beam efficiency are possible because of the high directivity of WPT using millimeter wave (MMW) methods. Nevertheless, no report of the relevant literature describes an investigation of sending power to an MAV using MMW because MMW rectennas have low efficiency. The purpose of our study is to conduct fundamental research of a high-efficiency and high-power rectenna at 94 GHz aimed at MAV application using MMW. As described herein, we developed and evaluated a 100-mW-class single-diode rectifier at 94 GHz with a finline of a waveguide (WG) to a microstrip-line (MSL) transducer. With the optimum load of 150 Ω at input power of 128 mW, the output DC power and rectifying efficiency were obtained respectively as 41.7 mW and 32.5%. By comparison to an earlier study, measurement of 94 GHz rectifiers under high power input becomes more accurate through this study.
Surveying the Impact of Authentic and Pragmatic Marketing by Paradigm Shift on Brand Authenticity: A Case Study of Selected Islamic Azad Universities (Anzali, Tehran Markaz, and Tonekabon)
Authors: Esmaeli Zohreh Ali , Kheiri Bahram , Farahbod Farzin
Published: August 2020

The contextual changes of the present age have altered the former order of personal and social relations in such a way that the creation of a new order is accompanied by an epistemic crisis; the crisis of knowledge of new relationships has rendered past valuations inefficient and invalid. In this regard, Kotler considers authenticity as the most influential element in this era of achieving sustainable development and customer trust, and since the production of university knowledge is the key to sustainable development, today it is faced with quality issues. This study aimed to investigate the effect of two marketing strategies, namely, authentic marketing and pragmatic marketing, through paradigm shifts as a solution to the epistemic crisis of brand authenticity. The research method of this study is based on quantitative and descriptive survey. The case study consists of Iranian students of Islamic Azad Universities (IAUs) stratified random sampling and sample size based on Morgan table were 385 people. Data were collected and distributed by questionnaire. The structural equation modeling technique with partial least squares approach and SmartPLS2 software were used for data analysis. The findings indicate that both authentic marketing and pragmatic marketing are more effective on brand authenticity through paradigm shift.
Aidi Injection, Compound Kushen Injection, or Kanglaite Injection: Which Is the Best Partner with Systemic Chemotherapy for Patients with HCC? A Network Meta‐Analysis
Authors: Dou Dou , Zhang Ze-yu , Wu Zhi-yuan , Qiu Xu-dong , Zhong Xiang-gen
Published: August 2020

Objective. The aim of this network meta‐analysis (NMA) was to explore the effectiveness of different traditional Chinese medicine injections (TCMIs) combined with systemic chemotherapy for the treatment of hepatocellular carcinoma (HCC). Methods. A comprehensive search for randomized controlled trials (RCTs) was performed with regard to different TCMIs for treating HCC in seven electronic databases up to November 2019. The quality assessment of the included RCTs was conducted according to the Cochrane risk of bias tool. The objective response rate (ORR), clinical benefit rate (CBR), and Karnofsky performance score (KPS) data were extracted. The network meta‐analysis used the network package in Stata software to analyse the data and draw a map of the evidence summarizing the direct and indirect comparisons. Results. A total of 1697 articles were retrieved through the comprehensive search. Twenty RCTs focusing on Aidi injection, compound Kushen injection, and Kanglaite injection as adjuvant therapies to chemotherapy were included, involving a total of 1418 patients. The NMA statistics showed that all three indicators (ORR, CBR, and KPS) were better in the combined treatment group of TCMIs with chemotherapy than that in the single treatment group of chemotherapy alone. Kanglaite injection tended to be better than the other two in terms of primary outcome, but there was not a significant difference. The combined treatment group had fewer adverse reactions than the single treatment group. Moreover, several articles reported that TCMIs combined with chemotherapy could increase the number of CD3+ and CD4+ T lymphocytes and the ratio of CD4+/CD8+ T lymphocytes. Conclusions. TCMIs combined with systemic chemotherapy could be an effective and safe treatment option for patients with HCC. Kanglaite injection showed a tendency to be better than the other two kinds of injections in terms of ORR. Nevertheless, additional results from multicentre trials and high‐quality studies will be pivotal for supporting our findings.
Urinary Peptides Associated Closely with Gestational Diabetes Mellitus
Authors: Hu Zhiying , Tian Yaping , Li Jia , Hu Mei , Zhang Man
Published: August 2020

