bluuebunny/crossref_metadata_2025 huggingface dataset:
Utilizing Deep Learning and Oversampling Methods to Identify Children’s Emotional and Behavioral Risk
Authors: Wang Jiandong , Liu Jin , DiStefano Christine , Pan Gaofeng , Gao Ruiqin , Tang Jijun
Published: August 2020

Deep neural network (DNN) has been widely used in various artificial intelligence applications and is, unsurprisingly, penetrating the field of school psychology. In the school environment, universal screening is used by teachers to identify children’s emotional and behavioral risk (EBR) within a screener. EBR can be used to predict possible emotional and behavioral disorders, which impact children’s educational and social outcomes. Using the BASC-2 Behavioral and Emotional Screening System Teacher Rating Scale (BASC-2 BESS TRS; Reynolds & Kamphaus (2004). Behavior Assessment System for Children (2nd ed.). Circle Pines, MN: American Guidance Service) norm data, we classified children’s EBR status from normal to at-risk using DNN. Data oversampling was used to overcome the imbalanced sample feature (i.e., few cases with emotional and behavioral disorder). Traditional machine learning methods, such as Naïve Bayes and logistic regression, were included for comparison. The results indicated that the DNN with oversampling achieved the highest performance levels with accuracy (ACC) of .957, precision (PPV) of .545, true positive rate (TPR or sensitivity) of 1.000, and true negative rate (TNR or specificity) of .942 compared with the other methods. This novel method is helpful to provide accurate screening results for early identification of children’s EBR. The current study provides a useful guide for researchers to apply the DNN and oversampling to classification in assessment-related research.
National identities in the context of Shakespeare’s Henry V: Exploring contemporary understandings through collocations
Authors: Culpeper Jonathan , Findlay Alison
Published: August 2020

Shakespeare’s clearest use of dialect for sociolinguistic reasons can be found in the play Henry V, where we meet the Welshman Captain Fluellen, the Scotsman Captain Jamy and the Irishman Captain Macmorris. But what might contemporary audiences have made of these Celtic characters? What popular understandings of Celtic identities did Shakespeare’s characters trigger? Recent technological developments, largely in the domain of corpus linguistics, have enabled us to construct robust but nuanced answers to such questions. In this study, we use CQPweb, a corpus analysis tool developed by Andrew Hardie at Lancaster University, to explore Celtic identity terms in a corpus developed by the Encyclopedia of Shakespeare’s Language Project. This corpus contains some 380 million words spanning the 80-year period 1560–1639 and allows us to tap into the attitudes and stereotypes that would have become entrenched in the years leading up to Henry V’s appearance in 1599. We will show how the words tending to co-occur with the words Scots/Scottish, Irish and Welsh reveal contemporary understandings of these identities. Results flowing from the analyses of collocates include the fact that the Irish were considered wild and savage, but also that the word Irish had one particular positive use – when modifying the word rug. In discussing our findings, we will take note of critical discussions, both present day and early modern, on ‘nationhood’ in relation to these characters and identities. We will also conduct, partly for contrastive purposes, a brief analysis of the English identity.
Epistemic Violence in Research on Eldercare
Authors: K. Esiaka Darlingtina , Adams Glenn
Published: August 2020

Decolonial perspectives challenge the notion that standard knowledge in hegemonic psychology is productive of progress and enlightenment. They instead emphasise its association with the colonial violence that constitutes the darker underside of modern development. Our contribution to the special issue applies a decolonial perspective to theory and research on obligation to an elderly parent. Thinking from the standpoint of West African epistemic locations not only illuminates the culture-bound character of standard models but also reveals their foundations in modern individualist selfways. Although modern individualist selfways can liberate well-endowed people to pursue fulfilling relationships and avoid unsatisfying connections with burdensome obligations, these ways of being pose risks of abandonment for people—like many elders—whose requirements for care might constitute a constraint on others’ satisfaction. In contrast, the cultural ecologies of embedded interdependence that inform everyday life in many West African settings afford selfways that emphasise careful maintenance of existing connections. Although these selfways may place constraints on the self-expansive pursuit of satisfying relationships, they provide elders and other vulnerable people with some assurance of support.
Neighbourhood Supports for Active Ageing in Urban India
Authors: Adlakha Deepti , Krishna Murali , Woolrych Ryan , Ellis Geraint
Published: August 2020

Developing urban environments that promote healthy, active living for older adults is at the forefront of global planning policy debates, resulting in concepts and design guidelines to support population ageing. However, current urban planning in India is overlooking the design of age-friendly cities. The share of older adults in India is estimated to increase from 8 per cent in 2015 to 20 per cent in 2050. This demographic shift towards a higher proportion of older adults and the associated health and social care expenditures make healthy ageing a public health priority. Existing studies in gerontology have focused on improving housing environments, but we are now understanding the significance of neighbourhood environments for active ageing. This study contributes to the knowledge on factors shaping active ageing in urban India. We present findings from 55 semi-structured interviews conducted with older adults (age > 60 years) in the metropolitan cities of New Delhi and Chennai in India. The findings explore three themes that emerged from this research: (a) neighbourhood design for active ageing, (b) social participation in community spaces and (c) navigating urban transport and mobility. Across these themes, this study highlights that access to neighbourhood amenities such as transportation, parks and green spaces, and opportunities for leisure and social interaction play a key role in determining older adults’ health and quality of life. In drawing on older adults’ lived experiences in their communities, this study informs policy efforts to improve neighbourhood supports for active ageing in urban India.
Memory and Artistic Dissent: An Analogical Reading of Woolf’s To the Lighthouse and Atwood’s Surfacing
Authors: Neimneh Shadi S. , Almwajeh Motasim O.
Published: August 2020

