bluuebunny/crossref_metadata_2025 huggingface dataset:
Reliable mode-dependent memorized projective lag synchronization for semi-Markovian jumping coupled networks
Authors: Ji Yidao , Wu Wei
Published: February 2021

This article investigates the reliable projective lag synchronization problem for semi-Markovian jumping coupled networks under the master–slave framework. More precisely, a novel mode-dependent memorized synchronization scheme is proposed for the master and slave dynamical networks. By utilizing the Lyapunov-Krasovskii method, sufficient delay-dependent conditions are derived to achieve the reliable synchronization in the mean-square sense. Based on the derived results, the mode-dependent synchronization controller is further designed by convex optimization. In the end, two numerical examples are given to illustrate the effectiveness of the obtained theoretical results.
Through the Lens of Recession 2.0: Diversification Dynamics Between the Leading Asian Stock Markets
Authors: Manu K. S.  , Nayak Surekha , Kalra Rameesha
Published: February 2021

The focus of this article is to analyse the inter-linkages between eight leading stock markets in Asian continent from the period of July 2011 to February 2018. This period holds relevance as this was the time when Recession 2.0 set in, which adversely affected the developed economies; however, the developing economies withstood the crisis without much of an impact. Co-integration and Granger causality tests were conducted to probe the inter-linkages. Study revealed a positive impact on Asian stock market indices collectively on each of the indexes. The highest number of unidirectional causalities was to KOPSI and NIFTY from rest of the stock indices. Results confirmed that no co-integration relationship existed among the selected indices indicating favourable diversification opportunities. Thus, the study fosters global market participants and policymakers to consider the nitty-gritties of stock market integration so as to benefit from international stock market diversification in the Asian region.
At Home in the World: Co-productions and Indian Alternative Cinema
Authors: Kaur Harmanpreet
Published: February 2021

Several Indian filmmakers and production houses making ‘alternative’ and ‘independent films’ have sought to develop co-production deals with European film funds, international film festivals, film markets and sales agents. Their bid is to build a profile with art house and ‘specialty cinema’ audiences in Europe, Asia and the USA, while also seeking to impact the Indian domestic market. This article analyses the assembling of such productions, and their aesthetic form, including a reflection on charges that their adaptation to international distribution requires a conformity to what is acceptable and intelligible to ‘international audiences’. It also explores how alternative films oriented to international art cinema affect the understanding of what constitutes ‘national cinemas’. The article explores these themes through two films, Qissa (2013) and The Lunchbox (2012).
Health Care Seeking Behavior in a Scheduled Tribe Community in India: A Mixed Methods Research Using the Framework of Andersen’s Behavioral Model
Authors: Podder Debayan , Dasgupta Aparajita , Dobe Madhumita , Paul Bobby , Bandyopadhyay Lina , Pal Arkaprovo
Published: February 2021

India’s scheduled tribe population very often bears the brunt of inequity in accessing health care. The mixed-method research assessed the health care seeking behavior (HSB) of a tribal community residing in the eastern fringes of Kolkata metropolis. An adult, preferably the head, in 209 households was interviewed followed by qualitative interviews with relevant stakeholders. Conceptual framework of Andersen’s behavioral model helped in identifying the potential predisposing, enabling, and need factors that influenced HSB. A total of 25.4% respondents reportedly sought informal care during last illness episode. Multivariable hierarchical-regression model (Nagelkerke R2 = 0.381) showed that respondents’ education level [adjusted odds ratio (AOR) = 2.52], household size (AOR = 3.14), nonenrollment to health insurance (AOR = 2.47), decision making by household head (AOR = 2.40), distance from the nearest urban primary health center (AOR = 3.18), and poor perception to illness severity (AOR = 2.24) were significantly associated to inappropriate HSB. Predominant health system barriers that emerged from qualitative interviews were irregular logistics, unfavorable outpatient timing, absence of female doctors, and nonretention of doctors at local urban primary health center. Community level barriers were poor awareness, self-medication practices, poor health insurance coverage, and poor public transportation. Recognition of these determinants may help in developing health promotion interventions tailored to their needs.
Centering “Grace”: Challenging Anti-Blackness in Schooling Through Motherwork
Authors: Watson Terri N. , Baxley Gwendolyn S.
Published: February 2021

