bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisitando as mobilidades turísticas
Authors: Allis Thiago , Moraes Camila Maria dos Santos , Sheller Mimi
Published: January 2021

Este artigo, de caráter ensaístico, tem por objetivos apresentar e discutir elementos essenciais para o estudo do turismo e das mobilidades, tendo por referência o paradigma das novas mobilidades. O argumento central do trabalho – que tem por base a tradução e ampliação de capítulo inicial do livro Tourism Mobilities: places do play, places in play (Sheller & Urry, 2004) – é que o turismo se desenvolve a partir da elaboração (ou invenção) lugares turísticos (places to play). Mas, ao mesmo tempo e de maneira metafórica, também os lugares estão em movimento (places in play), indicando a mobilidade de estilos de vida, visões de mundo e narrativas dão forma a este fenômeno conectado globalmente. O trabalho também dialoga com as reflexões de John Urry sobre futuros, especialmente nas críticas à alta dependência dos derivados do petróleo carbono nas sociedades capitalistas. Ainda que não seja o enfoque do texto, encerra com algumas reflexões sobre o futuro do turismo em um contexto (pós-)pandêmico, em que as mobilidades turísticas estarão potencialmente influenciadas por revisões nos novos protocolos sanitários e pela possível emergência de novos estilos e demandas de viagem.
Adherence to Single-Pill Versus Free-Equivalent Combination Therapy in Hypertension
Authors: Parati Gianfranco , Kjeldsen Sverre , Coca Antonio , Cushman William C. , Wang Jiguang
Published: January 2021

Poor adherence to antihypertensive therapy is a major cause of poor blood pressure (BP) control in patients with hypertension. Regimen simplification may improve adherence and BP control. This systematic review assessed whether single-pill combination (SPC) therapy led to improved adherence, persistence, and better BP control compared with free-equivalent combination (FEC) therapy in patients with hypertension. PubMed, Medline, Embase, and the Cochrane Library were searched until July 2020, in addition to manual searching of relevant congress abstracts from 2014 to 2020 for studies including adults with hypertension aged ≥18 years receiving SPC or FEC antihypertensive therapy measuring any of the following: adherence, persistence, and reductions in systolic BP and/or diastolic BP. Adherence and persistence were summarized in a narrative analysis; direct pair-wise meta-analysis was conducted to compare BP reductions with SPC therapy versus FEC therapy using fixed-effect and random-effects models. Following screening, 44 studies were included. The majority (18 of 23) of studies measuring adherence showed adherence was significantly improved in patients receiving SPCs versus FECs. Overall, 16 studies measured persistence, of which 14 showed that patients receiving SPCs had significantly improved persistence or were significantly less likely to discontinue therapy than patients receiving FECs. Systolic BP (mean difference, −3.99 [95% CI, −7.92 to −0.07];
P
=0.05) and diastolic BP (−1.54 [95% CI, −2.67 to −0.41];
P
=0.0076) were both significantly reduced with SPC therapy compared with FEC therapy at week 12. SPC therapy leads to improved adherence and persistence compared with FEC therapy and may lead to better BP control in patients with hypertension.
Renovascular Disease Induces Senescence in Renal Scattered Tubular-Like Cells and Impairs Their Reparative Potency
Authors: Chen Xiao-Jun , Kim Seo Rin , Jiang Kai , Ferguson Christopher M. , Tang Hui , Zhu Xiang-Yang , Lerman Amir , Eirin Alfonso , Lerman Lilach O.
Published: January 2021

Scattered tubular-like cells (STCs), dedifferentiated renal tubular epithelial cells, contribute to renal self-healing, but severe injury might blunt their effectiveness. We hypothesized that ischemic renovascular disease (RVD) induces senescence in STC and impairs their reparative potency. CD24+/CD133+ STCs were isolated from swine kidneys after 16 weeks of RVD or healthy controls. To test their reparative capabilities in injured kidneys, control or RVD-STC (5×10
5
) were prelabeled and injected into the aorta of 2 kidneys, 1-clip (2k,1c) mice 2 weeks after surgery. Murine renal function and oxygenation were studied in vivo 2 weeks after injection using micro-magnetic resonance imaging, and fibrosis, tubulointerstitial injury, capillary density, and expression of profibrotic and inflammatory genes ex vivo. STC isolated from swine RVD kidneys showed increased gene expression of senescence and senescence-associated secretory phenotype markers and positive SA-β-gal staining. Delivery of normal pig STCs in 2k,1c mice improved murine renal perfusion, blood flow, and glomerular filtration rate, and downregulated profibrotic and inflammatory gene expression. These renoprotective effects were blunted using STC harvested from RVD kidneys, which also failed to attenuate hypoxia, fibrosis, tubular injury, and capillary loss in injured mouse 2k,1c kidneys. Hence, RVD may induce senescence in endogenous STC and impair their reparative capacity. These observations implicate cellular senescence in the pathophysiology of ischemic kidney disease and support senolytic therapy to permit self-healing of senescent kidneys.
Key Aspects of Open Data in Finnish RDI Cooperation between Higher Education and Businesses
Authors: Päällysaho Seliina , Latvanen Jaana , Lehto Anttoni , Riihimaa Jaakko , Lahti Pekka , Kärki Anne , Puhakka-Tarvainen Helena
Published: January 2021

