bluuebunny/crossref_metadata_2025 huggingface dataset:
Entrepreneurial ecosystem and well-being in European smart cities: a comparative perspective
Authors: Penco Lara , Ivaldi Enrico , Ciacci Andrea
Published: October 2021

Purpose

This study investigates the relationship between the strength of innovative entrepreneurial ecosystems and subjective well-being in 43 European smart cities. Subjective well-being is operationalized by a Quality of Life (QOL) survey that references the level of multidimensional satisfaction or happiness expressed by residents at the city level. The entrepreneurial ecosystem concept depicted here highlights actor interdependence that creates new value in a specific community by undertaking innovative entrepreneurial activities. The research uses objective and subjective variables to analyze the relationships between the entrepreneurial ecosystem and subjective well-being.

Design/methodology/approach

The authors conducted a cluster analysis with a nonaggregative quantitative approach based on the theory of the partially ordered set (poset); the objective was to find significant smart city level relationships between the entrepreneurial ecosystem and subjective well-being.

Findings

The strength of the entrepreneurial ecosystem is positively related to subjective well-being only in large cities. This result confirms a strong interdependency between the creation of innovative entrepreneurial activities and subjective well-being in large cities. The smart cities QOL dimensions showing higher correlations with the entrepreneurial ecosystem include urban welfare, economic well-being and environmental quality, such as information and communications technology (ICT) and mobility.

Practical implications

Despite the main implications being properly referred to large cities, the governments of smart cities should encourage and promote programs to improve citizens' subjective well-being and to create a conducive entrepreneurship environment.

Originality/value

This study is one of the few contributions focused on the relationship between the entrepreneurial smart city ecosystem and subjective well-being in the urban environment.
Woolly hair nevus caused by somatic mutation and Costello syndrome caused by germline mutation in HRAS: Consider parental mosaicism in prenatal counseling
Authors: Liang Jianying , Guo Yifeng , Lu Zhiyong , Yu Hong , Wu Liangcai , Yao Zhirong
Published: October 2021

Germline mutations in HRAS cause Costello syndrome (CS), while mosaic mutations in HRAS show a variability of phenotypes, ranging from mild features such as keratinocytic epidermal nevus (KEN), sebaceous nevus (SN), woolly hair nevus (WHN) with KEN, to severe manifestations of CS with cutis laxa. We report two individuals. The first was a 2‐year‐old boy with woolly hair nevus (WHN) without any other cutaneous involvement, in whom somatic HRAS mutation (c.34G>A; p.Gly12Ser) was identified in his affected scalp and hair follicle specimens. This is the first reported WHN type 1 (no cutaneous involvement) patient caused by somatic HRAS mutation. The other individual was a 12‐year‐old girl with CS caused by germline HRAS mutation (c.34G>A), that manifested with coarse face, palmoplantar keratoderma, deep palmar and plantar creases, hyperpigmented patches, asymmetry and deformity of lower limbs, atopic dermatitis, as well as mental retardation. Of note, a linear hyperpigmented plaque was observed in her father’s lumbosacral region. Although the father refused to provide semen and skin tissue for further examination, this reminds us of possible mosaicism in parents of individuals with germline de novo HRAS mutation and underlines the importance of parental evaluation for prenatal counseling.
Inclusive curricula for students with severe intellectual disabilities or profound and multiple learning difficulties: a scoping review
Authors: Rendoth Tess , Duncan Jill , Foggett Judith
Published: October 2021

The capacity for all students to meaningfully access the curriculum is a central tenant of inclusion. Investigation into curriculum provision for students with severe intellectual disabilities or profound and multiple learning difficulties (S/PMLD) receives little consideration in the literature; however, it has increasing relevance in designing and implementing standardised curriculums intended to be inclusive of all students. This scoping review aims to analyse the structures and elements of a standardised curriculum that best enables the authentic inclusion of students who have S/PMLD. The philosophical, design and practice considerations in constructing an inclusive curriculum structure for students with S/PMLD in a standardised educational system are discussed. Results are further explored to create a basis for discussion, provide guidance for policymakers and outline a future research platform.
LSPR‐based colorimetric biosensing for food quality and safety
Authors: Wang Weizheng , You Youngsang , Gunasekaran Sundaram
Published: October 2021

Ensuring consistently high quality and safety is paramount to food producers and consumers alike. Wet chemistry and microbiological methods provide accurate results, but those methods are not conducive to rapid, onsite testing needs. Hence, many efforts have focused on rapid testing for food quality and safety, including the development of various biosensors. Herein, we focus on a group of biosensors, which provide visually recognizable colorimetric signals within minutes and can be used onsite. Although there are different ways to achieve visual color‐change signals, we restrict our focus on sensors that exploit the localized surface plasmon resonance (LSPR) phenomenon of metal nanoparticles, primarily gold and silver nanoparticles. The typical approach in the design of LSPR biosensors is to conjugate biorecognition ligands on the surface of metal nanoparticles and allow the ligands to specifically recognize and bind the target analyte. This ligand–target binding reaction leads to a change in color of the test sample and a concomitant shift in the ultraviolet‐visual absorption peak. Various designs applying this and other signal generation schemes are reviewed with an emphasis on those applied for evaluating factors that compromise the quality and safety of food and agricultural products. The LSPR‐based colorimetric biosensing platform is a promising technology for enhancing food quality and safety. Aided by the advances in nanotechnology, this sensing technique lends itself easily for further development on field‐deployable platforms such as smartphones for onsite and end‐user applications.
Assessment of non‐target toxicity effects of synthetic estradiol, quinestrol, in chickens
Authors: HE Siyuan , ZHOU Xunjun , WANG Yong , ZHANG Meiwen , WU Kangjuan
Published: October 2021