Gestational diabetes mellitus (GDM) is a common disease of pregnant women, which has a higher incidence in recent years. The purpose of this study is to explore urinary biomarkers that could predict and monitor gestational diabetes mellitus (GDM). Urine samples from 30 normal pregnant women and 78 GDM patients were collected and purified by weak cationic exchange magnetic beads (MB-WCX), then analyzed by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). The urinary peptide signatures of the two groups were compared by BioExplorer software. The potential ability of the differently expressed peptides to distinguish GDM patients from normal pregnant women was evaluated by receiver operating characteristic (ROC) analysis. At last, the differently expressed peptides were identified by liquid chromatography tandem mass spectrometry (LC-MS). There were four differently expressed peptides (m/z 1000.5, 1117.5, 1142.9, and 2022.9) between two groups, which were identified as fragments of urinary albumin, α2-macroglobulin, human hemopexin, and α1-microglobulin, respectively. The diagnostic efficacy of m/z 1142.9 was better than the other peptides. The area under the curve (AUC) of the m/z 1142.9 was 0.690 (95% CI: 0.583-0.796). The discovery of urinary polypeptides provides the possibility for the early prediction of GDM and the monitoring of glucose metabolism in GDM patients by a noninvasive method.
ERINA Is an Estrogen-Responsive LncRNA That Drives Breast Cancer through the E2F1/RB1 Pathway
Authors: Fang Zihui , Wang Yue , Wang Zehua , Xu Meishu , Ren Songrong , Yang Da , Hong Mei , Xie Wen
Published: August 2020

Resistance to therapeutic drugs is a major challenge in the treatment of cancers, including breast cancer. Long noncoding RNAs (lncRNA) are known to have diverse physiologic and pathophysiologic functions, including in cancer. In searching for lncRNA responsible for cancer drug resistance, we identified an intergenic lncRNA ERINA (estrogen inducible lncRNA) as a novel lncRNA highly expressed in multiple cancer types, especially in estrogen receptor–positive (ER+) breast cancers. Expression of ERINA was inversely correlated with survival of patients with ER+ breast cancer and sensitivity to CDK inhibitor in breast cancer cell lines. Functional characterization established ERINA as an oncogenic lncRNA, as knockdown of ERINA in breast cancer cells inhibited cell-cycle progression and tumor cell proliferation in vitro and xenograft tumor growth in vivo. In contrast, overexpression of ERINA promoted cell growth and cell-cycle progression. ERINA promoted cell-cycle progression by interacting with the E2F transcription factor 1 (E2F1), which prevents the binding of E2F1 to the tumor suppressor retinoblastoma protein 1 (RB1). ERINA also functioned as an estrogen and ER-responsive gene, and an intronic ER-binding site was identified as an enhancer that mediates the transactivation of ERINA. In summary, ERINA is an estrogen-responsive oncogenic lncRNA that may serve as a novel biomarker and potential therapeutic target in breast cancer.

Significance:

These findings identify ERINA as an estrogen-responsive, oncogenic lncRNA, whose elevated expression may contribute to drug resistance and poor survival of patients with ER+ breast cancer.
Effect of Specific Immunoglobulin E Response and Comorbidities on Effectiveness of MP-AzeFlu in a Real-Life Study
Authors: Klimek Ludger , Price David , Gálffy Gabriella , Emmeluth Melanie , Koltun Arkady , Kopietz Ferdinand , Nguyen Duc Tung , van Weissenbruch Ranny , Pohl Wolfgang , Kuhl Hans-Christian , Scadding Glenis , Mullol Joaquim
Published: August 2020

Introduction: Phenotyping allergic rhinitis (AR) by immunoglobulin E (IgE) sensitivity and comorbidities may help characterize AR and provide a framework for treatment decisions. Methods: This prospective, noninterventional study evaluated the effectiveness of MP-AzeFlu (azelastine hydrochloride plus fluticasone propionate intranasal spray formulation) across AR phenotypes. Patients with moderate-to-­severe seasonal or perennial AR for whom MP-AzeFlu was prescribed were enrolled. AR subpopulations (ARPs) were assigned based on the classification of IgE response and comorbidities. AR symptoms over the previous 24 h were documented using an AR visual analog scale (AR-VAS), with ratings from “not at all bothersome” (0 mm) to “extremely bothersome” (100 mm), at the inclusion visit and on days 1, 3, 7, and the last day of the study (approximately day 14). AR quality-of-life measures were recorded using a VAS. Results: A total of 1,103 patients with AR were included. Mean baseline AR-VAS scores ranged from 70.3 to 75.1 mm (severe) across ARPs. In the overall population, 86.6% of patients responded to treatment (AR-VAS score <50 mm on ≥1 days). In the ARPs, response rates ranged from 79.3 to 89.6%. Mean reduction in AR-VAS scores ranged from 47.9 to 40.9 mm, a decrease from severe to mild across all ARPs. Quality-of-life VAS scores were similarly reduced in the total population and ARPs. Discussion/Conclusion: MP-AzeFlu treatment reduced VAS severity and quality-of-life scores from baseline in the total population and ARPs, supporting MP-AzeFlu as an effective treatment for all patients with moderate-to-severe AR, regardless of AR phenotype or comorbidities.
Gut Microbiota-Associated Activation of TLR5 Induces Apolipoprotein A1 Production in the Liver
Authors: Yiu Jensen H.C. , Chan Kam-Suen , Cheung Jamie , Li Jin , Liu Yan , Wang Yao , Fung William W.L. , Cai Jieling , Cheung Samson W.M. , Dorweiler Bernhard , Wan Eric Y.F. , Tso Patrick , Xu Aimin , Woo Connie W.
Published: August 2020