Anti-Blackness is global and present in every facet of society, including education. In this article, we examine the challenges Black girls encounter in schools throughout the United States. Guided by select research centered on Black women in their roles as mothers, activists and school leaders, we assert that sociologist Patricia Hill Collins’ concept of Motherwork should be an essential component in reframing the praxis of school leadership and in helping school leaders to rethink policies, practices, and ideologies that are anti-Black and antithetical to Blackness and Black girlhood. While most research aimed to improve the schooling experiences of Black children focuses on teacher and school leader (mis)perceptions and systemic racial biases, few studies build on the care and efficacy personified by Black women school leaders. We argue that the educational advocacy of Black women on behalf of Black children is vital to culturally responsive school leadership that combats anti-Blackness and honors Black girlhood. We conclude with implications for school leaders and those concerned with the educational experiences of Black children, namely Black girls.
Effects of slide-to-roll ratio and varying velocity on the lubrication performance of grease at low speed
Authors: Han Yiming , Wang Jing , Jin Xuyang , Wang Shanshan , Zhang Rui
Published: February 2021

Under steady-state pure rolling conditions with low speed, the thickener fiber agglomerations can be maintained for a long time, generating a beneficial thicker film thickness. However, in industrial applications, motions with sliding or transient effects are very common for gears, rolling-element bearings or even chain drives, evaluation of the grease performance under such conditions is vital for determining the lubrication mechanism and designing new greases. In this project, optical interferometry experiments were carried out on a ball-disk test rig to study the disintegration time of the grease thickener agglomerations with the increase of the slide-to-roll ratio under steady-state and reciprocation motions. Under steady-state conditions, the thickener fiber agglomeration can exist for a while and the time becomes shorter with the increase of the slide-to-roll ratio above the critical speed. Below the critical speed, the thickener fiber can exist in the contact in the form of a quite thick film for a very long time under pure rolling conditions but that time is decreased with the increase of the slide-to-roll ratio. The introduction of the transient effect can further reduce the existence time of the thickener.
Transdisciplinarity and Shifting Network Boundaries: The Challenges of Studying an Evolving Stakeholder Network in Participatory Settings
Authors: Prell Christina , Hesed Christine D. Miller , Johnson Katherine , Paolisso Michael , Teodoro Jose Daniel , Van Dolah Elizabeth
Published: February 2021

Participatory research engages a transdisciplinary team of stakeholders in all aspects of the research process. Such engagement can lead to shifts in the research design, as well as who is considered a participant. We detail our experiences of studying an evolving stakeholder network in the context of a 2.5-year transdisciplinary, participatory project. We show how participation leads to shifts in the network boundary overtime and how a transdisciplinary effort was needed to retrospectively redefine the network boundary. Through tacking back and forth between ethnographic insights, research aims, and modeling assumptions, the team eventually reached agreement on what determined network membership and how to code network members according to their timing and level of participation. Our account advances literature on boundary and modeling approaches to shifting, evolving networks by demonstrating how participatory transdisciplinarity can be both a driver of, and solution to, capturing the complexity of evolving networks.
Revision Targeted Muscle Reinnervation Improves Secondary Pain Insult in an Upper Extremity Amputee: A Case Report
Authors: Rivedal David D. , Guo Meng , Sanger James , Morgan Aaron
Published: February 2021

Targeted muscle reinnervation (TMR) has been shown to improve phantom and neuropathic pain in both the acute and chronic amputee population. Through rerouting of major peripheral nerves into a newly denervated muscle, TMR harnesses the plasticity of the brain, helping to revert the sensory cortex back toward the preinsult state, effectively reducing pain. We highlight a unique case of an above-elbow amputee for sarcoma who was initially treated with successful transhumeral TMR. Following inadvertent nerve biopsy of a TMR coaptation site, his pain returned, and he was unable to don his prosthetic. Revision of his TMR to a more proximal level was performed, providing improved pain and function of the amputated arm. This is the first report to highlight the concept of secondary neuroplasticity and successful proximal TMR revision in the setting of multiple insults to the same extremity.
Exercise Counseling in Pregnancy: Do Women Perceive Receiving the Information They Need?
Authors: Evins Connor , Dennis Jasmine , Mostert Karson , Patel Shiv , Enyart David , Eichelberger Kacey , Ewing Joseph , Tan Xiyan , Trilk Jennifer L.
Published: February 2021