Fertility control agents for the management of rodent populations are developing and maturing. Investigating the impacts on non‐target species of consumption of these agents is essential. The present study assessed the non‐target toxicity effects of quinestrol, a synthetic estrogen‐based antifertility agent for managing rodent populations. Various quinestrol doses administered to male and female (n = 60 each) chickens through single oral gavage were 0 (A), 10 (B), 50 (C), and 150 (D) mg/kg body weight. Chickens were assessed for effect on body weight, weight of vital and reproductive organs, reproductive hormones, histology of reproductive organs and egg laying rates after 15, 30, and 135 days of treatment. Quinestrol did not induce mortality in chickens and its effects were time and dose dependent. The 90% egg‐laying rates were delayed by 30, 60 for groups B and C compared with the control group, and group D did not reach the 90% egg‐laying rate by 135 days. Reproductive organs in males and females returned to normal levels within 30 and 135 days, respectively. With the exception of the FSH concentration in group D, reproductive hormones of both sexes were similar to controls by 30 days. No other significant effects were found. The present research demonstrated the safety of quinestrol on non‐target species and facilitates recommendations for the general administration of quinestrol for rodent pest management.
The power of crowds: can minority shareholder activism promote management earnings forecast accuracy
Authors: Nie Yinju , Jia Ming
Published: October 2021

Novel online activism of minority shareholders could be a new governance mechanism but has received little academic attention. This study examines the impact of such minority shareholder activism on management earnings forecast accuracy. Based on a sample of publicly listed firms in the Chinese Shenzhen Stock Exchange between 2010 and 2018, we find that online activism promotes earnings forecast accuracy. The effect is stronger with more negative media coverage and higher manager response quality. Overall, our results indicate that minority shareholders in China could play a monitoring role when they are empowered with voice in the information age.
A review of key cytokines based on gene polymorphism in the pathogenesis of pre‐eclampsia
Authors: Guan Chengcheng , Zhao Fei , Yang Zhencui , Tang Qian , Wang Ling , Li Xueli , Zhang Lixia , Deng Ziwen , Hou Huabin , Wang Jingli , Xu Yinglei , Zhang Ru , Lin Yan , Tan Ping , Zhang Yan , Liu Shiguo , Zhang Lu
Published: October 2021

Although a number of theories have been suggested, including roles for oxidative stress, an abnormal maternal‐fetal interface, and genetic and environmental factors, the etiopathology of pre‐eclampsia (PE) remains unclear. Maternal immune tolerance is important for maintaining pregnancy, and researchers have increasingly focused on the critical roles of cytokines in the pathogenesis of PE in recent years. The assessment of candidate genetic polymorphisms in PE could partially elucidate the mechanisms of susceptibility to disease, and contribute to seeking for new diagnosis and treatment methods of PE. PE can lead to severe complications, and even the death of both mother and fetus. Although the complex pathology is not yet clear, some evidence suggested that the occurrence of PE is related to inflammatory factors. We reviewed the current understandings of roles of cytokines in PE, and provided an extensive overview of the role of single nucleotide chain polymorphisms (SNPs) in the genes potentially underlying the pathophysiology of PE.
Toward educational equity in China: The relationships between language performance and socioeconomic status at the individual, school, and district levels
Authors: Wen Hongbo , Yang Jianqiang , Zhao Ningning
Published: October 2021

This study aimed to examine educational equity status in China through exploring the relationships between students’ language performance and family socioeconomic status (SES) at the individual, school, and district levels. Furthermore, the current study mainly investigated how the interaction among SES at three levels influenced students’ language performance. The sample included 26,997 pupils from 994 schools situated in 79 districts. The three‐level multilevel analysis found that language performance was positively associated with SES at all three levels, and that there were three kinds of significant interactive effects. Specifically, the relationship between individual‐level SES and language performance became stronger in schools with higher SES. Moreover, in districts with higher SES, the interactive effect of school‐level SES and individual‐level SES on language performance grew weaker. In addition, the relationship between school‐level SES and average language performance became weaker in districts with higher levels of SES. These findings uncovered the full picture of the intra‐school and intra‐district educational equity and revealed that high school‐level SES worsened the intra‐school individual equity while high district‐level SES enhanced the intra‐school and intra‐district equity. Implications for educational equity and quality in China are discussed.
A three‐stage design for allergen immunotherapy trials
Authors: Tang Xinyu , Rabin Ronald L. , Yan Lihan K.
Published: October 2021

Background

Clinical trials of allergen immunotherapy (AIT) may require up to 5 years to complete. These lengthy trials may be complicated by high and potentially differential dropouts, especially among participants who perceive that they are receiving placebo. We propose a three‐stage design in which the placebo group in Stage 1 crosses over to receive active treatment in Stage 2. In Stage 3, AIT is discontinued to determine whether benefit is maintained post‐treatment. We apply inferential statistics to support the three‐stage design for clinical trials to determine clinical efficacy, treatment response over time, and sustained response to AIT.