This article examines the intersections between memory and artistic vision in Virginia Woolf’s To the Lighthouse (1927) and Margaret Atwood’s Surfacing (1972), two novels resonating with feminist tensions and gender issues. Investigating two anxious female artists—Lily Briscoe in Woolf’s novel and the unnamed narrator of Atwood’s novel—the researchers argue that memory functions as a source of order and recuperation. Against patriarchal norms, memory allows for psychic healing, liberation and a fresh start. It engenders a space that can correct the wrongs of the past and help the female characters explore their imaginative abilities and enhance their self-esteem. Digging into the past, these artistic figures redeem their lives from the ravages of time, war and patriarchal oppressions. This approach allows for the liberation and the future growth of the artistic visions of the two painters. Each artist, however, reacts differently to the resurfacing of the painful past. For instance, in To the Lighthouse (a modernist text), Lily embraces art as a form of redemption and thus finishes her painting through her positive memory of Mrs Ramsay. However, the unnamed artist in Surfacing (a postmodern manifestation of art) renounces art and destroys her drawings in the process of coming to terms with her past. This article situates both texts within modernist and postmodernist notions on the value and function of art in order to explicate the essential junctions between memory and art and, therefore, demonstrate dissident artistic responses oscillating between (modernist) espousal and (postmodernist) repudiation.
Slum Rehabilitation Through Public Housing Schemes in India: A Case of Chandigarh
Authors: Gupta Namita , Kavita
Published: August 2020

It is a widely accepted fact that sustainable development cannot be achieved without sustainable human settlements. Cities cannot be made sustainable without ensuring access to adequate and affordable housing to all and improving informal settlements. According to the Census of India (2011), 13.75 million urban households, that is, 65–70 million people live in informal settlements and about 1.77 million people were homeless in India. The goal of sustainable cities cannot be fulfilled with such a large number of populations still being deprived of their basic right to adequate housing. Chandigarh is one of the first planned cities of modern India and has the second highest percentage (89.8%) of urban population to its total population among all the states and union territories in India. This article endeavours to analyse the adequacy and affordability of public housing for urban poor in the Union Territory of Chandigarh.
Consumption of Green Product as a Means of Expressing Green Behaviour in an Emerging Economy: With the Case Study of Malaysia
Authors: Ogiemwonyi Osarodion , Harun Amran Bin
Published: August 2020

This article examines ‘green products’ as a means of expressing ‘green behaviour’ in an emerging economy. The empirical evidence focused on green awareness, behaviour and green culture as a contributing factor. A self-administered questionnaire was run to collect data from consumers ( n = 280) approximately 93 per cent of urbanite in Kuala Lumpur, Malaysia. SmartPLS3.0 was used to analyse the measurement and structural model assessment. Findings suggest that attitude and the green culture had a higher influence on green behaviour. However, the evaluation of green behaviour is not dependent on economic development. Perceived behavioural control (PBC) was found to be insignificant among Malaysian citizens. In particular, awareness interaction between behaviour and culture were insignificant, not sufficient to predict behaviour. The study suggested it is important to educate Malaysian citizens from grassroots about the significance of environmental education and put forward actions to improve green behaviour status and promote green marketing.
Extending Urban Development on Water: Jakarta Case Study
Authors: Setiadi Rukuh , Baumeister Joerg , Burton Paul , Nalau Johanna
Published: August 2020

This article introduces the concept of ‘Sea Cities’ to emphasize a range of tactics to acknowledge the relationship between the sea and cities. This concept is critical for the possibility of integrating future aquatic-based urbanism to address climate change, and in particular, the issue of rising sea levels, which is currently faced by the majority of coastal cities. We compare and assess the tactics of four sea cities (i.e., to fortify, accommodate, release, and floating) against the case study of Jakarta. Jakarta is deemed to be among the metropolitan cities most vulnerable to sea level rise, owing to overpopulation alongside the fact that its land is sinking rapidly due to massive urban development. In order to understand the prospects and pitfalls of each tactic for Jakarta, we analyse scholarly literature on the subject, official government reports and documents, as well as policy briefs released by governments at the national level. This study finds that massive hard structural solutions are not only insufficient but also ineffective towards solving the challenges of climate change in Jakarta, especially the rising sea level. At the same time, it also identifies that while the combination of accommodating and floating tactics has never been considered as future a planning option, this could enable more resilient and adaptive solutions for the future development trajectory of Jakarta. In doing so, it could also provide important transferrable lessons for other coastal cities, especially those within developing countries.
Housing Affordability of Ready-made Garment Workers in the Dhaka Metropolitan Area
Authors: Sultana Shahana , Nazem Nurul Islam
Published: August 2020