The American College of Obstetricians and Gynecologists recommends that women exercise throughout pregnancy unless they have a condition-related contraindication. This study’s purpose was to determine if pregnant women perceive receiving exercise counseling by their providers with details of frequency, intensity, type, and time (FITT principle). Women in 2 postpartum care units of a large health care system were invited to complete a voluntary, anonymous survey regarding whether they received exercise counseling during their prenatal care. Survey results were descriptively reported, stratified by demographic variables, and analyzed using Fisher’s exact tests. Of 224 postpartum women surveyed, 130 (58.0%) perceived receiving exercise counseling during pregnancy; 119 (91.5%) did not recall receiving counseling on exercise frequency. Though 165 (73.6%) exercised before becoming pregnant, 64 (38.8%) ceased exercise during pregnancy. Eighty-eight (39.3%) received advice from other sources/non–health care professionals. Privately insured women reported receiving exercise counseling at a higher rate (70.1%) than those on Medicaid (44.8%) or uninsured (40.0%; P = .004). A disproportionate number of pregnant women perceived not receiving adequate prenatal exercise counseling or received incomplete counseling. Women at a socioeconomic disadvantage may be vulnerable. As social determinants of health, structural barriers, and socioeconomic status likely contribute, women may benefit from more targeted inclusive and equitable messaging.
Qualitative Inquiry, Activism, the Academy, and the Infinite Game: An Introduction to the Special Issue
Authors: Rodríguez-Dorans Edgar , Murray Fiona , de Andrade Marisa , Wyatt Jonathan , Stenhouse Rosie
Published: February 2021

This is the first of two special issues on qualitative inquiry as activism. This first issue focuses upon activism and/in the academy (academic work, academic cultures, academic practices, etc.), the second on activism in the processes of research itself and activism beyond the academy, in the world. Two issues with different themes, but the overlaps and conversations between them are both obvious and significant: inquiry is part of, rooted in, the academy; inquiry and the academy are both of, and in, the world. Drawing upon the concept of the “infinite game” where, rather than being driven by the need to win and compete (the “finite game”), we argue for the collective, collaborative work of giving close, deep attention to the human, the nonhuman, and the more-than-human in order to “create and recreate our institutions,” with activism key to this work.
Climate change and antibiotic resistance: a deadly combination
Authors: Burnham Jason P.
Published: February 2021

Climate change is driven primarily by humanity’s use of fossil fuels and the resultant greenhouse gases from their combustion. The effects of climate change on human health are myriad and becomingly increasingly severe as the pace of climate change accelerates. One relatively underreported intersection between health and climate change is that of infections, particularly antibiotic-resistant infections. In this perspective review, the aspects of climate change that have already, will, and could possibly impact the proliferation and dissemination of antibiotic resistance are discussed.
Triple Aim and the Hospital Readmission Reduction Program
Authors: Ayabakan Sezgin , Bardhan Indranil , Zheng Zhiqiang (Eric)
Published: February 2021

Objectives:

Despite substantial attention on hospital readmission rates, the impact of the Hospital Readmission Reduction Program (HRRP) on a comprehensive set of Triple Aim goals has not been studied: improve hospital quality, reduce cost, and improve patient experience.

Methods:

We analyze inpatient claims data from 2006 to 2015 from the Dallas Fort Worth Hospital Council Foundation with a panel of 27,397 patients with chronic obstructive pulmonary disease and congestive heart failure. We deploy a quasi-natural experiment using a difference-in-difference specification to estimate the effect of HRRP effect on readmission rates, length of stay (LOS), and hospital satisfaction.

Results:

We find that the likelihood of 30-day readmissions declined by 2.6%, average LOS decreased by 7.9%, and overall hospital rating increased by 2.1% among hospitals that fell under the scope of the HRRP, compared to non-HRRP hospitals. Our results provide evidence of a spillover effect of the HRRP in terms of its impact not only on Medicare patients, but across all insurance types, and other performance measures such as cost and patient experience.

Conclusion:

Our findings indicate that HRRP hospitals do not trade-off reductions in readmission rates with lower quality across other patient health outcomes. Rather, we find evidence that the HRRP has affected all 3 dimensions of the Triple Aim with respect to patient and hospital outcomes.
WACS: improving ChIP-seq peak calling by optimally weighting controls
Authors: Awdeh Aseel , Turcotte Marcel , Perkins Theodore J.
Published: February 2021

Background

Chromatin immunoprecipitation followed by high throughput sequencing (ChIP-seq), initially introduced more than a decade ago, is widely used by the scientific community to detect protein/DNA binding and histone modifications across the genome. Every experiment is prone to noise and bias, and ChIP-seq experiments are no exception. To alleviate bias, the incorporation of control datasets in ChIP-seq analysis is an essential step. The controls are used to account for the background signal, while the remainder of the ChIP-seq signal captures true binding or histone modification. However, a recurrent issue is different types of bias in different ChIP-seq experiments. Depending on which controls are used, different aspects of ChIP-seq bias are better or worse accounted for, and peak calling can produce different results for the same ChIP-seq experiment. Consequently, generating “smart” controls, which model the non-signal effect for a specific ChIP-seq experiment, could enhance contrast and increase the reliability and reproducibility of the results.