Methods

The proposed framework constitutes a series of hypothesis tests for comparing treatment responses at the end of each stage. A simulation study was performed to illustrate the statistical properties under varying statistical missing mechanisms and effect sizes.

Results

The statistical properties in terms of bias and statistical power were consistent with what are expected from conventional analyses. Specifically, the extent of bias depended on the missing mechanism and magnitude. The statistical powers were largely driven by effect and sample sizes as well as prespecified success margins. As an illustration, assuming relative treatment differences of 25% and stagewise dropout rate of 15%, a sample size of 200 per group may achieve 93% power to demonstrate a treatment effect and 60% power to demonstrate a maintained response post‐treatment.

Conclusions

Inferential statistics support our proposed study design for evaluating benefits of AIT over time and inform clinical understanding and decisions.
Glutamine deficiency shifts the asthmatic state toward neutrophilic airway inflammation
Authors: Kim June‐Mo , Im Yoo Na , Chung Yun‐Jo , Youm Jung‐ho , Im Suhn Young , Han Myung Kwan , Lee Hern Ku
Published: October 2021

Background

The administration of L‐glutamine (Gln) suppresses allergic airway inflammation via the rapid upregulation of MAPK phosphatase (MKP)‐1, which functions as a negative regulator of inflammation by deactivating p38 and JNK mitogen‐activated protein kinases (MAPKs). However, the role of endogenous Gln remains to be elucidated. Therefore, we investigated the mechanism by which endogenous Gln regulates MKP‐1 induction and allergic airway inflammation in an ovalbumin‐based murine asthma model.

Methods

We depleted endogenous Gln levels using L‐γ‐glutamyl‐p‐nitroanilide (GPNA), an inhibitor of the Gln transporter ASCT2 and glutamine synthetase small interfering siRNA. Lentivirus expressing MKP‐1 was injected to achieve overexpression of MKP‐1. Asthmatic phenotypes were assessed using our previously developed ovalbumin‐based murine model, which is suitable for examining sequential asthmatic events, including neutrophil infiltration. Gln levels were analyzed using a Gln assay kit.

Results

GPNA or glutamine synthetase siRNA successfully depleted endogenous Gln levels. Importantly, homeostatic MKP‐1 induction did not occur at all, which resulted in prolonged p38 MAPK and cytosolic phospholipase A2 (cPLA2) phosphorylation in Gln‐deficient mice. Gln deficiency augmented all examined asthmatic reactions, but it exhibited a strong bias toward increasing the neutrophil count, which was not observed in MKP‐1‐overexpressing lungs. This neutrophilia was inhibited by a cPLA2 inhibitor and a leukotriene B4 inhibitor but not by dexamethasone.

Conclusion

Gln deficiency leads to the impairment of MKP‐1 induction and activation of p38 MAPK and cPLA2, resulting in the augmentation of neutrophilic, more so than eosinophilic, airway inflammation.
Use of a point‐of‐care web‐based application to enhance adherence to the CANMAT and ISBD 2018 guidelines for the management of bipolar disorder
Authors: Kozicky Jan‐Marie , Schaffer Ayal , Beaulieu Serge , McIntosh Diane , Yatham Lakshmi N.
Published: October 2021

Objectives

While clinical guidelines exist for the management of bipolar disorder (BD), there are significant challenges to their widespread dissemination and implementation in clinical practice. The Canadian Network of Mood and Anxiety Treatment Improving Patient Care and Outcomes in the Treatment of Bipolar Disorder (C‐IMPACT BD) web‐based application was developed for use at the point‐of‐care to improve adherence to guidelines for evidence‐based pharmacological management of BD.

Methods

C‐IMPACT BD uses a point‐of‐care practice assessment which, via adaptive questioning of patient‐specific information, text/video descriptions of the guidelines, and pop‐up prompts delivers personalized, evidence‐based treatment recommendations for patients with BD. In order to inform quality improvement of the newly developed tool, a sample of Canadian physicians were invited to use the application and record its influence on their prescribing behavior.

Results

Of 375 patients with bipolar I (BD‐I) or bipolar II (BD‐II) disorder for whom a point‐of‐care practice assessment was completed, a change in therapy was considered for 225 (60.0%). Prior to completing the assessment, 59.6% of these patients were receiving first‐line therapy recommended for their phase of illness. Following the assessment, the overall number of patients for whom a first‐line recommended therapy was being considered increased significantly to 76.9% (p = 0.0001).