Rationale:

Dysbiosis of gut microbiota plays an important role in cardiovascular diseases but the molecular mechanisms are complex. An association between gut microbiome and the variance in HDL-C (high-density lipoprotein-cholesterol) level was suggested in a human study. Besides, dietary fat was shown to increase both HDL-C and LDL-C (low-density lipoprotein-cholesterol) levels. We speculate that certain types of gut bacteria responding to dietary fat may help to regulate HDL-C level and potentially affect atherosclerotic development.

Objective:

We aimed to investigate whether and how high-fat diet (HFD)-associated gut microbiota regulated HDL-C level.

Methods and Results:

We found that HFD increased gut flagellated bacteria population in mice. The increase in HDL-C level was adopted by mice receiving fecal microbiome transplantation from HFD-fed mouse donors. HFD led to increased hepatic but not circulating flagellin, and deletion of TLR5 (Toll-like receptor 5), a receptor sensing flagellin, suppressed HFD-stimulated HDL-C and ApoA1 (apolipoprotein A1) levels. Overexpression of TLR5 in the liver of TLR5-knockout mice was able to partially restore the production of ApoA1 and HDL-C levels. Mechanistically, TLR5 activation by flagellin in primary hepatocytes stimulated ApoA1 production through the transcriptional activation responding to the binding of NF-κB (nuclear factor-κB) on
Apoa1
promoter region. Furthermore, oral supplementation of flagellin was able to stimulate hepatic ApoA1 production and HDL-C level and decrease atherosclerotic lesion size in apolipoprotein E-deficient (
Apoe
−/−
) mice without triggering hepatic and systemic inflammation. The stimulation of ApoA1 production was also seen in human ApoA1-transgenic mice treated with oral flagellin.

Conclusions:

Our finding suggests that commensal flagellated bacteria in gut can facilitate ApoA1 and HDL-C productions in liver through activation of TLR5 in hepatocytes. Hepatic TLR5 may be a potential drug target to increase ApoA1.
General Versus Local Anesthesia With Conscious Sedation in Transcatheter Aortic Valve Implantation
Authors: Thiele Holger , Kurz Thomas , Feistritzer Hans-Josef , Stachel Georg , Hartung Philipp , Lurz Philipp , Eitel Ingo , Marquetand Christoph , Nef Holger , Doerr Oliver , Vigelius-Rauch Ursula , Lauten Alexander , Landmesser Ulf , Treskatsch Sascha , Abdel-Wahab Mohamed , Sandri Marcus , Holzhey David , Borger Michael , Ender Jörg , Ince Hüseyin , Öner Alper , Meyer-Saraei Roza , Hambrecht Rainer , Fach Andreas , Augenstein Thomas , Frey Norbert , König Inke R. , Vonthein Reinhard , Rückert Yvonne , Funkat Anne-Kathrin , Desch Steffen , Berggreen Astrid E. , Heringlake Matthias , de Waha-Thiele Suzanne ,   On behalf of the SOLVE-TAVI Investigators
Published: August 2020

Background:

In clinical practice, local anesthesia with conscious sedation (CS) is performed in roughly 50% of patients undergoing transcatheter aortic valve replacement. However, no randomized data assessing the safety and efficacy of CS versus general anesthesia (GA) are available.

Methods:

The SOLVE-TAVI (Comparison of Second-Generation Self-Expandable Versus Balloon-Expandable Valves and General Versus Local Anesthesia in Transcatheter Aortic Valve Implantation) trial is a multicenter, open-label, 2×2 factorial, randomized trial of 447 patients with aortic stenosis undergoing transfemoral transcatheter aortic valve replacement comparing CS versus GA. The primary efficacy end point was powered for equivalence (equivalence margin 10% with significance level 0.05) and consisted of the composite of all-cause mortality, stroke, myocardial infarction, infection requiring antibiotic treatment, and acute kidney injury at 30 days.