Result

We propose a peak calling algorithm, Weighted Analysis of ChIP-seq (WACS), which is an extension of the well-known peak caller MACS2. There are two main steps in WACS: First, weights are estimated for each control using non-negative least squares regression. The goal is to customize controls to model the noise distribution for each ChIP-seq experiment. This is then followed by peak calling. We demonstrate that WACS significantly outperforms MACS2 and AIControl, another recent algorithm for generating smart controls, in the detection of enriched regions along the genome, in terms of motif enrichment and reproducibility analyses.

Conclusions

This ultimately improves our understanding of ChIP-seq controls and their biases, and shows that WACS results in a better approximation of the noise distribution in controls.
Cortical hemodynamics as a function of handgrip strength and cognitive performance: a cross-sectional fNIRS study in younger adults
Authors: Herold Fabian , Behrendt Tom , Törpel Alexander , Hamacher Dennis , Müller Notger G. , Schega Lutz
Published: February 2021

Background

There is growing evidence for a positive correlation between measures of muscular strength and cognitive abilities. However, the neurophysiological correlates of this relationship are not well understood so far. The aim of this study was to investigate cortical hemodynamics [i.e., changes in concentrations of oxygenated (oxyHb) and deoxygenated hemoglobin (deoxyHb)] as a possible link between measures of muscular strength and cognitive performance.

Methods

In a cohort of younger adults (n = 39, 18–30 years), we assessed (i) handgrip strength by a handhold dynamometer, (ii) short-term working memory performance by using error rates and reaction times in the Sternberg task, and (iii) cortical hemodynamics of the prefrontal cortex (PFC) via functional near-infrared spectroscopy (fNIRS).

Results

We observed low to moderate negative correlations (rp =  ~ − 0.38 to − 0.51; p < 0.05) between reaction time and levels of oxyHb in specific parts of the PFC. Furthermore, we noticed low to moderate positive correlations (rp =  ~ 0.34 to 0.45; p < 0.05) between reaction times and levels of deoxyHb in distinct parts of the PFC. Additionally, higher levels of oxyHb (rp (35) = 0.401; p = 0.014) and lower levels of deoxyHb (rp (34) = − 0.338; p = 0.043) in specific parts of the PFC were linked to higher percentage of correct answers. We also found low to moderate correlations (p < 0.05) between measures of handgrip strength and levels of oxyHb (rp =  ~ 0.35; p < 0.05) and levels of deoxyHb (rp =  ~ − 0.25 to − 0.49; p < 0.05) in specific parts of the PFC. However, there was neither a correlation between cognitive performance and handgrip strength nor did cortical hemodynamics in the PFC mediate the relationship between handgrip strength and cognitive performance (p > 0.05).

Conclusion

The present study provides evidence for a positive neurobehavioral relationship between cortical hemodynamics and cognitive performance. Our findings further imply that in younger adults higher levels of handgrip strength positively influence cortical hemodynamics although the latter did not necessarily culminate in better cognitive performance. Future research should examine whether the present findings can be generalized to other cohorts (e.g., older adults).
A prospective observational cohort pilot study of the association between midazolam use and delirium in elderly endoscopy patients
Authors: Lee Dickson , Petersen Fiona , Wu Maurice , Chapman Gwenda , Hayman Melanie , Tomkins Kerrilyn , Fernando Jeremy
Published: February 2021

Background

Midazolam is a benzodiazepine commonly used in procedural sedation and general anaesthesia. Current anaesthetic guidelines advise the avoidance of benzodiazepines in elderly patients due to concerns of an increased risk of delirium. Delirium is associated with significant patient morbidity and mortality, while also increasing health costs. Despite this, midazolam is often used in elderly patients undergoing low risk procedures due to the benefits of rapid onset, anxiolysis and haemodynamic stability compared to other sedatives. To date, studies describing the relationship between midazolam use and delirium in elderly patients undergoing low risk procedures, such as endoscopy, are limited.