Conclusions

Outcomes suggest that the C‐IMPACT BD web‐based application has the potential to improve physician adherence to clinical treatment guidelines. Formal research investigations are warranted to explore the impact of this tool on physician prescribing behavior and patient outcomes.
Soluble GC stimulators and activators: Past, present and future
Authors: Sandner Peter , Follmann Markus , Becker‐Pelster Eva , Hahn Michael G. , Meier Christian , Freitas Cecilia , Roessig Lothar , Stasch Johannes‐Peter
Published: October 2021

The discovery of soluble GC (sGC) stimulators and sGC activators provided valuable tools to elucidate NO–sGC signalling and opened novel pharmacological opportunities for cardiovascular indications and beyond. The first‐in‐class sGC stimulator riociguat was approved for pulmonary hypertension in 2013 and vericiguat very recently for heart failure. sGC stimulators enhance sGC activity independent of NO and also act synergistically with endogenous NO. The sGC activators specifically bind to, and activate, the oxidised haem‐free form of sGC. Substantial research efforts improved on the first‐generation sGC activators such as cinaciguat, culminating in the discovery of runcaciguat, currently in clinical Phase II trials for chronic kidney disease and diabetic retinopathy. Here, we highlight the discovery and development of sGC stimulators and sGC activators, their unique modes of action, their preclinical characteristics and the clinical studies. In the future, we expect to see more sGC agonists in new indications, reflecting their unique therapeutic potential.
Metabolic positron emission tomography/CT response after induction chemotherapy and chemo(re)irradiation is associated with higher negative resection margin rate in patients with locally recurrent rectal cancer
Authors: van Zoggel Desley M. G. I. , Voogt Eva L. K. , van Lijnschoten Ineke G. , Cnossen Jeltsje S. , Creemers Geert‐Jan , Nederend Joost , Bloemen Johanne G. , Nieuwenhuijzen Grard A. P. , Burger Pim J. W. A. , Lardenoije Sabine G. G. F. , Rutten Harm J. T. , Roef Mark J.
Published: October 2021

Aim

Positron emission tomography (PET)/CT can be used to monitor the metabolic changes that occur after intensified treatment with induction chemotherapy and chemo(re)irradiation for locally recurrent rectal cancer (LRRC). This study aimed to analyse the correlation between the PET/CT response and final histopathological outcomes.

Methods

All LRRC patients who underwent induction chemotherapy prior to surgery between January 2010 and July 2020 and were monitored with pretreatment and post‐treatment PET/CT were included. Visual qualitative analysis was performed, and patients were scored as having achieved a complete metabolic response (CMR), partial metabolic response (PMR) or no response (NR). The histopathological response was assessed according to the Mandard tumour regression (TRG) score and categorized as major (TRG 1–2), partial (TRG 3) or poor (TRG 4–5). The PET/CT and TRG categories were compared, and possible confounders were analysed.

Results

A total of 106 patients were eligible for analysis; 24 (23%) had a CMR, 54 (51%) had a PMR and 28 (26%) had NR. PET/CT response was a significant predictor of the negative resection margin rate, achieving 96% for CMR, 69% for PMR and 50% for NR. The overall accuracy between PET score and pathological TRG was 45%, and the positive predictive value for CMR was 63%. A longer interval between post‐treatment PET/CT and surgery negatively influenced the predictive value.

Conclusion

Metabolic PET/CT response evaluation after neoadjuvant treatment proves to be a complementary diagnostic tool to standard MRI in assessing tumour response, and may play a role for treatment planning in LRRC patients.
Do income tax breaks for the elderly affect economic growth?
Authors: Brewer Ben , Conway Karen Smith , Rork Jonathan C.
Published: October 2021

Income tax breaks for elderly taxpayers are sizable, widespread, and potentially affect growth through migration and other behaviors. We provide the first investigation into the growth effects of differential tax policy by age, taking a multi‐pronged empirical approach to US state‐level data since 1977. Some analyses include panel error‐correction models combined with variation in state‐level policies over time. Alternative analyses use how changes in federal tax law manifest at the state‐level. Results suggest that taxes on lower income taxpayers, of any age, decrease growth the most, while taxing the high income elderly—those targeted recently—has little effect.
Access to transportation, residential segregation, and economic opportunity
Authors: Yılmaz Kuzey , Yeşilırmak Muharrem
Published: October 2021

The Housing Choice Voucher Program assists low‐income families to afford decent housing and provide them with better economic opportunities. There is growing evidence that public transportation plays an important role in shaping the residential location choices of low‐income households. However, transportation has not been a major focus of the research related to housing voucher programs. We develop a general equilibrium model of a city with multiple districts, decentralized employment, multiple commuting modes, and locally financed education. We compare housing vouchers with transportation vouchers with respect to poverty deconcentration, educational quality in each district, unskilled employment in the suburbs, and welfare.
Removal of the Black race coefficient from the estimated glomerular filtration equation improves transplant eligibility for Black patients at a single center
Authors: Hoenig Melanie P. , Mann Alison , Pavlakis Martha
Published: October 2021

Race is a social construct that cannot be measured, can be used imprecisely and may contribute to disparities in kidney transplant access for Black patients. At Beth Israel Deaconess Medical Center, we dropped the Black race coefficient in the estimated glomerular filtration rate (eGFR) report in 2017. We conducted a quality improvement project to examine the impact of this change. Before the change, only 26% of our Black patients were listed for preemptive transplant compared to 70% of White patients. Since the change, we found a steady increase in the percentage of Black patients listed before starting dialysis. The average eGFR at listing prior to 2017 was significantly lower in Black patients but after, there was no longer a significant difference. Nine patients “gained” an average of 457 days of wait time directly related to discarding the Black race coefficient. Increased time on the list prior to dialysis initiation allows for evaluation of potential live donors and improves the possibility of a pre‐emptive live or deceased donor transplant and allows for a shorter period on dialysis before transplant. In this single center initiative, we demonstrate the benefit of discarding race from the eGFR report for Black patients awaiting kidney transplantation.
Beyond ‘drinking occasions’: Examining complex changes in drinking practices during COVID‐19
Authors: Caluzzi Gabriel , Pennay Amy , Laslett Anne‐Marie , Callinan Sarah , Room Robin , Dwyer Robyn
Published: October 2021