The article highlights aspects that should be considered during an open Research, Development, and Innovation (RDI) process cycle to improve the utilization of research data and foster open cooperation between higher education and businesses. The viewpoint here is in publicly funded joint research projects of the universities of applied sciences (UAS), the concept is, however, applicable in other higher education and research organizations as well. There are various challenges related to research data management in general as well as to the openness and reuse of data and results. The findings of this article are based on the results of a two-day expert workshop, and these results are interlinked with five phases of an open RDI process cycle: planning, implementation, documentation, sharing, and commercialization. Various drivers and barriers can be identified in different stages of the process. On a general level, special attention must be paid to critical factors such as ownership and sharing of data and results, confidential information and business secrets as well as following the requirements of the Open Science (OS) policies of the participating organizations and funders. This article also highlights several best practices that should be considered in each phase of an open RDI process cycle with businesses.
Impact of constructional complexity and intralingual influence on the effectiveness of skewed input
Authors: Zhang Xiaopeng , Mai Chunping
Published: January 2021

This article reports on two studies, testing how three different types of input (skewed first, skewed random and balanced) affect second language (L2) learning of English present counterfactual (IF-Is) and past counterfactual (IF-IIs) conditionals, two constructions differing in complexity. The experiment included a proficiency test, a pretest, a posttest and a delayed posttest for both IF-Is and IF-IIs. Results suggest that the three types of input did not affect learning gains within the two complexity conditions. However, there was a difference in learning gains between the two conditions, namely that more gains were made in the simpler condition (i.e. IF-Is). In a follow-up study, effects of intralingual influence were tested. Participants who had studied IF-Is were taught the more complex construction, IF-IIs. Again, there were three different types of input (skewed first, skewed random and balanced). Results suggest that participants who received skewed input had higher gains and were less influenced by IF-Is they had learned before. Based on this, we concluded that skewed first input was able to effectively reduce the influence of IF-Is on IF-IIs during L2 learning.
Whole-genome sequencing reveals insights into the adaptation of French Charolais cattle to Cuban tropical conditions
Authors: Ramírez-Ayala Lino C. , Rocha Dominique , Ramos-Onsins Sebas E. , Leno-Colorado Jordi , Charles Mathieu , Bouchez Olivier , Rodríguez-Valera Yoel , Pérez-Enciso Miguel , Ramayo-Caldas Yuliaxis
Published: January 2021

Background

In the early 20th century, Cuban farmers imported Charolais cattle (CHFR) directly from France. These animals are now known as Chacuba (CHCU) and have become adapted to the rough environmental tropical conditions in Cuba. These conditions include long periods of drought and food shortage with extreme temperatures that European taurine cattle have difficulty coping with.

Results

In this study, we used whole-genome sequence data from 12 CHCU individuals together with 60 whole-genome sequences from six additional taurine, indicus and crossed breeds to estimate the genetic diversity, structure and accurate ancestral origin of the CHCU animals. Although CHCU animals are assumed to form a closed population, the results of our admixture analysis indicate a limited introgression ofBos indicus. We used the extended haplotype homozygosity (EHH) approach to identify regions in the genome that may have had an important role in the adaptation of CHCU to tropical conditions. Putative selection events occurred in genomic regions with a high proportion ofBos indicus, but they were not sufficient to explain adaptation of CHCU to tropical conditions byBos indicusintrogression only. EHH suggested signals of potential adaptation in genomic windows that include genes of taurine origin involved in thermogenesis (ATP9A,GABBR1,PGR,PTPN1andUCP1) and hair development (CCHCR1andCDSN). Within these genes, we identified single nucleotide polymorphisms (SNPs) that may have a functional impact and contribute to some of the observed phenotypic differences between CHCU and CHFR animals.

Conclusions

Whole-genome data confirm that CHCU cattle are closely related to Charolais from France (CHFR) and Canada, but also reveal a limited introgression ofBos indicusgenes in CHCU. We observed possible signals of recent adaptation to tropical conditions between CHCU and CHFR founder populations, which were largely independent of theBos indicusintrogression. Finally, we report candidate genes and variants that may have a functional impact and explain some of the phenotypic differences observed between CHCU and CHFR cattle.
Statistical model and testing designs to increase response to selection with constrained inbreeding in genomic breeding programs for pigs affected by social genetic effects
Authors: Chu Thinh Tuan , Henryon Mark , Jensen Just , Ask Birgitte , Christensen Ole Fredslund
Published: January 2021

Background

Social genetic effects (SGE) are the effects of the genotype of one animal on the phenotypes of other animals within a social group. Because SGE contribute to variation in economically important traits for pigs, the inclusion of SGE in statistical models could increase responses to selection (RS) in breeding programs. In such models, increasing the relatedness of members within groups further increases RS when using pedigree-based relationships; however, this has not been demonstrated with genomic-based relationships or with a constraint on inbreeding. In this study, we compared the use of statistical models with and without SGE and compared groups composed at random versus groups composed of families in genomic selection breeding programs with a constraint on the rate of inbreeding.

Results

When SGE were of a moderate magnitude, inclusion of SGE in the statistical model substantially increased RS when SGE were considered for selection. However, when SGE were included in the model but not considered for selection, the increase in RS and in accuracy of predicted direct genetic effects (DGE) depended on the correlation between SGE and DGE. When SGE were of a low magnitude, inclusion of SGE in the model did not increase RS, probably because of the poor separation of effects and convergence issues of the algorithms. Compared to a random group composition design, groups composed of families led to higher RS. The difference in RS between the two group compositions was slightly reduced when using genomic-based compared to pedigree-based relationships.