Method

This was a prospective observational cohort pilot study identifying the prevalence of delirium pre-procedure and incidence of delirium post-procedure in elderly endoscopy patients receiving midazolam. The study population was elderly patients greater than 65 years of age, without underlying cognitive dysfunction, undergoing elective endoscopy. Electronic databases were used for collection of demographic and clinical information. Delirium was identified through the administration of the Family Confusion Assessment Method survey; this was administered to carers of the study population 24–48 h pre and post procedure to categorically identify the presence or absence of delirium.

Results

Fifty-eight participants were recruited for this study and eighteen were subsequently excluded based upon additional exclusion criteria. Forty patients were included in the final results. American Society of Anaesthesiology Classification (ASA) of patients were as follows: 1 (9 patients), 2 (12 Patients), 3 (16 Patients) and 4 (3 patients). Patients underwent gastroscopy, colonoscopy or combined gastroscopy and colonoscopy. This study identified no cases of delirium in elderly patients after administration of midazolam for elective endoscopy procedures 24–48 h post-procedure. Additionally, a high proportion of elderly patients were found to have received midazolam.

Conclusion

No episodes of delirium were identified in this study. This finding runs counter to current guideline recommendations regarding midazolam use in the elderly patient and that elderly patients undergoing elective endoscopy represent a significantly different patient population compared to those previously studied. This study suggests that in the study population that the risk of delirium in patients exposed to midazolam in elective endoscopy was not demonstrated and that it may be safe to perform experimental studies to elucidate the safety of midazolam in larger studies.
Feasibility, effectiveness, and safety of endoscopic vacuum therapy for intrathoracic anastomotic leakage following transthoracic esophageal resection
Authors: Zhang Chengcheng Christine , Liesenfeld Lukas , Klotz Rosa , Koschny Ronald , Rupp Christian , Schmidt Thomas , Diener Markus K. , Müller-Stich Beat P. , Hackert Thilo , Sauer Peter , Büchler Markus W. , Schaible Anja
Published: February 2021

Background

Anastomotic leakage (AL) in the upper gastrointestinal (GI) tract is associated with high morbidity and mortality rates. Especially intrathoracic anastomotic leakage leads to life-threatening complications. Endoscopic vacuum therapy (EVT) for anastomotic leakage after transthoracic esophageal resection represents a novel concept. However, sound clinical data are still scarce. This retrospective, single-center study aimed to evaluate the feasibility, effectiveness, and safety of EVT for intrathoracic anastomotic leakage following abdomino-thoracic esophageal resection.

Methods

From March 2014 to September 2019 259 consecutive patients underwent elective transthoracic esophageal resection. 72 patients (27.8%) suffered from AL. The overall collective in-hospital mortality rate was 3.9% (n = 10). Data from those who underwent treatment with EVT were included.

Results

Fifty-five patients were treated with EVT. Successful closure was achieved in 89.1% (n = 49) by EVT only. The EVT-associated complication rate was 5.4% (n = 3): bleeding occurred in one patient, while minor sedation-related complications were observed in two patients. The median number of EVT procedures per patient was 3. The procedures were performed at intervals of 3–5 days, with a 14-day median duration of therapy. The mortality rate of patients with AL was 7.2% (n = 4). Despite successfully terminated EVT, three patients died because of multiple organ failure, acute respiratory distress syndrome, and urosepsis (5.4%). One patient (1.8%) died during EVT due to cardiac arrest.

Conclusions

EVT is a safe and effective approach for intrathoracic anastomotic leakages following abdomino-thoracic esophageal resections. It offers a high leakage-closure rate and the potential to lower leakage-related mortalities.

Trial registration: This trial was registered and approved by the Institutional Ethics Committee of the University of Heidelberg on 16.04.2014 (Registration Number: S-635/2013).
Frailty related all-cause mortality or hospital readmission among adults aged 65 and older with stage-B heart failure inpatients
Authors: Zheng Pei-Pei , Yao Si-Min , He Wei , Wan Yu-Hao , Wang Hua , Yang Jie-Fu
Published: February 2021

Background

Frailty increases the adverse outcomes of clinical heart failure; however, the relationship between frailty and stage-B heart failure (SBHF) remains unknown. We aimed to explore the epidemiology and predictive value of frailty in older adults with SBHF.