Introduction

‘Drinking occasions’ are commonly used to capture quantities of alcohol consumed. Yet this standardised terminology brings with it numerous assumptions and epistemological limitations. We suggest that social changes brought on by COVID‐19 restrictions have influenced routines, patterns of time use and drinking practices, highlighting the need to re‐examine how we conceptualise drinking and ‘drinking occasions’ in alcohol research.

Methods

This analysis draws on data gathered from 59 qualitative interviews conducted during the second half of 2020 with Australian drinkers aged 18 and over. The interviews explored how COVID‐19 restrictions impacted daily practices and alcohol consumption patterns.

Findings

Participants spoke about their work, study and social routines changing, which influenced the times, timing and contexts of their drinking practices. We separated these shifts into four overarching themes: shifting of structures shaping drinking; the permeability of drinking boundaries; the extension of drinking occasions; and new contexts for drinking.

Discussion and Conclusion

COVID‐19 restrictions have led to shifts in the temporal boundaries and contexts that would otherwise shape people's drinking, meaning drinking practices may be less bound by structures, norms, settings and rituals. The drinking occasions concept, although a simple tool for measuring how much people drink, has not been able to capture these complex developments. This is a timely consideration given that COVID‐19 may have enduring effects on people's lifestyles, work and drinking practices. It may be useful to examine drinking as practice, rather than just an occasion, in order to better contextualise epidemiological studies going forward.
Positive predictive value of the clinical diagnosis of T1a‐epithelial/lamina propria esophageal cancer depends on lesion size
Authors: Tajiri Ayaka , Ishihara Ryu , Sakurai Hirohisa , Nakamura Takahiko , Tani Yasuhiro , Inoue Takahiro , Matsueda Katsunori , Miyake Muneaki , Waki Kotaro , Fukuda Hiromu , Shichijo Satoki , Maekawa Akira , Kanesaka Takashi , Yamamoto Sachiko , Takeuchi Yoji , Higashino Koji , Uedo Noriya , Michida Tomoki , Kitamura Masanori , Honma Keiichiro
Published: October 2021

Objectives

Endoscopic resection (ER) is a minimally invasive treatment for esophageal squamous cell carcinoma (ESCC). However, stricture may develop after ER for widespread lesions. Application of ER is justified if these cancers are pathological T1a‐epithelial/lamina propria (pEP/LPM) cancers that can be cured by ER. We conducted a study to clarify the association between pathological invasion depth and lesion size or circumference in clinical (c) EP/LPM cancers.

Methods

From our database, we identified patients diagnosed with cEP/LPM ESCC via endoscopic examination who underwent endoscopic or surgical tumor resection. The accuracy of the cEP/LPM ESCC diagnosis was determined by histologically diagnosing cancer invasion depth as a reference standard.

Results

Between January 2015 and December 2019, 1271 cancer patients were diagnosed with cEP/LPM ESCC, of which 1195 (94.0%) were correctly diagnosed with pEP/LPM cancer. The positive predictive value (PPV) classified according to lesion sizes of ≤25, 26–49, and ≥50 mm was 95.8% (981/1024 lesions), 89.7% (191/213 lesions), and 67.6% (23/34 lesions), respectively. PPV according to the circumferential extent of <3/4, ≥3/4, and <1, and whole was 94.6% (1164/1230 lesions), 75.0% (24/32 lesions), and 77.8% (7/9 lesions), respectively. In multivariate analysis, the PPV of cEP/LPM ESCC was significantly associated with lesion size (P < 0.001) and male sex.

Conclusions

Between January 2015 and December 2019, 1271 cancer patients were diagnosed with cEP/LPM ESCC, of which 1195 (94.0%) were correctly diagnosed with pEP/LPM cancer. The PPV of cEP/LPM ESCC was related to lesion size. Treatment should be determined considering the high risk of cancer invasion into the muscularis mucosa or deeper in cEP/LPM cancers with a lesion size of ≥50 mm.
Long‐term outcomes of esophageal squamous cell carcinoma with invasion depth of pathological T1a‐muscularis mucosae and T1b‐submucosa by endoscopic resection followed by appropriate additional treatment
Authors: Naito Sakiko , Yoshio Toshiyuki , Ishiyama Akiyoshi , Tsuchida Tomohiro , Tokura Junki , Namikawa Ken , Tokai Yoshitaka , Yoshimizu Shoichi , Horiuchi Yusuke , Hirasawa Toshiaki , Asari Takao , Mine Shinji , Watanabe Masayuki , Ogura Mariko , Chin Keisho , Fukuzawa Masakatsu , Itoi Takao , Fujisaki Junko
Published: October 2021

Objectives

Endoscopic resection (ER) is indicated for a wide range of superficial esophageal squamous cell carcinomas (ESCCs). We examined the long‐term outcomes in patients with pathological (p) invasion of ESCC into the T1a‐muscularis mucosae (MM) and T1b‐submucosa (SM) after ER, for which data on prognosis are limited.