Generally, it is assumed that the poor in cities cannot afford to own a house. Thus, real estate developers hardly consider them as potential buyers. Despite the fact that the government has framed favourable policies towards housing the poor, the poor cannot own houses due to the inadequacy of institutional supports. This study examines the affordability of owned or rental accommodation for the poor, taking ready-made garment (RMG) workers in Dhaka as a case in point. Data from across 138 households have been gathered for this study. The study shows that if the rent increases further than the minimum standard for a dwelling unit, then about half of the RMG households become unable to afford their rental houses. An analysis of home ownership shows that only 28 per cent of families can buy a house of 300 sq. ft. on the basis of existing loan structures, and only if the loan covers the total property value, particularly at the periphery of the city area. If the loan structure for housing finance is changed by lowering the interest rate and increasing the loan repayment period, then more workers would be able to afford to own a small house of moderate standard.
Examining Commitment to Prevention, Equity, and Meaningful Engagement: A Review of School District Discipline Policies
Authors: Green Ambra L. , Hatton Heather , Stegenga Sondra M. , Eliason Bert , Nese Rhonda N. T.
Published: August 2020

Although there is increasing awareness of policy decisions contributing to disproportionality in exclusionary practices, few studies have empirically examined common elements of discipline policies across the nation. We utilized a methodological review and the Checklist for Analyzing Discipline Policies and Procedures for Equity (CADPPE) to examine the extent to which current policies reflect recommendations from research regarding best practices for encouraging appropriate behaviors and preventing undesired behaviors, as well as correlations between those policies and exclusionary disciplinary outcomes for all students of color and students of color with disabilities. Data came from 147 district discipline policies and disciplinary outcomes (i.e., suspension and expulsion) from all 50 U.S. states and the District of Columbia. The analyses indicated the majority of policies do not include most of the research-based recommendations for preventing the overuse of exclusionary practices. Furthermore, there was no correlation found between CADPPE ratings and the risk ratios for exclusionary discipline for students of color and students of color with disabilities. Implications for policy development and implementation and limitations are provided.
Mobilizing a Community–Academic Partnership to Provide DIY Handwashing Stations to Skid Row Residents During COVID-19
Authors: DiGuiseppi Graham , Corcoran Callahan , Cunningham Todd , Nguyen Hoan , Noel Monique , White Pete , Bar François
Published: August 2020

The coronavirus (COVID-19) pandemic is having a devastating impact on global health. In the United States and abroad, there is concern for how the novel coronavirus will affect vulnerable populations, including people experiencing homelessness. Individuals who lack stable housing are more likely to have preexisting health conditions and limited access to basic preventative hygiene practices such as handwashing and sanitizing. The situation has become critical in Los Angeles’ Skid Row neighborhood, where nearly 5,000 unhoused residents (13% of the city’s homeless population) reside on any given night. Community members’ concerns have mounted as social and health services in the area have decreased, and early efforts to prevent the transmission of coronavirus did not adequately address the lack of access to handwashing stations and hand sanitizing products. This Practice Note details an academic–community partnership that uses grassroots organizing to provide “do-it-yourself” handwashing stations to the Skid Row neighborhood. We describe how an academic–community partnership was mobilized to establish innovative practices in response to the coronavirus, offering lessons and recommendations for others hoping to do similar work.
The Association Between Oral Hygiene Behavior and Gingival Health Status with the Stage and Grade of Periodontitis: A Cross-Sectional Study
Authors: Dikilitas¸ Ahu , Karaaslan Fatih , Yig˘it Umut
Published: August 2020

Aim:

To analyze the association between teeth brushing (TB) and interdental cleansing (IDC) frequency changes with gingival health status and the stage and grade of periodontitis.

Materials and Methods:

This cross-sectional study consisted of clinical examination and questionnaires. The questionnaires include demographic information and oral hygiene (TB and IDC) behavior. More than 18-year-old participants who underwent a periodontal treatment were randomly included. 548 individuals were classified as gingival healthy, gingivitis, and periodontitis according to the 2017 classification system. The degree of periodontitis was based on stage and grade systems. The data were analyzed by using Kruskal–Wallis and Mann–Whitney U tests.

Results:

The highest TB frequency (twice daily) was the highest in patients with gingivitis (83.7%) followed by healthy patients (82.9%) and patients with stage I periodontitis (52.2%). Compared to those who performed IDC daily, 18.9% of patients were healthy and 8.1% had stage II periodontitis. There was a statistically significant association between the oral hygiene behavior and periodontal health status of participants. Statistically significant association was seen between the TB and IDC with stage-grade of periodontitis. When the TB and IDC scores of different grade groups were compared at the same stage level, no statistically significant difference was found.

Conclusion:

This study showed that periodontal health status was positively correlated with TB and IDC frequency.
Evaluation of the Posterior Superior Alveolar Artery Prior to Sinus Floor Elevation via Lateral Window Technique: A Cone-Beam Computed Tomography Study
Authors: Bedelog˘lu Elçin , Yalçın Mustafa
Published: August 2020

Aim:

To evaluate the prevalence, diameter, localization of the posterior superior alveolar artery (PSAA) and the relationship between PSAA and the floor of the maxillary sinus and the thickness of the maxillary sinus lateral wall using cone-beam computed tomography (CBCT).