Conclusions

The use of a statistical model that includes SGE can substantially improve response to selection at a fixed rate of inbreeding, because it allows the heritable variation from SGE to be accounted for and capitalized on. Compared to having random groups, family groups result in greater response to selection in the presence of SGE but the advantage of using family groups decreases when genomic-based relationships are used.
Home blood-pressure measurement for the diagnosis and monitoring of arterial hypertension by French general practitioners: a cross-sectional survey in the Auvergne region
Authors: Xavier Mangiavillano , Jéromine Tréfond , Guillaume Plaquevent-Hostache , Gilles Tanguy , Sylvaine Bœuf-Gibot , Aurélien Mulliez , Philippe Vorilhon
Published: January 2021

Background

Home blood-pressure measurement (HBPM) is recommended for the diagnosis of hypertension and monitoring of patients with hypertension. Since 2013, the French National Health Insurance Body (FNHIB) has promoted HBPM to general practitioners (GPs). The objective of the study was to evaluate the practice of HBPM by French GPs to diagnose and monitor hypertension, 3 years after the beginning of the FNHIB campaign.

Methods

We conducted a postal survey from 7 March to 31 May 2016. All of the 1040 GPs practising in the Auvergne region in France were invited to participate, using a self-reporting questionnaire. We obtained information on the characteristics of the GPs, and their practice regarding the use of HBPM. Use of HBPM was reported as “never, occasionally, regularly and systematically”. Frequency of HBMP use was analysed using multivariate ordered logistic regression model.

Results

A total of 569 (54.7%) GPs responded to the survey. They were 50.3 (± 11.5) years old, 241 (43.0%) were female, and 352 (62.7%) worked in urban areas. Among them, 530 (94.5%) reported the use of HBPM for diagnosis and 519 (92.5%) for monitoring hypertension. To diagnose hypertension, younger GPs (OR = 0.97; 95% CI: 0.95–0.98), GPs practising in a group (OR = 1.45; 95% CI: 1.00–2.10) and in an MHC (OR = 2.09; 95% CI: 1.15–3.78), as compared to GPs with individual practices, and Clinical Tutors, as compared to non-Clinical Tutors, (OR = 1.92; 95% CI: 1.33–2.79) reported more frequent use of HBPM. To manage hypertension, female GPs, as compared to male GPs, (OR=1.47; 95% CI: 1.04–2.06), younger GPs (OR = 0.98; 95% CI: 0.97–0.99), and Clinical Tutors (OR = 1.90; 95% CI: 1.31–2.75) reported more frequent use of HBPM.

Conclusions

Our survey reveals that 3 years after the introduction of the FNHIB incentives, the use of HBPM by participating GPs to diagnose and manage hypertension is well established. A larger survey of GPs from other regions would make it possible to verify whether our results can be extrapolated to France as a whole.
Epidemiologic characteristics of orthopedic surgical site infections and under-reporting estimation of registries using capture-recapture analysis
Authors: Taherpour Niloufar , Mehrabi Yadollah , Seifi Arash , Eshrati Babak , Hashemi Nazari Seyed Saeed
Published: January 2021

Background

Surgical Site Infections (SSIs) are among the leading causes of the postoperative complications. This study aimed at investigating the epidemiologic characteristics of orthopedic SSIs and estimating the under-reporting of registries using the capture-recapture method.

Methods

This study, which was a registry-based, cross-sectional one, was conducted in six educational hospitals in Tehran during a one-year period, from March, 2017 to March, 2018. The data were collected from two hospital registries (National Nosocomial Infection Surveillance System (NNIS) and Health Information Management database (HIM)). First, all orthopedic SSIs registered in these sources were used to perform capture-recapture (N = 503). Second, 202 samples were randomly selected to assess patients` characteristics.

Results

Totally, 76.24% of SSIs were detected post-discharge. Staphylococcus aureus (11.38%) was the most frequently detected bacterium in orthopedic SSIs. The median time between the detection of a SSI and the discharge was 17 days. The results of a study done on 503 SSIs showed that the coverage of NNIS and HIM was 59.95 and 65.17%, respectively. After capture-recapture estimation, it was found that about 221 of orthopedic SSIs were not detected by two sources among six hospitals and the real number of SSIs were estimated to be 623 ± 36.58 (95% CI, 552–695) and under-reporting percentage was 63.32%.

Conclusion

To recognize the trends of SSIs mortality and morbidity in national level, it is significant to have access to a registry with minimum underestimated data. Therefore, according to the weak coverage of NNIS and HIM among Iranian hospitals, a plan for promoting the national Infection Prevention and Control (IPC) programs and providing updated protocols is recommended.
Thymus size and its correlates among children admitted with severe acute malnutrition: a cross-sectional study in Uganda
Authors: Nabukeera-Barungi Nicolette , Lanyero Betty , Grenov Benedikte , Friis Henrik , Namusoke Hanifa , Mupere Ezekiel , Michaelsen Kim F. , Mølgaard Christian , Wiese Maria , Nielsen Dennis S. , Mohammed Musemma K. , Christensen Vibeke B. , Rytter Maren
Published: January 2021

Background

Malnutrition continues to be a major cause of mortality and morbidity among children in resource limited settings. Children with severe acute malnutrition (SAM) experience severe thymus atrophy, possibly reflecting poor immune function. This immune dysfunction is responsible for the severe infections they experience which lead to mortality. Since their immune dysfunction is not fully understood and there has been a lapse in research in this field, more research is needed. Knowing the correlates of thymus size may help clinicians identify those with more severe atrophy who might have more severe immune impairment. We aimed to describe thymus size and its correlates at admission among children hospitalized with SAM.