Methods

Of the 1217 patients with superficial ESCC who underwent ER, 225 patients with a pathological diagnosis of ESCC invasion into the MM, minute submucosal invasion ≤200 µm (SM1), or massive submucosal invasion (SM2) were included. In patients with lymphovascular invasion, droplet infiltration, or SM2 invasion, additional treatments, including chemoradiation (CRT) or esophagectomy with two‐ to three‐field lymph node dissection, were recommended. The median observation period was 66 months (interquartile range 48–91 months).

Results

In total, there were 151, 28, and 46 pT1a‐MM, pT1b‐SM1, and pT1b‐SM2 cases, respectively. Metastatic recurrence was observed in 1.3%, 10.7%, and 6.5% patients with pT1a‐MM, pT1b‐SM1, and pT1b‐SM2 ESCCs, respectively. Of the eight patients with metastatic recurrence, six were successfully treated, and two died of ESCC. The 5‐year overall survival rates were 84.1%, 71.4%, and 67.4%, the 5‐year relapse‐free survival rates were 82.8%, 64.3%, and 65.2%, and the 5‐year disease‐specific survival rates were 100%, 96.4%, and 99.1% in patients with pT1a‐MM, pT1b‐SM1, and pT1b‐SM2 ESCCs, respectively. Multivariate analysis showed that additional CRT and esophagectomy, and T1b‐SM2 were positively and negatively associated with overall survival, respectively.

Conclusions

Endoscopic resection preceding appropriate additional treatments resulted in favorable outcomes. Many cases of metastatic recurrence in this cohort could be successfully treated.
Physical therapy in children with cerebral palsy in Brazil: a scoping review
Authors: Furtado Michelle A S , Ayupe Kênnea M A , Christovão Isabella S , Sousa Junior Ricardo R , Rosenbaum Peter , Camargos Ana C R , Leite Hércules R
Published: October 2021

Aim

To identify and assess published studies concerning physical therapy in Brazilian children and adolescents with cerebral palsy (CP) using the International Classification of Functioning, Disability and Health (ICF) framework.

Method

Articles in English and Portuguese published until October 2020, with no date restrictions, were searched in several different databases. Study characteristics, journal metrics, sample characteristics, and ICF domains explored intervention components and outcomes were extracted. Studies were classified according to the Oxford Centre for Evidence‐Based Medicine hierarchy levels to characterize the evidence.

Results

Ninety‐four studies were included. Spastic CP with fewer limitations in gross motor abilities was the most reported; 67% of the studies had low levels of evidence and were published in journals without an impact factor. The three most frequent interventions were neurodevelopmental treatment, suit therapy, and transcranial direct current stimulation. Intervention components explored body functions and structures (73.4%), activity (59.6%), environment (2.1%). They did not explore participation (0%). The outcomes investigated addressed activity (79.8%), body functions and structures (67.0%), and participation (1.1%), but not environment (0%).

Interpretation

Studies of physical therapy for Brazilian children and adolescents with CP focused on reducing impairments and activity limitations. Studies with higher levels of evidence and an expanded focus on participation and environmental factors are necessary.
The structural design of conditional cash transfers: Colombia, India, and the USA compared
Authors: De Venanzi Augusto
Published: October 2021

Motivation

In recent years, conditional cash transfer (CCT) programmes have become progressively popular in low‐, lower‐middle, and upper‐middle income countries, although a recent attempt has been made to replicate this type of programme in the United States. Yet, the potential of CCTs to perform well under different settings and to address a broader range of challenges is not clear.

Purpose

The article aims is to identify the major differences in the structural design and outcomes of CCTs in three areas of the world.

Methods and approach

The article looks at differences in the objectives, targeting mechanisms, incentives, conditionalities, cash transfer systems, and outcomes of Colombia's Más Familias en Acción, India's Janani Suraksha Yojana—although reference is made to other Indian CCTs—and the US's Family Rewards.

Findings

The study found differences among the selected CCTs not only in terms of their objectives and cultural underpinnings, but also in their targeting effectiveness and ability to monitor compliance. These limitations were markedly present in the case of the implementation of CCTs in India where undue political interference also represents an issue of concern for the proper operation and evaluation of these programmes. Yet, despite their differences in structural design, the observed CCTs were able to provide several benefits to targeted populations.

Policy implications

The need for strong programme governance emerges as the main policy implication of this study.
The skin microbiome of infected pressure ulcers: A review and implications for health professionals
Authors: Gomes Fernanda , Furtado Guilherme Eustáquio , Henriques Mariana , Sousa Liliana Baptista , Santos‐Costa Paulo , Bernardes Rafael , Apóstolo João , Parreira Pedro , Salgueiro‐Oliveira Anabela
Published: October 2021

Background

Pressure ulcers (PUs) are injuries resulting from ischaemia caused by prolonged compression or shear forces on the skin, adjacent tissues and bones. Advanced stages of PUs are associated with infectious complications and constitute a major clinical challenge, with high social and economic impacts in health care.

Goals

This study aims to identify and describe the relationship between PU risk factors, stages and anatomical locations, and the relevance of microbial cohabitation and biofilm growth.