Material and Methods:

In this retrospective study, more than 500 CBCT images were retrieved. Out of them 156 CBCT images were related to the sinus floor elevation, among which 120 CBCT images were enrolled in the study based on the inclusion criteria, and 36 CBCT images were excluded. A total of 120 CBCT images of the PSSA from 60 patients comprising 32 (53.3%) men and 28 (46.7%) women were analyzed. Statistical data were analyzed using SPSS for Windows version 22. Descriptive statistics (mean, standard deviation, frequency) were used for the analyses.

Results:

The ages of the participants ranged between 26 and 76 years and the mean age was 54.48 ± 10.92 years. The PSAA was detected on the right side in 95% of the CBCT scans and on the left side in 85% of the maxillary sinuses. At the first detection point (FDP) and last detection point (LDP), the mean values of the distance between the inferior border of the PSAA and the floor of the maxillary sinus were 9.54 ± 4.27 mm and 7.91 ± 4.75 mm, respectively. The mean diameters of the PSAA at the FDP and LDP were 1.36 ± 0.46 mm and 1.12 ± 0.35 mm, respectively.

Conclusion:

Detection of the characteristics of the PSAA by using CBCT is crucial for handling the sinus floor elevation procedures uneventfully.
Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art
Authors: Liu Pei , Jin Dongxu , Zhang Changqing , Gao Youshui
Published: August 2020

Failed treatment of intertrochanteric (IT) femoral fractures leads to remarkable disability and pain, and revision surgery is frequently accompanied by higher complication and reoperation rates than primary internal fixation or primary hip arthroplasty. There is an urgent need to establish a profound strategy for the effective surgical management of these fragile patients. Salvage options are determined according to patient physiological age, functional level, life expectancy, nonunion anatomical site, fracture pattern, remaining bone quality, bone stock, and hip joint competency. In physiologically young patients, care should be taken to preserve the vitality of the femoral head with salvage internal fixation; however, for the elderly population, conversion arthroplasty can result in early weight bearing and ambulation and eliminates the risks of delayed fracture healing. Technical challenges include a difficult surgical exposure, removal of broken implants, deformity correction, critical bone defects, poor bone quality, high perioperative fracture risk, and prolonged immobilization. Overall, the salvage of failed internal fixations of IT fractures with properly selected implants and profound techniques can lead to the formulation of valuable surgical strategies and provide patients with satisfactory clinical outcomes.
Does a ketogenic diet have beneficial effects on quality of life, physical activity or biomarkers in patients with breast cancer: a randomized controlled clinical trial
Authors: Khodabakhshi Adeleh , Seyfried Thomas N. , Kalamian Miriam , Beheshti Maryam , Davoodi Sayed Hossein
Published: August 2020

Introduction

Despite recent interest in the use of ketogenic diets (KDs) for cancer, evidence of beneficial effects is lacking. This study examined the impact of a randomly assigned KD on quality of life, physical activity and biomarkers in patients with breast cancer.

Method

A total of 80 patients with locally advanced or metastatic breast cancer and without a history of renal disease or diabetes were randomly assigned to either a KD or a control group for this 12-week trial. Concurrent with the first, third, and fifth chemotherapy sessions, quality of life, physical activity, and biomarkers (thyroid function tests, electrolytes, albumin, ammonia, ALP, lactate and serum ketones) were assessed. Dietary intake was also recorded on admission and the end of the treatment.

Results

No significant differences were seen in quality of life or physical activity scores between the two groups after 12 weeks; however, the KD group showed higher global quality of life and physical activity scores compared to the control group at 6 weeks (P = 0.02 P = 0.01). Also, serum lactate and ALP levels decreased significantly in the KD group compared to the control group at the end of the intervention (10.7 ± 3 vs 13.3 ± 4, 149 ± 71 vs 240 ± 164, P = 0.02 and P = 0.007, respectively). A significant inverse association was observed between total carbohydrate intake and serum beta-hydroxybutyrate at 12 weeks (r = − 0.77 P < 0.001). No significant differences between groups were observed in thyroid hormones, electrolytes, albumin, LDH or ammonia. Compliance among KD subjects ranged from 66.7 to 79.2% as assessed by dietary intake and serum ketones levels of > 0.5.

Conclusion

According to our results, besides a higher global quality of life and physical activity scores compared to the control group at 6 weeks, KD diet combined to chemotherapy in patients with breast cancer does not bring additional benefit about quality of life and physical activity at 12 weeks. However, decreases seen in levels of lactate and ALP in the KD group suggest that a KD may benefit patients with breast cancer.

Trial registration

This trial has been registered on Iranian Registry of Clinical Trials (IRCT) under the identification code: IRCT20171105037259N2 https://www.irct.ir/trial/30755
High-intensity statin therapy yields better outcomes in acute coronary syndrome patients: a meta-analysis involving 26,497 patients
Authors: Yu Shiyong , Jin Jun , Chen Zhongxiu , Luo Xiaolu
Published: August 2020

Background

Whether high-intensity statin treatment provides more clinical benefits compared with standard statin regimens in acute coronary syndrome (ACS) patients remains controversial. This meta-analysis aimed to comparatively assess high-intensity and standard statin regimens for efficacy and safety in patients with ACS.

Methods

The PubMed, EMBASE, and Cochrane Library databases were searched for studies assessing high-intensity vs. standard statin regimens for ACS treatment from inception to April 2020. The publication language was limited to English, and 16 randomized controlled trials were finally included in this study, with a total of 26,497 patients.