Methods

A prospective cohort of SBHF inpatients aged 65 years or older who were hospitalized between September 2018 and February 2019 and were followed up for 6 months were included. SBHF was defined as systolic abnormality, structural abnormality (left ventricular enlargement, left ventricular hypertrophy, wall motion abnormalities, valvular heart disease), or prior myocardial infarction. Frailty was assessed by the Fried frailty phenotype. Multivariable Cox proportional hazards regression was used to explore the independent risk and prognostic factors.

Results

Data of 443 participants (age: 76.1 ± 6.79 years, LVEF: 62.8 ± 4.92%, men: 225 [50.8%], frailty: 109 [24.6%]) were analyzed. During the 6-month follow-up, 83 (18.7%) older SBHF inpatients experienced all-cause mortality or readmission, and 29 (6.5%) of them developed clinical HF. Frail individuals had a 1.78–fold (95%CI: 1.02–3.10, P = 0.041) higher risk of 6-month mortality or readmission and a 2.83–fold (95%CI 1.24–6.47, P = 0.014) higher risk of developing clinical HF, independent of age, sex, left ventricular ejection fraction, and N-terminal pro-B-type natriuretic peptide level.

Conclusions

Frailty is common in older SBHF inpatients and should be considered to help identify individuals with an increased risk of mortality or readmission, and developing clinical HF.

Trial registration

ChiCTR1800017204.
Renin-angiotensin system modulators and other risk factors in COVID-19 patients with hypertension: a Korean perspective
Authors: Kim Hee-Sung , Kang Minseok , Kang Gilwon
Published: February 2021

Background

While hypertension is the most common comorbid condition in patients with coronavirus disease 2019 (COVID-19) in Korea, there is a lack of studies investigating risk factors in COVID-19 patients with hypertension in Korea. In this study, we aimed to examine the effects risk factors in hypertensive Korean COVID-19 patients.

Methods

We selected patients from the database of the project #OpenData4Covid19. This information was linked to their 3-year historical healthcare data. The severity of the disease was classified into five levels. We also clustered the levels into two grades.

Results

The risk factors associated with COVID-19 severity were old age, diabetes mellitus, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), malignancy, and renal replacement therapy. The use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) both before and after a diagnosis of COVID-19 were not associated with COVID-19 severity. A multivariate analysis revealed that old age, male sex, diabetes mellitus, and renal replacement therapy were risk factors for severe COVID-19.

Conclusion

The results suggest that in hypertensive patients with COVID-19, older age, male sex, a diagnosis of diabetes mellitus, and renal replacement therapy were risk factors for a severe clinical course. In addition, the use of ARBs and ACEIs before or after COVID-19 infection did not affect a patient’s risk of contracting COVID-19 nor did it contribute to a worse prognosis for the disease. These results highlighted that precautions should be considered for hypertensive patients with those risk factors and do not support discontinuation of ARBs and ACEIs during COVID-19 pandemic.
Involvement of mutant and wild-type CYSLTR2 in the development and progression of uveal nevi and melanoma
Authors: Nell Rogier J. , Menger Nino V. , Versluis Mieke , Luyten Gregorius P. M. , Verdijk Robert M. , Madigan Michele C. , Jager Martine J. , van der Velden Pieter A.
Published: February 2021

Background

Activating Gαq signalling mutations are considered an early event in the development of uveal melanoma. Whereas most tumours harbour a mutation in GNAQ or GNA11, CYSLTR2 (encoding G-protein coupled receptor CysLT2R) forms a rare alternative. The role of wild-type CysLT2R in uveal melanoma remains unknown.

Methods

We performed a digital PCR-based molecular analysis of benign choroidal nevi and primary uveal melanomas. Publicly available bulk and single cell sequencing data were mined to further study mutant and wild-type CYSLTR2 in primary and metastatic uveal melanoma.

Results

1/16 nevi and 2/120 melanomas carried the CYSLTR2 mutation. The mutation was found in a subpopulation of the nevus, while being clonal in both melanomas. In the melanomas, secondary, subclonal CYSLTR2 alterations shifted the allelic balance towards the mutant. The resulting genetic heterogeneity was confirmed in distinct areas of both tumours. At the RNA level, further silencing of wild-type and preferential expression of mutant CYSLTR2 was identified, which was also observed in two CYSLTR2 mutant primary melanomas and one metastatic lesion from other cohorts. In CYSLTR2 wild-type melanomas, high expression of CYSLTR2 correlated to tumour inflammation, but expression originated from melanoma cells specifically.