Methods

The narrative review method to advocating a critical and objective analysis of the current knowledge on the topic was performed. Indexed databases and direct consultation to specialized and high‐impact journals on the subject were used to extract relevant information, guided by co‐authors. The Medical Subject Headings of pressure ulcer (or injury), biofilms, infection and other analogues terms were used.

Results

Development of PUs and consequent infection depends on several direct and indirect risk factors, including cutaneous/PU microbiome, microclimate and behavioural factors. Infected PUs are polymicrobial and characterized by biofilm‐associated infection, phenotypic hypervariability of species and inherent resistance to antimicrobials. The different stages and anatomical locations also play an important role in their colonization. The prevention and monitoring of PUs remain crucial for avoiding the emergence of systemic infections and reducing health care–associated costs, improve the quality of life of patients and reduce the mortality‐associated infected PUs.
Reconstructing large interaction networks from empirical time series data
Authors: Chang Chun‐Wei , Miki Takeshi , Ushio Masayuki , Ke Po‐Ju , Lu Hsiao‐Pei , Shiah Fuh‐Kwo , Hsieh Chih‐hao
Published: October 2021

Reconstructing interactions from observational data is a critical need for investigating natural biological networks, wherein network dimensionality is usually high. However, these pose a challenge to existing methods that can quantify only small interaction networks. Here, we proposed a novel approach to reconstruct high‐dimensional interaction Jacobian networks using empirical time series without specific model assumptions. This method, named “multiview distance regularised S‐map,” generalised the state space reconstruction to accommodate high dimensionality and overcome difficulties in quantifying massive interactions with limited data. When evaluating this method using time series generated from theoretical models involving hundreds of interacting species, estimated strengths of interaction Jacobians were in good agreement with theoretical expectations. Applying this method to a natural bacterial community helped identify important species from the interaction network and revealed mechanisms governing the dynamical stability of a bacterial community. The proposed method overcame the challenge of high dimensionality in large natural dynamical systems.
Hedge inflation risk of specific purpose guarantee funds
Authors: Chen Ze , Chen Bingzheng , Hu Yi , Zhang Hai
Published: October 2021

Specific purpose guarantee funds (SPGFs) such as pension guarantee funds are popular among investors with both specific investment purpose and guaranteed return requirement but receive little academic attention. We propose a practical purpose‐oriented constant proportion portfolio insurance (PO‐CPPI) strategy that optimally allocates its assets into a risk‐free fund (floor) and a purpose‐related portfolio (cushion) to maximize prospect theory investors' utility with consideration of their purpose‐related inflation risk. Our closed‐form solution of optimal PO‐CPPI allocation derived in the continuous time case and Monte‐Carlo simulations in the discrete‐time and dynamic cases prove the superiority of PO‐CPPI over general portfolio insurance strategies.
Pre‐race and race management impacts serum muscle enzyme activity in Australian endurance horses
Authors: Buckley Petra , Buckley David J. , Freire Rafael , Hughes Kristopher J.
Published: October 2021

Background

Marked increases in serum muscle enzyme activity can occur in endurance horses but the diagnostic certainty in predicting cases of myopathy is unclear. Improved understanding of horse management effects on serum muscle enzyme activity as markers of muscle health would assist interpretation of serum muscle enzyme activity and guide management to reduce myopathy risk.

Objectives

To investigate associations between serum muscle enzyme activity and management factors in endurance horses.

Study design

Cross‐sectional study.

Methods

One hundred endurance horses competing in four endurance events (offering distances of 20‐120 km) in south‐eastern Australia were observed. Data were collected from official horse logbooks, pre‐and post‐race serum samples, an owner questionnaire of pre‐race and race management of horses and the Australian Endurance Riders Association results database. Multivariable linear regression modelling tested associations between management factors and serum muscle enzyme activity.

Results

First leg speed, distance raced, number of rest days pre‐race, and pre‐race activity of aspartate aminotransferase (AST) and creatine kinase (CK) explained 47.3% of the variance in post‐race CK. As first leg speed increased by 1 km/h, CK activity increased by 25.8% (95% CI 11%‐35%). Race distances >80 km increased post‐race CK activity by 124% (95% CI 116%‐145%). Each additional pre‐race rest day increased post‐race CK activity by 30.5% (95% CI 11%‐42%). Modelling a 10% increase in pre‐race CK and pre‐race AST activity was associated with post‐race CK activity increasing by 7.3% (95% CI 3%‐14.4%) and 8.5% (95% CI 0.3%‐14.2%) respectively. Horses experiencing training distances >40 km and a greater number of rest days prior to race day developed increased pre‐race AST and CK activity respectively.

Main limitations

Owner questionnaires may be subject to bias. Limited data were available to model ride terrain, horse fitness, ration detail and myopathy. Muscle biopsies were not used to confirm myopathy.