Results

Compared to the standard statin regimens, the relative ratio (RR) of major adverse cardiovascular events (MACE) in ACS patients treated by high-intensity statin was 0.77 (95%CI, 0.68–0.86; P < 0.00001; prediction interval, 0.56–1.07). In subgroup analysis, high-intensity statin therapy resulted in more clinical benefits regarding MACE compared with standard statin treatment in both Asian (RR = 0.77; 95%CI, 0.61–0.98; P = 0.03) and non-Asian (RR = 0.79; 95%CI, 0.71–0.89; P < 0.0001) patients. Although adverse events were acceptable in patients with ACS administered high-intensity statin therapy, this treatment was associated with a higher rate of adverse events (4.99% vs. 2.98%), including myopathy/myalgia and elevated liver enzymes, as reflected by elevated serum aminotransferase or aminotransferase amounts.

Conclusion

The current findings indicated that high-intensity statin therapy might be beneficial in patients with ACS, and close monitoring for adverse effects should be performed.
Patterns of changes in serum lipid profiles in prediabetic subjects: results from a 16-year prospective cohort study among first-degree relatives of type 2 diabetic patients
Authors: Safari Shahla , Amini Masoud , Aminorroaya Ashraf , Feizi Awat
Published: August 2020

Background

Lipid abnormality pervasively is associated with the risk of type 2 diabetes mellitus. To the best of our knowledge, there is no study that has examined the longitudinal changes in a wide range of serum lipid profiles in prediabetic subjects in association with the risk of developing type 2 diabetes mellitus in the future. This study aimed to identify the patterns of changes in lipid profiles over time in prediabetic patients and to classify these subjects in order to highlight which patients are at high risk for future diabetes.

Methods

This prospective 16-year (2003–2019) cohort study was conducted among 1228 prediabetic subjects. The study subjects were followed, and the changes in their lipid profiles, including triglycerides, cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, were evaluated. The latent Markov model was used for data analysis.

Results

The mean (standard deviation) age of subjects was 44.0 (6.8) years, and 73.6% of them were female. The latent Markov model identified two latent states of subjects in terms of changes in lipid profiles: a low tendency to progress diabetes / high tendency to progress diabetes (74, 26%). The latent Markov model showed that the transition probability from a “low tendency to progress diabetic” state to a “high tendency to progress diabetic” state was lower than the transition probability from “high tendency to progress diabetic” state to “low tendency to progress diabetic” state.

Conclusions

The present study showed that more than half of the first-degree relatives of T2DM had approximately normal lipid profiles and that these patients are more inclined to transition from a higher- to a lower-tendency diabetic state. These findings confirm the value of regular screening of first-degree relatives of T2DM. Moreover, preventive intervention strategies are recommended to reduce their risk of developing T2DM.
Sarcopenia as a prognostic factor in patients with recurrent pancreatic cancer: a retrospective study
Authors: Sakamoto Teruhisa , Yagyu Takuki , Uchinaka Ei , Miyatani Kozo , Hanaki Takehiko , Kihara Kyoichi , Matsunaga Tomoyuki , Yamamoto Manabu , Tokuyasu Naruo , Honjo Soichiro , Fujiwara Yoshiyuki
Published: August 2020

Background

Sarcopenia is a prognostic factor in various cancers. However, the impact of sarcopenia in patients with recurrent pancreatic cancer remains unclear. This study evaluated the prognostic significance of sarcopenia in patients with recurrent pancreatic cancer.

Methods

Seventy-four patients who developed postoperative recurrence of pancreatic cancer after undergoing pancreatectomies were enrolled. Sarcopenia in these patients was defined according to the psoas muscle index (PMI) measured via computed tomography at the third vertebra.

Results

The mean PMIs at the time of recurrence were 4.47 ± 1.27 cm2/m2 for men and 3.26 ± 0.70 cm2/m2 for women. Of the 74 patients, 65 (87.8%) were diagnosed with sarcopenia with low PMI. The 2-year post-recurrence survival curve in the sarcopenia group was significantly worse than that in the non-sarcopenia group (P = 0.034). Multivariate analysis revealed that sarcopenia at the time of recurrence was an independent prognostic factor (P = 0.043) along with a high neutrophil-to-lymphocyte ratio (P = 0.004), early recurrence (P = 0.001), and chemotherapy after recurrence (P = 0.005) in patients with recurrent pancreatic cancer. Furthermore, the area under the curve (AUC) of the combination of sarcopenia and time to recurrence for predicting 2-year survival was 0.763, which was much higher than that of sarcopenia alone (AUC = 0.622).

Conclusions

Sarcopenia is a useful prognostic factor in patients with recurrent pancreatic cancer. The combination of sarcopenia and time of recurrence may more accurately predict post-recurrence survival than can sarcopenia alone.
Application of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma
Authors: Li Xue-Qin , Wang Xing , Zhao Da-Wei , Sun Jun , Liu Jiao-Jiao , Lin Dong-Dong , Yang Guang , Liu Hui , Xia Zhen-Ying , Jia Cui-Yu , Li Hong-Jun
Published: August 2020

Background

Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver, and its morbidity and mortality have been increasing in recent years. The early diagnosis and prompt treatment of small HCC are crucial to improve the prognosis and quality of life of patients. In China, hepatitis B virus infection is the main cause. HCC with a single tumor nodule of ≤ 3 cm in diameter, or HCC with a number of nodules, in which each nodule is ≤ 2 cm in diameter, with a total diameter of ≤ 3 cm, is considered as small HCC. The MRI liver-specific contrast agent can detect small HCC at the early stage. This has important clinical implications for improving the survival rate of patients.