Methods

This cross-sectional study involved children 6-59 months admitted with complicated SAM in Mulago National Referral Hospital. Well-nourished children from same communities were used as a community reference group for thymus size. At admission, thymus size was measured by ultrasound scan. Demographic, clinical and laboratory variables were identified at admission. A linear regression model was used to determine correlates of thymus size among children with SAM.

Results

Among 388 children with SAM, the mean age was 17±8.5 months and 58% were boys. The mean thymus size was 3.14 (95% CI 2.9; 3.4) cm2 lower than that of the 27 healthy community reference children (1.06 vs 4.2 cm2, p<0.001) when controlled for age. Thymus size positively correlated with current breastfeeding (0.14, 95% CI 0.01, 0.26), anthropometric measurements at admission (weight, length, mid-upper-arm circumference, weight-for-height Z scores and length-for-age Z scores) and suspected tuberculosis (0.12, 95% CI 0.01; 0.22). Thymus size negatively correlated with > 2 weeks duration of sickness (-0.10; 95% CI -0.19; -0.01).

Conclusion

The thymus is indeed a barometer for nutrition since all anthropometric measurements and breastfeeding were associated with bigger thymus. The immune benefits of breastfeeding among children with SAM is underscored. Children with longer duration of illness had a smaller thymus gland indicating that infections have a role in the cause or consequence of thymus atrophy.
Does husband’s alcohol consumption increase the risk of domestic violence during the pregnancy and postpartum periods in Nepalese women?
Authors: Bhatta Narayan , Assanangkornchai Sawitri , Rajbhandari Ishwari
Published: January 2021

Background

Domestic violence against women during pregnancy and the postpartum period not only violates the human rights of women but also harms on the health of both mother and child. Domestic violence is entrenching in social norms, customs and structural factors against women in Nepal. The use of alcohol also exacerbates domestic violence. The objective of this study was to determine the association between domestic violence against women and husband’s drinking behavior across the periods of pregnancy and postpartum.

Methods

This study was a cross-sectional study conducted in the antenatal care and postnatal care clinics of a government hospital in Kathmandu district. Among 660 women (aged 15–49), 165 women were consecutively recruited from each trimester of pregnancy and the postpartum period. Adjusted odds ratios (AOR) were computed from a multivariate logistic regression model to determine the association between domestic violence against women and the husband’s drinking behavior.

Results

Women whose husbands drank alcohol were twice as likely to suffer from domestic violence, compared to those women whose husbands did not drink (AOR = 2.12; 95% CI: 1.4–3.2), independently of their socio-demographic status. Women suffered from domestic violence in each period of pregnancy and postpartum due to their husband’s drinking habits, but the most affected period was the second trimester of pregnancy. Among women who suffered from physical, psychological and sexual violence during the pregnancy and postpartum periods, 70.2, 67.9, and 64.2% respectively experienced violence due to their husband’s drinking habit. Other associated factors for domestic violence included the ethnic culture of Janjati ethnicity, illiteracy of the women, duration of marriage 2–5 years (compared to one year or less) and a husband who behaved in a controlling manner.

Conclusions

Having a husband who has alcohol drinking behavior is an important risk factor for domestic violence against women in the pregnancy and postpartum periods. Screening of alcohol use in husbands will not prevent domestic violence but could lead to a referral to integrated treatment for alcohol and domestic violence treatment.
Feasibility of mesentericoportal vein reconstruction by autologous falciform ligament during pancreaticoduodenectomy—cohort study
Authors: Shao Yi , Feng Jiaojiao , Jiang Yuancong , Hu Zhenhua , Wu Jian , Zhang Min , Shen Yan , Zheng Shusen
Published: January 2021

Background

Mesentericoportal vein (MPV) resection in pancreatic ductal adenocarcinoma (PDAC) surgery has become a common procedure. A few studies had described the use of falciform ligament (FL) for MPV reconstruction and received encouraging preliminary effects.

Aims

This study was designed to explore the feasibility and efficacy of this technique compared with others.

Methods

Patients who underwent pancreaticoduodenectomy (PD) with MPV resection for PDAC from 2009 to 2018 were enrolled. Medical records were retrospectively reviewed, MPV reconstructions using FL were distinguished and compared with other techniques.

Results

146 patients underwent MPV reconstruction, and 13 received FL venoplasty. Other reconstruction techniques included primary end-to-end anastomosis (primary, n = 30), lateral venorrhaphy (LV, n = 19), polytetrafluoroethylene conduit interposition (PTFE, n = 24), iliac artery (IA) allografts interposition (n = 47), and portal vein (PV) allografts interposition (n = 13). FL group holds the advantages of shortest operation time (p = 0.023), lowest blood loss (p = 0.109), and shortest postoperative hospital stay (p = 0.125). The grouped patency rates of FL, primary, LV, PTFE, IA, and PV were 100%, 90%, 68%, 54%, 68%, and 85% respectively. Comparison displayed that FL had the highest patency rate (p = 0.008) and lowest antiplatelet/anticoagulation proportion (p = 0.000). Complications and long-term survival were similar among different techniques. The median survival time of patent group (24.0 months, 95% CI: 22.0–26.0) was much longer than that of the thrombosed (17.0 months, 95% CI: 13.7–20.3), though without significant difference (P = 0.148).