Conclusions

Nearly half of the variation in post‐race CK activity observed can be attributed to management factors unrelated to myopathy, suggesting increased CK activity may not be pathognomonic for myopathy. We advise caution in relying solely on serum muscle enzyme activity for diagnosis of myopathy until the strength of association between CK and myopathy is further ascertained in future studies.
Temporal trends and spatial patterns of chironomid communities in alpine lakes recovering from acidification under accelerating climate change
Authors: Svitok Marek , Kubovčík Vladimír , Kopáček Jiří , Bitušík Peter
Published: October 2021

The biological recovery of remote aquatic ecosystems from atmospheric acidification under ongoing climate change is a complex and poorly understood process, often developing along unanticipated trajectories. Our objective was to evaluate the interacting effects of changing water chemistry and climate on the biological recovery of chironomid communities in the Tatra Mountain lake district (Slovakia and Poland), one of the most strongly acidified alpine regions worldwide. Chironomid communities were chosen as a sensitive indicator to disentangle the effects of acidification and climate change.

We used sediment records of a shallow, strongly acidified lake, Starolesnianske pleso, plus data on 77 alpine lakes sampled across the whole study region in 2000–2004 and 2010–2014.

Paleolimnological data from Starolesnianske pleso revealed a dramatic effect of acidification on the chironomid communities from the mid‐20th century. A rapid decline of water pH and a depletion of the carbonate buffering system were accompanied by the establishment of a species‐poor chironomid community. The previously dominant Tanytarsus lugens‐type was replaced by the congeneric Tanytarsus mendax‐type in the late 1970s. A subsequent reversal of water chemistry from acidification starting in the early 1990s was followed by a compositional change towards a more diverse community. The effect of chemical recovery was, however, overwhelmed by rising temperatures. Tiny larvae of more thermophilous Corynoneura scutellata‐type quickly gained dominance in the lake community. Throughout the lake district, C. scutellata‐type significantly shifted towards higher elevations, by more than 100 m per decade.

The absence of significant interactions between recovering water chemistry and rising temperatures suggests independent effects of these processes on chironomid communities. The observed climate‐related compositional shifts towards the dominance of small‐bodied species are in line with the metabolic theory of ecology predicting higher metabolic demands in warmer environments, which can favour smaller, faster growing organisms and may lead to future changes in the ecosystem functioning of alpine lakes in general.

The combination of monitoring and palaeoecological data provided a useful tool for tracking environmental changes. This approach may also help in disentangling the roles of other multiple pressures on aquatic ecosystems. The sensitive responses of shallow Starolesnianske pleso to atmospheric acidification and climate warming suggest that small lentic waterbodies could be useful sentinels of freshwater deterioration, thus deserving special attention in the future monitoring of alpine environments.
‘What is industrial culture anyway?’ Theoretical framing of the concept in economic geography
Authors: Bole David
Published: October 2021

In geography, industrial culture is a surprisingly understudied concept. Even when it is considered to play a role in the transformation processes of industrial cities or regions, it is not only terminologically diverse, but also lacks a firm theoretical and conceptual basis. This study conceptualises industrial culture and relates it to ongoing debates in various fields of geography by examining a range of literature from geography and related disciplines. This review structures the existing knowledge into four theoretical approaches: social class (Bourdieusian view), anthropological, institutional and evolutionary. Industrial culture is defined as a dynamic phenomenon in which past and present industrial production is embedded in the human physical environment, social structures, cognitive abilities, and institutions that may influence the future development choices of (post)industrial communities. This concept brings a more nuanced view of the less tangible aspects of culture to economic geography to strengthen its theoretical and empirical basis. This study explores how this concept can be integrated into current geographical research, focussing on the interaction between industrial culture and regional development through different approaches in economic geography (e.g., studies of regional assets, evolution of development paths, agency, deindustrialisation, innovation, entrepreneurship).
Prevalence of and factors related to homebound and semi‐homebound older adults in a rural area in Japan
Authors: Yamazaki Sachiko , Imuta Hiromi , Fujita Koji
Published: October 2021

Aim

The homebound status is associated with unhealthy factors and physical disability. However, the prevalence of those who may be at an earlier stage of the homebound status (“semi‐homebound”) is unclear. This study thus examines the prevalence of semi‐homebound individuals and identifies the associated physical, psychological, and social factors.

Methods

A cross‐sectional study invited 1,157 participants aged 65 years and more in rural Japan. The mean age was 74.7 ± 6.8. The survey questionnaire accounted for different parameters, such as age, sex, homebound status, morbidity, instrumental activities of daily living (IADL), and mental health. Ordinal regression analysis examined participants’ homebound status; socio‐demographic characteristics; and physical, psychological, and social variables.

Results

The prevalence of the homebound status was 0.11 (95%CI = 0.99–0.13), and the semi‐homebound status was 0.30 (95%CI = 0.28–0.33). In the multivariable analysis, the homebound status was negatively associated with IADL (p < .001), mobility (p < .001), being alone during the day (p < .001), depression and anxiety (p < .05), and self‐efficacy for going out (p < .001).

Discussion

The prevalence of semi‐homebound individuals was approximately 30%. Homebound and semi‐homebound individuals were associated with older, female, IADL, functional fitness, being alone during the day, depression and anxiety, and self‐efficacy for going out. In the case of psychical, psychological, and social factors, the semi‐homebound individuals revealed that these indicators fluctuated between homebound and non‐homebound. Our findings further focused on semi‐homebound individuals at elevated risks of disability, thereby emphasizing the need for customized intervention. Geriatr Gerontol Int 2021; 21: 1033–1039.