Conclusions

Our findings suggest that CYSLTR2 is involved in both early and late development of uveal melanoma. Whereas the CYSLTR2 p.L129Q mutation is likely to be the initiating oncogenic event, various mechanisms further increase the mutant allele abundance during tumour progression. This makes mutant CysLT2R an attractive therapeutic target in uveal melanoma.
Measuring capabilities in health and physical activity promotion: a systematic review
Authors: Till M. , Abu-Omar K. , Ferschl S. , Reimers A. K. , Gelius P.
Published: February 2021

Background

The capability approach by Amartya Sen and Martha Nussbaum has gained increasing attention in the field of public health. As it combines individual, social and structural factors and shifts the focus of attention from the actual behavior towards available options for health behaviors that people can actually choose from, it may help advance our understanding of complex health issues.

Objectives

The aim of this article is to identify and describe tools available to measure capabilities within the context of health, with a specific focus on capabilities for health-enhancing physical activity.

Method

We conducted a systematic literature review using 11 databases covering scientific journal articles published in English or German between the years 2000 and 2020 with a focus on capabilities for health or physical activity.

Results

We found a total of 51 articles meeting our inclusion criteria. Four articles measured capabilities using qualitative methods, one combined qualitative and quantitative methods, while the rest used quantitative methods. We identified a total 11 different capability questionnaires, all showing moderate to good validity/reliability. Only one questionnaire and one interview-based tool specifically dealt with capabilities for health enhancing physical activity.

Conclusion

Although we were able to identify measurement tools for capabilities in health, this review has shown that there is no generic tool available for the measurement across all population- and age-groups, and tools focusing on physical activity are scarce. However, our results can be used as guide for future projects that aim at measuring capabilities.
Coping or adapting? Experiences of food and nutrition insecurity in specialised fishing households in Komodo District, eastern Indonesia
Authors: Gibson Emily , Stacey Natasha , Sunderland Terry C. H. , Adhuri Dedi S.
Published: February 2021

Background

There is growing recognition of the need for fish to be better integrated into nutrition-sensitive strategies for addressing malnutrition. Fish are overwhelmingly produced by the small-scale sector, which supports food and nutrition security directly through the provision of fish and indirectly through the generation of income which can be used to purchase other desired foods. However, there has been relatively little research on the extent of food and nutrition security in specialised fishing communities. This study assessed food and nutrition security among households in specialised fishing communities in Komodo District, eastern Indonesia.

Methods

We assessed the seasonal nutrition quality of household diets using the Food Consumption Score for nutritional analysis and food insecurity using the Household Food Insecurity Access Scale in 66 households across three communities, using a modified cluster sampling strategy. We calculated and generated descriptive statistics for these indicators with Microsoft Excel and ran a logistic generalized linear mixed model to determine factors associated with severe food insecurity using SPSS. We used semi-structured interviews and focus group discussions to understand perceptions of, change over time, and strategies for dealing with food shortfalls.

Results

While most households have acceptable access to nutritious foods, especially protein and heme iron-rich foods, nearly one half of households consumed vitamin A rich foods on less than 3 days of the 7-day recall period in either season. More than half of households reported experiencing a moderate or severe level of food insecurity, with higher food insecurity in the wet season. Low maternal education (OR: 3.8, 95%CI 1.5–9.9) and lower household wealth (OR: 0.5, 95%CI 0.3–0.9) were found to be associated with a severe level of food insecurity. Household’s consumptive and non-consumptive response strategies reflect adaptation to chronic food insecurity but are nutritionally and economically unsustainable.

Conclusion

Households in specialised fishing communities in Komodo District consumed diets with low diversity and experienced high levels of food insecurity. There is a need for culturally-appropriate nutrition-sensitive strategies to enhance food and nutrition security in vulnerable fishing communities.
School-based vision screening in Quetta, Pakistan: a qualitative study of experiences of teachers and eye care providers
Authors: Bechange Stevens , Gillani Munazza , Jolley Emma , Iqbal Robina , Ahmed Leena , Bilal Muhammed , Khan Itfaq Khaliq , Yasmin Sumrana , Schmidt Elena
Published: February 2021

Background

Visual impairment in children is a significant public health problem affecting millions of children globally. Many eye problems experienced by children can be easily diagnosed and treated. We conducted a qualitative study with teachers and optometrists involved in a school-based vision screening programme in Quetta district of Pakistan to explore their experiences of training, vision screening and referrals and to identify factors impacting on the effectiveness of the programme.