Conclusions

PD with MPV resection and reconstruction by FL is safe, feasible, and efficacious, it might provide a potential benefit for patients.
Lessons from a community based interdisciplinary learning exposure: benefits for both students and communities in Uganda
Authors: Buregyeya Esther , Atusingwize Edwinah , Nsamba Peninah , Nalwadda Christine , Osuret Jimmy , Kalibala Patrick , Nuwamanya Ronald , Okech Samuel , Ssekamatte Tonny , Nitumusiima Sarah , Wakabi Timothy , Bikaako Winnie , Yawe Agnes , Naigaga Irene , Kagarama Juvenal , Kabasa John David , Bazeyo William
Published: January 2021

Background

Makerere University implemented a One Health Institute (OHI) in 2016 involving undergraduate students selected from different disciplines. The students were first taken through theoretical principles of One Health followed by a field attachment in communities. The field attachment aimed to expose students to experiential educational opportunities in the communities in a One Health approach. In this paper, we present students’ experiences and their contributions to the communities of attachment.

Methods

This was a cross-sectional study, utilizing qualitative data collection methods. The study involved students who participated in the OHI field attachment and community members in a One Health demonstration site-Western Uganda. Four focus group discussions (FGDs) and four in-depths interviews (IDIs) were conducted among the students, while four FGDs and twelve IDIs were conducted among community members. All interviews were audio-recorded, transcribed and analysed manually.

Results

The four themes that emerged are: students’ understanding and appreciation of One Health concept, their experiences and gains from the multi-disciplinary field attachment, students’ contributions to the community, and challenges faced by the students. Students had good knowledge of One Health. They appreciated that health cannot be achieved by one discipline or sector and thus the need to collaborate across sectors. Regarding experiences and gains during the multi-disciplinary field attachment, the students appreciated that each discipline had a role to play in achieving health in the community. They appreciated the training citing skills gained in communication, team work and collaboration. They also reported a feeling of gratitude and accomplishment because they felt they made a positive change to the community by putting in place interventions to address some of the community challenges. Similarly, the communities appreciated the students’ contribution in solving their health challenges, ranging from conducting health education to improving sanitation and hygiene.

Conclusions

Through the OHI, students gained One Health competencies including communication, teamwork, and collaboration. Adopting an interdisciplinary model in university teaching system especially during field placement would strengthen skills of collaboration, team work and communication which are critical for a multi-disciplinary approach which is needed among the future workforce in order to solve the current health challenges.
Discovering healthcare provider behavior patterns through the lens of Medicare excess charge
Authors: Sen Sagnika , Deokar Amit V.
Published: January 2021

Background

The phenomenon of excess charge, where a healthcare service provider bills Medicare beyond the limit allowed for a medical procedure, is quite common in the United States public healthcare system. For example, in 2014, healthcare providers charged an average of 3.27 times (and up to 528 times) the allowable limit for cataract surgery. Previous research contends that such excess charges may be indicative of the actual amount that providers bill to non-Medicare patients and subsequent cost-shifting behavior, where a healthcare provider tries to recoup underpayment by Medicare from privately insured, self-pay, out-of-network, and uninsured patients.

Objectives

The objective of this study is to examine the drivers of a provider’s excess charge patterns, especially the extent to which the degree of excess charges may be associated with physician characteristics, Medicare reimbursement policy, or socioeconomic status and demographics of a provider’s patient base.

Methods

Using data from the 2014 Medicare Provider Utilization files, we identify three procedures with the highest variation in Medicare reimbursements to study the excess charge phenomenon. We then employ a two-step cluster analysis within each procedure to identify distinct provider groups.

Results

Each procedure code yielded distinct healthcare provider segments with specific patient demographics and related behavior patterns. Cluster silhouette coefficients indicate that these segments are unique. Three random subsamples from each procedure establish the stability of the clusters.

Conclusions

For each of the three procedures investigated in this study, a sizeable number of healthcare providers serving poorer, riskier patients are often paid significantly lower than their peers, and subsequently have the highest excess charges. For some providers, excess charges reveal possible cost-shifting to private insurance. Patterns of excess charges also indicate an imbalance of market power, especially in areas with lower provider competition and access to health care, thus leading to urban-rural healthcare disparities. Our results reinforce the call for price transparency and an upper limit to overbilling.
Public-private partnerships in primary health care: a scoping review
Authors: Joudyian Nasrin , Doshmangir Leila , Mahdavi Mahdi , Tabrizi Jafar Sadegh , Gordeev Vladimir Sergeevich
Published: January 2021

Background

The Astana Declaration on Primary Health Care reiterated that PHC is a cornerstone of a sustainable health system for universal health coverage (UHC) and health-related Sustainable Development Goals. It called for governments to give high priority to PHC in partnership with their public and private sector organisations and other stakeholders. Each country has a unique path towards UHC, and different models for public-private partnerships (PPPs) are possible. The goal of this paper is to examine evidence on the use of PPPs in the provision of PHC services, reported challenges and recommendations.