Results:

The primary composite end point occurred in 27.2% of CS and 26.4% of GA patients (rate difference, 0.8 [90% CI, −6.2 to 7.8];
P
equivalence
=0.015). Event rates for the individual components were as follows: all-cause mortality, 3.2% versus 2.3% (rate difference, 1.0 [90% CI, −2.9 to 4.8];
P
equivalence
<0.001); stroke, 2.4% versus 2.8% (rate difference, −0.4 [90% CI, −3.8 to 3.8];
P
equivalence
<0.001); myocardial infarction, 0.5% versus 0.0% (rate difference, 0.5 [90% CI, −3.0 to 3.9];
P
equivalence
<0.001), infection requiring antibiotics 21.1% versus 22.0% (rate difference, −0.9 [90% CI, −7.5 to 5.7];
P
equivalence
=0.011); acute kidney injury, 9.0% versus 9.2% (rate difference, −0.2 [90% CI, −5.2 to 4.8];
P
equivalence
=0.0005). There was a lower need for inotropes or vasopressors with CS (62.8%) versus GA (97.3%; rate difference, −34.4 [90% CI, −41.0 to −27.8]).

Conclusions:

Among patients with aortic stenosis undergoing transfemoral transcatheter aortic valve replacement, use of CS compared with GA resulted in similar outcomes for the primary efficacy end point. These findings suggest that CS can be safely applied for transcatheter aortic valve replacement.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02737150.
Biomarkers Enhance Discrimination and Prognosis of Type 2 Myocardial Infarction
Authors: Horiuchi Yu , Wettersten Nicholas , Patel Mitul P. , Mueller Christian , Neath Sean-Xavier , Christenson Robert H. , Morgenthaler Nils G. , McCord James , Nowak Richard M. , Vilke Gary M. , Daniels Lori B. , Hollander Judd E. , Apple Fred S. , Cannon Chad M. , Nagurney John T. , Schreiber Donald , deFilippi Christopher , Hogan Christopher , Diercks Deborah B. , Headden Gary , Limkakeng Alexander T. , Anand Inder , Wu Alan H.B. , Ebmeyer Stefan , Jaffe Allan S. , Peacock W. Frank , Maisel Alan
Published: August 2020

Background:

The observed incidence of type 2 myocardial infarction (T2MI) is expected to increase with the implementation of increasingly sensitive cTn assays. However, it remains to be determined how to diagnose, risk-stratify, and treat patients with T2MI. We aimed to discriminate and risk-stratify T2MI using biomarkers.

Methods:

Patients presenting to the emergency department with chest pain, enrolled in the CHOPIN study (Copeptin Helps in the early detection Of Patients with acute myocardial INfarction), were retrospectively analyzed. Two cardiologists adjudicated type 1 MI (T1MI) and T2MI. The prognostic ability of several biomarkers alone or in combination to discriminate T2MI from T1MI was investigated using receiver operating characteristic curve analysis. The biomarkers analyzed were cTnI, copeptin, MR-proANP (midregional proatrial natriuretic peptide), CT-proET1 (C-terminal proendothelin-1), MR-proADM (midregional proadrenomedullin), and procalcitonin. The prognostic utility of these biomarkers for all-cause mortality and major adverse cardiovascular event (a composite of acute myocardial infarction, unstable angina pectoris, reinfarction, heart failure, and stroke) at 180-day follow-up was also investigated.

Results:

Among the 2071 patients, T1MI and T2MI were adjudicated in 94 and 176 patients, respectively. Patients with T1MI had higher levels of baseline cTnI, whereas those with T2MI had higher baseline levels of MR-proANP, CT-proET1, MR-proADM, and procalcitonin. The area under the receiver operating characteristic curve for the diagnosis of T2MI was higher for CT-proET1, MR-proADM, and MR-proANP (0.765, 0.750, and 0.733, respectively) than for cTnI (0.631). Combining all biomarkers resulted in a similar accuracy to a model using clinical variables and cTnI (0.854 versus 0.884,
P
=0.294). Addition of biomarkers to the clinical model yielded the highest area under the receiver operating characteristic curve (0.917). Other biomarkers, but not cTnI, were associated with mortality and major adverse cardiovascular event at 180 days among all patients, with no interaction between the diagnosis of T1MI or T2MI.

Conclusions:

Assessment of biomarkers reflecting pathophysiologic processes occurring with T2MI might help differentiate it from T1MI. All biomarkers measured, except cTnI, were significant predictors of prognosis, regardless of the type of myocardial infarction.