Main body

Gd-EOB-DTPA-enhanced MRI can significantly improve the sensitivity and specificity of the detection of HBV-related small hepatocellular carcinoma, providing an important basis for the clinical selection of appropriate personalized treatment. Gd-EOB-DTPA-enhanced MRI can reflect the degree of HCC differentiation, and the evaluation of HCC on Gd-EOB-DTPA-enhanced MRI would be helpful for the selection of the treatment and prognosis of HCC patients. The present study reviews the progress of the application of Gd-EOB-DTPA in the early diagnosis of small HCC, its clinical treatment, the prediction of the degree of differentiation, and the assessment of recurrence and prognosis of HCC, including the pharmacoeconomics and application limitations of Gd-EOB-DTPA. The value of the application of HCC with the Gd-EOB-DTPA was summarized to provide information for improving the quality of life and prolonging the survival of patients.

Conclusion

Gd-EOB-DTPA-enhanced MRI has the diagnostic capability for small HCC with a diameter of ≤ 2 cm. This will have a broader application prospect in the early diagnosis of small liver cancer with a diameter of ≤ 1 cm in the future. The relationship between GD-EOB-DTPA-MRI and the degree of HCC differentiation has a large research space, and Gd-EOB-DTPA is expected to become a potential tool for the preoperative prediction and postoperative evaluation of HCC, which would be beneficial for more appropriate treatments for HCC patients.
The survival effect of ovary preservation in early stage endometrial cancer: a single institution retrospective analysis
Authors: Shin Wonkyo , Park Sang-Yoon , Kang Sokbom , Lim Myong Cheol , Seo Sang-Soo
Published: August 2020

Purpose

We investigated the effect of ovary preserving surgery in early International Federation of Obstetrics and Gynecology (FIGO) stage endometrial cancer patients.

Methods

Medical records were retrospectively reviewed for 539 patients who were diagnosed with early stage endometrial cancer between Jan 2006 and Dec 2017. Patients were categorized into ovary preservation and ovary removal groups. Demographics, recurrence free survival (RFS), and five-year overall survival (OS) rate were compared, and the clinical factors affecting survival were evaluated by univariate and multivariate analysis.

Results

The median follow-up period was 85 months (range, 6–142 months), and the median age was 52.7 years. The mean age was higher in the ovary removal group than in the ovary preservation group (54.4 vs 40.94 years; P < 0.001). The ovary preservation group showed an earlier FIGO stage than the ovary removal group (P = 0.0264). There was a greater incidence of adjuvant chemotherapy administration in the removal group. There were no statistical differences in other baseline characteristics. When comparing the RFS and OS rates, there were no statistical differences between the preservation and removal groups. (recurrence free rate 98.5% vs 92.7%, p = 0.4360, and 5-year survival rate 98.6% vs 93.0%, p = 0.0892, respectively). Endometrioid histology (p = 0.006) and post-operative adjuvant chemotherapy (p = 0.0062) were related to OS, and adjuvant chemotherapy (p < 0.001) and radiotherapy (p = 0.005) were related to RFS.

Conclusions

Ovary preservation in early stage endometrial cancer is worth considering, as it does not affect survival in early stage endometrial cancer patients.
Correction to: Pakistan Randomized and Observational Trial to Evaluate Coronavirus Treatment (PROTECT) of Hydroxychloroquine, Oseltamivir and Azithromycin to treat newly diagnosed patients with COVID-19 infection: A structured summary of a study protocol for a randomized controlled trial
Authors: Akram Javed , Azhar Shehnoor , Shahzad Muhammad , Latif Waqas , Khan Khalid Saeed
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Correction to: High rate of extended-spectrum beta-lactamase-producing gram-negative infections and associated mortality in Ethiopia: a systematic review and meta-analysis
Authors: Tufa Tafese B. , Fuchs Andre , Tufa Takele B. , Stötter Loraine , Kaasch Achim J. , Feldt Torsten , Häussinger Dieter , Mackenzie Colin R.
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Role of biochar in promoting circular economy in the agriculture sector. Part 2: A review of the biochar roles in growing media, composting and as soil amendment
Authors: Jindo Keiji , Sánchez-Monedero Miguel Angel , Mastrolonardo Giovanni , Audette Yuki , Higashikawa Fábio Satoshi , Silva Carlos Alberto , Akashi Kinya , Mondini Claudio
Published: August 2020