Methods

We systematically reviewed peer-reviewed studies in six databases (ScienceDirect, Ovid Medline, PubMed, Web of Science, Embase, and Scopus) and supplemented it by the search of grey literature. PRISMA reporting guidelines were followed.

Results

Sixty-one studies were included in the final review. Results showed that most PPPs projects were conducted to increase access and to facilitate the provision of prevention and treatment services (i.e., tuberculosis, education and health promotion, malaria, and HIV/AIDS services) for certain target groups. Most projects reported challenges of providing PHC via PPPs in the starting and implementation phases. The reported challenges and recommendations on how to overcome them related to education, management, human resources, financial resources, information, and technology systems aspects.

Conclusion

Despite various challenges, PPPs in PHC can facilitate access to health care services, especially in remote areas. Governments should consider long-term plans and sustainable policies to start PPPs in PHC and should not ignore local needs and context.
CircNOL10 suppresses breast cancer progression by sponging miR-767-5p to regulate SOCS2/JAK/STAT signaling
Authors: Wang Fang , Wang Xiaochun , Li Jingruo , Lv Pengwei , Han Mingli , Li Lin , Chen Zhuo , Dong Lingling , Wang Nan , Gu Yuanting
Published: January 2021

Background

Circular RNAs (circRNAs) have caught increasing attentions and interests for their important involvement in cancer initiation and progression. This study aims to investigate the biological functions of circNOL10 and its potential molecular mechanisms in breast cancer (BC).

Materials and methods

qRT-PCR and western blot assays were performed to measure the expression of related genes. CCK-8, colony formation, flow cytomerty and transwell assays were used to assess cell proliferation, cell cycle, migration and invasion. RNA pull-down, luciferase reporter and RIP assays were applied to address the potential regulatory mechanism of circNOL10.

Results

CircNOL10 was down-regulated in BC tissues and cells. Low expression of circNOL10 was associated with larger tumor size, advanced TNM stage, lymph node metastasis and unfavorable prognosis. Overexpression of circNOL10 inhibited cell proliferation, migration, invasion and EMT in vitro and slowed xenograft tumor growth in vivo. Mechanistically, circNOL10 could act as a molecular sponge for miR-767-5p, leading to the up-regulation of suppressors of cytokine signaling 2 (SOCS2) and inactivation of JAK2/STAT5 pathway. Moreover, circNOL10-mediated suppression of malignant phenotypes was attenuated by miR-767-5p. Similar to circNOL10, enforced expression of SOCS2 also resulted in the suppression of cell proliferation and metastasis. Furthermore, knockdown of SOCS2 reversed the tumor-suppressive effect induced by circNOL10.

Conclusions

CircNOL10 repressed BC development via inactivation of JAK2/STAT5 signaling by regulating miR-767-5p/SOCS2 axis. Our findings offer the possibility of exploiting circNOL10 as a therapeutic and prognostic target for BC patients.
Effect of tofogliflozin on arterial stiffness in patients with type 2 diabetes: prespecified sub-analysis of the prospective, randomized, open-label, parallel-group comparative UTOPIA trial
Authors: Katakami Naoto , Mita Tomoya , Yoshii Hidenori , Shiraiwa Toshihiko , Yasuda Tetsuyuki , Okada Yosuke , Torimoto Keiichi , Umayahara Yutaka , Kaneto Hideaki , Osonoi Takeshi , Yamamoto Tsunehiko , Kuribayashi Nobuichi , Maeda Kazuhisa , Yokoyama Hiroki , Kosugi Keisuke , Ohtoshi Kentaro , Hayashi Isao , Sumitani Satoru , Tsugawa Mamiko , Ryomoto Kayoko , Taki Hideki , Nakamura Tadashi , Kawashima Satoshi , Sato Yasunori , Watada Hirotaka , Shimomura Iichiro ,   On behalf of the UTOPIA study investigators
Published: January 2021

Background

Tofogliflozin, an SGLT2 inhibitor, is associated with favorable metabolic effects, including improved glycemic control and serum lipid profile and decreased body weight, visceral adipose tissue, and blood pressure (BP). This study evaluated the effects of tofogliflozin on the brachial-ankle pulse wave velocity (baPWV) in patients with type 2 diabetes (T2DM) without a history of apparent cardiovascular disease.

Methods

The using tofogliflozin for possible better intervention against atherosclerosis for type 2 diabetes patients (UTOPIA) trial is a prospective, randomized, open-label, multicenter, parallel-group, comparative study. As one of the prespecified secondary outcomes, changes in baPWV over 104 weeks were evaluated in 154 individuals (80 in the tofogliflozin group and 74 in the conventional treatment group) who completed baPWV measurement at baseline.

Results

In a mixed-effects model, the progression in the right, left, and mean baPWV over 104 weeks was significantly attenuated with tofogliflozin compared to that with conventional treatment (– 109.3 [– 184.3, – 34.3] (mean change [95% CI] cm/s,p = 0.005; – 98.3 [– 172.6, – 24.1] cm/s,p = 0.010; – 104.7 [– 177.0, – 32.4] cm/s,p = 0.005, respectively). Similar findings were obtained even after adjusting the mixed-effects models for traditional cardiovascular risk factors, including body mass index (BMI), glycated hemoglobin (HbA1c), total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglyceride, systolic blood pressure (SBP), hypertension, smoking, and/or administration of drugs, including hypoglycemic agents, antihypertensive agents, statins, and anti-platelets, at baseline. The findings of the analysis of covariance (ANCOVA) models, which included the treatment group, baseline baPWV, and traditional cardiovascular risk factors, resembled those generated by the mixed-effects models.

Conclusions

Tofogliflozin significantly inhibited the increased baPWV in patients with T2DM without a history of apparent cardiovascular disease, suggesting that tofogliflozin suppressed the progression of arterial stiffness.

Trial RegistrationUMIN000017607. Registered 18 May 2015. (https://www.umin.ac.jp/icdr/index.html)
Targeting CDK7 suppresses super enhancer-linked inflammatory genes and alleviates CAR T cell-induced cytokine release syndrome
Authors: Wei Ye , Li Chong , Bian Huifang , Qian Wei , Jin Kairui , Xu Tingting , Guo Xiaomao , Lu Xueguan , Su Fengtao
Published: January 2021

Background

Cytokine release syndrome (CRS) is a systemic inflammatory response characterized by the overexpression of inflammatory genes. Controlling CRS is essential for improving the therapeutic effects of chimeric antigen receptor (CAR) engineered T cells. However, current treatment options are limited given the complexity of cytokine interactions so it is important to seek a mild strategy with broad-spectrum inhibition to overcome this challenge.

Methods

Using THZ1, a covalent inhibitor of cyclin-dependent kinase 7 (CDK7), we demonstrated the transcriptional suppression of inflammatory genes in activated macrophages. RNA sequencing and ChIP sequencing were conducted to identify the key target genes of the inflammatory response. Pathogen- and CAR T cell-induced CRS models were also established to assess the efficacy and safety of targeting CDK7.

Results

CDK7 blockade attenuated cytokine release, mitigated hyperinflammatory states and rescued mice from lethal CRS. Targeting CDK7 preferentially suppressed a set of inflammatory genes, of which STAT1 and IL1 were the key targets associated with super enhancers. Furthermore, we confirmed the potent efficacy of THZ1 in alleviating the CRS induced by CAR T cell infusion without causing tissue injury or impairing antitumor effects.

Conclusions

Our work indicates the CDK7-dependent transcription addiction of inflammatory genes. Targeting CDK7 is a promising strategy for treating CRS by inhibiting multiple cytokines.
Nanocomposite scaffolds for accelerating chronic wound healing by enhancing angiogenesis
Authors: Nosrati Hamed , Aramideh Khouy Reza , Nosrati Ali , Khodaei Mohammad , Banitalebi-Dehkordi Mehdi , Ashrafi-Dehkordi Korosh , Sanami Samira , Alizadeh Zohreh
Published: January 2021

Skin is the body’s first barrier against external pathogens that maintains the homeostasis of the body. Any serious damage to the skin could have an impact on human health and quality of life. Tissue engineering aims to improve the quality of damaged tissue regeneration. One of the most effective treatments for skin tissue regeneration is to improve angiogenesis during the healing period. Over the last decade, there has been an impressive growth of new potential applications for nanobiomaterials in tissue engineering. Various approaches have been developed to improve the rate and quality of the healing process using angiogenic nanomaterials. In this review, we focused on molecular mechanisms and key factors in angiogenesis, the role of nanobiomaterials in angiogenesis, and scaffold-based tissue engineering approaches for accelerated wound healing based on improved angiogenesis.
Apoptosis of endplate chondrocytes in cervical kyphosis is associated with chronic forward flexed neck: an in vivo rat bipedal walking model
Authors: Lai Jinliang , Ji Guanglin , Zhou Yuqiao , Chen Jincai , Zhou Min , Mo Jianwen , Zheng Tiansheng
Published: January 2021

Background

This study was undertaken to establish a rat bipedal walking model of cervical kyphosis (CK) associated with chronic forward flexed neck and assess the effects of chronic forward flexed neck on endplate chondrocytes.

Methods

Forty-eight 1-month-old Sprague-Dawley rats were randomly divided into 3 groups: forward flexed neck group (n = 16), bipedal group (n = 16), and normal group (n = 16). Cervical curves were analyzed on a lateral cervical spine X-ray using Harrison’s posterior tangent method before the experiment and at 2-week intervals for a 6-week period. Histologic changes in cartilaginous endplate chondrocytes were observed using hematoxylin and eosin (H&E) staining, transmission electron microscopy (TEM), and terminal deoxyribonucleotidyl transferase (TdT)-mediated dUTP nick-end labeling.

Results

Radiographic findings suggested a significantly decreased cervical physiological curvature in the forward flexed neck group over the 6-week follow-up; normal cervical curves were maintained in other groups. The average cervical curvature (C2–C7) was − 7.6 ± 0.9° in the forward flexed neck group before the experiment, − 3.9 ± 0.8° at 2 weeks post-experiment, 10.7 ± 1.0° at 4 weeks post-experiment, and 20.5 ± 2.1° at the last follow-up post-experiment. Histologically, results of H&E staining unveiled that cartilaginous endplate chondrocytes were arranged in an irregular fashion, with the decreased number at the observation period; the incidence of apoptotic cells in the forward flexed neck group was noticeably higher at the 6-week follow-up than that in other groups.