Biochar is utilized in modern society for multiple agricultural and environmental purposes in the framework of circular economy. The aims of this study were to review the leading edge of knowledge of studies where biochar was used in the agriculture sector, as an input for growing media, composting and to improve soil physical and chemical properties along with crop yield. Usage of biochar is promising as substitute for peat and in the composting as it reduces N losses, accelerates the process and improves the quality of final composts. The right selection of feedstock and optimization of pyrolysis conditions are key factors to tailor biochar thereby improving soil properties and increasing crop yield. Potential benefits and flaws for the usage of biochar technology in the agricultural domain are broadly reviewed and thoroughly discussed.
Response of Mitochondrial Respiration in Adipose Tissue and Muscle to 8 Weeks of Endurance Exercise in Obese Subjects
Authors: Hoffmann Christoph , Schneeweiss Patrick , Randrianarisoa Elko , Schnauder Günter , Kappler Lisa , Machann Jürgen , Schick Fritz , Fritsche Andreas , Heni Martin , Birkenfeld Andreas , Niess Andreas M , Häring Hans-Ulrich , Weigert Cora , Moller Anja
Published: August 2020

Context

Exercise training improves glycemic control and increases mitochondrial content and respiration capacity in skeletal muscle. Rodent studies suggest that training increases mitochondrial respiration in adipose tissue.

Objective

To assess the effects of endurance training on respiratory capacities of human skeletal muscle and abdominal subcutaneous adipose tissue and to study the correlation with improvement in insulin sensitivity.

Design

Using high-resolution respirometry, we analyzed biopsies from 25 sedentary (VO2 peak 25.1 ± 4.0 VO2 mL/[kg*min]) subjects (16 female, 9 male; 29.8 ± 8.4 years) with obesity (body mass index [BMI] 31.5 ± 4.3 kg/m2), who did not have diabetes. They performed a supervised endurance training over 8 weeks (3 × 1 hour/week at 80% VO2 peak).

Results

Based on change in insulin sensitivity after intervention (using the Matsuda insulin sensitivity index [ISIMats]), subjects were grouped in subgroups as responders (>15% increase in ISIMats) and low-responders. The response in ISIMats was correlated to a reduction of subcutaneous and visceral adipose tissue volume. Both groups exhibited similar increases in fitness, respiratory capacity, and abundance of mitochondrial enzymes in skeletal muscle fibers. Respiratory capacities in subcutaneous adipose tissue were not altered by the intervention. Compared with muscle fibers, adipose tissue respiration showed a preference for β-oxidation and complex II substrates. Respiratory capacities were higher in adipose tissue from female participants.

Conclusion

Our data show that the improvement of peripheral insulin sensitivity after endurance training is not directly related to an increase in mitochondrial respiratory capacities in skeletal muscle and occurs without an increase in the respiratory capacity of subcutaneous adipose tissue.
The Clinicopathological Results of Thyroid Cancer With BRAF
V600E Mutation in the Young Population of Fukushima
Authors: Iwadate Manabu , Mitsutake Norisato , Matsuse Michiko , Fukushima Toshihiko , Suzuki Satoshi , Matsumoto Yoshiko , Ookouchi Chiyo , Mizunuma Hiroshi , Nakamura Izumi , Nakano Keiichi , Sakamoto Atsuhiko , Hirokawa Mitsuyoshi , Ito Masahiro , Naganuma Hiroshi , Hashimoto Yuko , Shimura Hiroki , Yamashita Shunichi , Suzuki Shinichi
Published: August 2020

Background

Thyroid ultrasound screening for children aged 0 to 18 years was performed in Fukushima following the accident at the Fukushima Daiichi Nuclear Power Plant. As a result, many thyroid cancer cases were detected. To explore the carcinogenic mechanisms of these cancers, we analyzed their clinicopathological and genetic features.

Methods

We analyzed 138 cases (52 males and 86 females) who had undergone surgery between 2013 and 2016 at Fukushima Medical University Hospital. Postoperative pathological diagnosis revealed 136 (98.6%) cases of papillary thyroid cancer (PTC).

Results

The BRAFV600E mutation was detected using direct DNA sequencing in 96 (69.6%) of the thyroid cancer cases. In addition, oncogenic rearrangements were detected in 23 cases (16.7%). Regarding chromosomal rearrangements, 8 (5.8%) RET/PTC1, 6 (4.3%) ETV6(ex4)/NTRK3, 2 (1.4%) STRN/ALK, and 1 each of RET/PTC3, AFAP1L2/RET, PPFIBP/RET, KIAA1217/RET, ΔRFP/RET, SQSTM1/NTRK3 and TPR/NTRK1 were detected. Tumor size was smaller in the BRAFV600E mutation cases (12.8 ± 6.8 mm) than in wild-type BRAF cases (20.9 ± 10.5 mm). In the BRAFV600E mutation cases, 83 (86.5%) showed lymph node metastasis, whereas 26 (61.9%) of the wild-type BRAF cases showed lymph node metastasis.

Conclusions

The BRAFV600E mutation was mainly detected in residents of Fukushima, which was different from post-Chernobyl PTC cases with RET/PTC3 rearrangement. PTC with the BRAFV600E mutation was smaller but was shown in the high rate of central cervical lymph node metastasis than the wild-type BRAF PTC in the young population of Fukushima.
Parathyroid Hormone and Bone Mineral Density: A Mendelian Randomization Study
Authors: Qu Zihao , Yang Fangkun , Hong Jianqiao , Wang Wei , Yan Shigui
Published: August 2020

Purpose

Accumulating evidence implicates parathyroid hormone (PTH) in the development of osteoporosis. However, the causal effect of PTH on bone mineral density (BMD) remains unclear. Thus, this study is aimed at exploring the association between the concentrations of serum PTH and BMD.