Conclusions

CK developed as the result of chronic forward flexed neck. Histologic changes suggested that chondrocyte apoptosis may play a critical role in the development of cervical kyphotic deformity associated with chronic forward flexed neck.
In vivo nuclear RNA structurome reveals RNA-structure regulation of mRNA processing in plants
Authors: Liu Zhenshan , Liu Qi , Yang Xiaofei , Zhang Yueying , Norris Matthew , Chen Xiaoxi , Cheema Jitender , Zhang Huakun , Ding Yiliang
Published: January 2021

Background

mRNA processing is critical for gene expression. A challenge in regulating mRNA processing is how to recognize the actual mRNA processing sites, such as splice and polyadenylation sites, when the sequence content is insufficient for this purpose. Previous studies suggested that RNA structure affects mRNA processing. However, the regulatory role of RNA structure in mRNA processing remains unclear.

Results

Here, we perform in vivo selective 2′-hydroxyl acylation analyzed by primer extension (SHAPE) chemical profiling onArabidopsisand generate the in vivo nuclear RNA structure landscape. We find that nuclear mRNAs fold differently from cytosolic mRNAs across translation start and stop sites. Notably, we discover a two-nucleotide single-stranded RNA structure feature upstream of 5′ splice sites that is strongly associated with splicing and the selection of alternative 5′ splice sites. The regulatory role of this RNA structure feature is further confirmed by experimental validation. Moreover, we find the single-strandedness of branch sites is also associated with 3′ splice site recognition. We also identify an RNA structure feature comprising two close-by single-stranded regions that is specifically associated with both polyadenylation and alternative polyadenylation events.

Conclusions

We successfully identify pre-mRNA structure features associated with splicing and polyadenylation at whole-genome scale and validate an RNA structure feature which can regulate splicing. Our study unveils a new RNA structure regulatory mechanism for mRNA processing.
Validation of the adjusted multi-biomarker disease activity score as a prognostic test for radiographic progression in rheumatoid arthritis: a combined analysis of multiple studies
Authors: Curtis Jeffrey R. , Weinblatt Michael E. , Shadick Nancy A. , Brahe Cecilie H. , Østergaard Mikkel , Hetland Merete Lund , Saevarsdottir Saedis , Horton Megan , Mabey Brent , Flake Darl D. , Ben-Shachar Rotem , Sasso Eric H. , Huizinga T. W.
Published: January 2021

Background

The multi-biomarker disease activity (MBDA) test measures 12 serum protein biomarkers to quantify disease activity in RA patients. A newer version of the MBDA score, adjusted for age, sex, and adiposity, has been validated in two cohorts (OPERA and BRASS) for predicting risk for radiographic progression. We now extend these findings with additional cohorts to further validate the adjusted MBDA score as a predictor of radiographic progression risk and compare its performance with that of other risk factors.

Methods

Four cohorts were analyzed: the BRASS and Leiden registries and the OPERA and SWEFOT studies (total N = 953). Treatments included conventional DMARDs and anti-TNFs. Associations of radiographic progression (ΔTSS) per year with the adjusted MBDA score, seropositivity, and clinical measures were evaluated using linear and logistic regression. The adjusted MBDA score was (1) validated in Leiden and SWEFOT, (2) compared with other measures in all four cohorts, and (3) used to generate curves for predicting risk of radiographic progression.

Results

Univariable and bivariable analyses validated the adjusted MBDA score and found it to be the strongest, independent predicator of radiographic progression (ΔTSS > 5) compared with seropositivity (rheumatoid factor and/or anti-CCP), baseline TSS, DAS28-CRP, CRP SJC, or CDAI. Neither DAS28-CRP, CDAI, SJC, nor CRP added significant information to the adjusted MBDA score as a predictor, and the frequency of radiographic progression agreed with the adjusted MBDA score when it was discordant with these measures. The rate of progression (ΔTSS > 5) increased from < 2% in the low (1–29) adjusted MBDA category to 16% in the high (45–100) category. A modeled risk curve indicated that risk increased continuously, exceeding 40% for the highest adjusted MBDA scores.

Conclusion

The adjusted MBDA score was validated as an RA disease activity measure that is prognostic for radiographic progression. The adjusted MBDA score was a stronger predictor of radiographic progression than conventional risk factors, including seropositivity, and its prognostic ability was not significantly improved by the addition of DAS28-CRP, CRP, SJC, or CDAI.
A novel community detection based genetic algorithm for feature selection
Authors: Rostami Mehrdad , Berahmand Kamal , Forouzandeh Saman
Published: January 2021

The feature selection is an essential data preprocessing stage in data mining. The core principle of feature selection seems to be to pick a subset of possible features by excluding features with almost no predictive information as well as highly associated redundant features. In the past several years, a variety of meta-heuristic methods were introduced to eliminate redundant and irrelevant features as much as possible from high-dimensional datasets. Among the main disadvantages of present meta-heuristic based approaches is that they are often neglecting the correlation between a set of selected features. In this article, for the purpose of feature selection, the authors propose a genetic algorithm based on community detection, which functions in three steps. The feature similarities are calculated in the first step. The features are classified by community detection algorithms into clusters throughout the second step. In the third step, features are picked by a genetic algorithm with a new community-based repair operation. Nine benchmark classification problems were analyzed in terms of the performance of the presented approach. Also, the authors have compared the efficiency of the proposed approach with the findings from four available algorithms for feature selection. Comparing the performance of the proposed method with three new feature selection methods based on PSO, ACO, and ABC algorithms on three classifiers showed that the accuracy of the proposed method is on average 0.52% higher than the PSO, 1.20% higher than ACO, and 1.57 higher than the ABC algorithm.