Methods

The instrumental variables for PTH were selected from a large-scale genome-wide association study (GWAS; n = 29 155). Outcomes included BMD of the forearm (FA; n = 8143), femoral neck (FN; n = 33 297), lumbar spine (LS; n = 32 735), heel (HL; n = 394 929), and risk of fractures in these bones (n = 361 194). Furthermore, the BMD of 5 different age groups: 15 years or younger (n = 11 807), 15–30 (n = 4180), 30–45 (n = 10 062), 45–60 (n = 18 805), and 60 years or older (n = 22 504) were extracted from a GWAS meta-analysis study. The analyses were performed using the 2-sample Mendelian randomization method.

Results

Mendelian randomization analysis revealed that the level of serum PTH was inversely associated with BMD of FA (95% CI: -0.763 to -0.016), FN (95% CI: -0.669 to -0.304), and LS (95% CI: -0.667 to -0.243). A causal relationship between serum PTH levels and BMD was observed in individuals aged 30–45 (95% CI: -0.888 to -0.166), 45–60 (95% CI: -0.758 to -0.232), and over 60 years (95% CI: -0.649 to -0.163).

Main Conclusions

This study demonstrated that the concentrations of serum PTH is inversely associated with BMD of several bones. Further analysis revealed site- and age-specific correlations between serum PTH levels and BMD, which implies that the levels of serum PTH contribute to the development of osteoporosis.
Effects of Sleeve Gastrectomy on Bone Marrow Adipose Tissue in Adolescents and Young Adults with Obesity
Authors: Bredella Miriam A , Singhal Vibha , Hazhir Karzar Nazanin , Animashaun Abisayo , Bose Amita , Stanford Fatima C , Carmine Brian , Misra Madhusmita
Published: August 2020

Context

Sleeve gastrectomy (SG), the most common metabolic and bariatric surgery in adolescents, is associated with bone loss. Marrow adipose tissue (MAT) is a dynamic endocrine organ that responds to changes in nutrition and might serve as a novel biomarker for bone health. Two types of MAT have been described, which differ in anatomic location—proximal regulated MAT vs distal constitutive MAT.

Objective

To determine the effects of SG on volumetric bone mineral density (vBMD) and MAT in adolescents with obesity. We hypothesized that SG would lead to a decrease in vBMD and differential changes in MAT.

Design

12-month prospective study in 52 adolescents with moderate-to-severe obesity (38 female; mean age:17.5 ± 2.2 years; mean BMI 45.2 ± 7.0 kg/m2), comprising 26 subjects before and after SG and 26 nonsurgical controls.

Main Outcome Measures

Lumbar vBMD by quantitative computed tomography; MAT of the lumbar spine, femur and tibia by proton magnetic resonance spectroscopy; abdominal fat and thigh muscle by magnetic resonance imaging.

Results

Adolescents lost 34.1 ± 13.1 kg after SG vs 0.3 ± 8.4 kg in the control group (P < 0.001). Lumbar vBMD decreased in the SG group (P = 0.04) and this change was associated with a reduction in weight and muscle area (P < 0.05) and an increase in lumbar MAT (P = 0.0002). MAT of the femur and tibia decreased after SG vs controls (P < 0.05); however, the differences were no longer significant after controlling for change in weight.

Conclusion

SG in adolescents decreased lumbar vBMD associated with an increase in lumbar MAT and decrease in extremity MAT. This demonstrates differential changes of regulated MAT in the lumbar spine and constitutive MAT in the distal skeleton in adolescents in response to SG.
Case Studies Using the Electroencephalogram to Monitor Anesthesia-Induced Brain States in Children
Authors: Brandt Steven P. , Walsh Elisa C. , Cornelissen Laura , Lee Johanna M. , Berde Charles , Shank Erik S. , Purdon Patrick L.
Published: August 2020

For this child, at this particular moment, how much anesthesia should I give? Determining the drug requirements of a specific patient is a fundamental problem in medicine. Our current approach uses population-based pharmacological models to establish dosing. However, individual patients, and children in particular, may respond to drugs differently. In anesthesiology, we have the advantage that we can monitor our patients in real time and titrate drugs to the desired effect. Examples include blood pressure management or muscle relaxation. Although the brain is the primary site of action for sedative-hypnotic drugs, the brain is not routinely monitored during general anesthesia or sedation, a fact that would surprise many patients. One reason for this is that, until recently, physiologically principled approaches for anesthetic brain monitoring have not been articulated. In the past few years, our knowledge of anesthetic brain mechanisms has developed rapidly. We now know that anesthetic drug effects are clearly visible in the electroencephalogram (EEG) of adults and reflect underlying anesthetic pharmacology and brain mechanisms. Most recently, similar effects have been characterized in children. In this article, we describe how EEG monitoring could be used to guide anesthetic management in pediatric patients. We review previous evidence and present multiple case studies showing how drug-specific and dose-dependent EEG signatures seen in adults are visible in children and infants, including those with neurological disorders. We propose that the EEG can be used in the anesthetic care of children to enable anesthesiologists to better assess the drug requirements of individual patients in real time and improve patient safety and experience.