Methods

Between April 2018 and June 2018, we conducted semi-structured in-depth interviews with 14 teachers from eight purposefully selected schools with high rates of inaccurate (false positive) referrals. Interviews were also conducted with three optometrists from a not-for profit private eye care hospital that had trained the teachers. Interviews were audio recorded and professionally transcribed. NVIVO software version 12 was used to code and thematically analyze the data.

Results

Findings suggest that the importance of school-based vision screening was well understood and appreciated by the teachers and optometrists. Most participants felt that there was a strong level of support for the vision screening programme within the participating schools. However, there were a number of operational issues undermining the quality of screening. Eight teachers felt that the duration of the training was insufficient; the training was rushed; six teachers said that the procedures were not sufficiently explained, and the teachers had no time to practice. The screening protocol was not always followed by the teachers. Additionally, many teachers reported being overburdened with other work, which affected both their levels of participation in the training and the time they spent on the screening.

Conclusions

School-based vision screening by teachers is a cost-effective strategy to detect and treat children’s vision impairment early on. In the programme reviewed here however, a significant number of teachers over referred children to ophthalmic services, overwhelming their capacity and undermining the efficiency of the approach. To maximise the effectiveness and efficiency of school-based screening, future initiatives should give sufficient attention to the duration of the teacher training, experience of trainers, support supervision, refresher trainings, regular use of the screening guidelines, and the workload and motivation of those trained.
Poor linkage to care for HIV-positive OVC with disabled caregivers: a longitudinal study in Tanzania
Authors: Bajaria Shraddha , Exavery Amon , Toroka Noreen , Abdul Ramadhani
Published: February 2021

Background

Despite extensive efforts to scale up counseling and testing services and care and treatment clinics (CTCs) in Tanzania, linkage between points of diagnosis and CTCs remains low. Studies have looked at barriers such as lack of trained health providers, poor referral system, economic costs or distance to health facilities, but fewer assessed the association between caregivers’ vulnerability such as disability and linkage of orphans and vulnerable children (OVCs) in their care to health facilities. This study describes the magnitude of caregivers’ disability and assesses its relationship with successful linkage to care of their OVC living with HIV/AIDS in Tanzania.

Methods

Data for this analysis came from the USAID Kizazi Kipya project in 79 councils of Tanzania. Data on HIV risk, service use and ART adherence among OVC aged 0–19 years were collected during the project’s quarterly routine data collection (Oct 2017-Sep 2018). Characteristics of caregivers were collected during the project beneficiary screening and enrollment process. Generalized estimating equation models were used to analyze the factors that are associated with linkage of 14,538 HIV positive OVC to CTC, who were taken care of by 11,834 caregivers.

Results

The majority of caregivers (70%) were females, had completed primary education (67%), 54% were married or cohabiting. Of all the OVC, 3% were living with disabled caregivers; of whom 89% were physically disabled while 11% were mentally disabled. OVCs living with disabled caregivers were less likely to be linked to care (OR 0.76, 95% CI 0.58, 0.99). Factors positively associated with OVC linkage to care were high caregivers’ education level (OR 1.99, 95% CI 1.51, 2.63) and OVC living with a HIV positive caregivers (OR 1.25, 95% CI 1.12, 1.41). OVC living in household with high socio-economic status were less likely to be linked to care (OR 0.76, 95% CI 0.67, 0.86) than those in low-SES households.

Conclusion

These results suggest HIV positive OVC living with disabled caregivers had poor linkage to care. The findings highlighted the need to focus attention to the disabilities-led household to promote inclusion and improve access to the HIV services.
A novel closed reduction technique for treating femoral shaft fractures with intramedullary nails, haemostatic forceps and the lever principle
Authors: Shui Wei , Yang Youyin , Pi Xinling , Luo Gang , Qiao Bo , Ni Weidong , Guo Shuquan
Published: February 2021

Background

Faster, easier, more economical and more effective versions of the minimally invasive reduction procedure for femoral shaft fractures need to be developed for use by orthopaedic surgeons. In this study, a fracture table was used to restore limb length, and long, curved haemostatic forceps and the lever principle were utilized to achieve minimally invasive reduction and intramedullary nail fixation of femoral shaft fractures.

Methods

A retrospective analysis involving 20 patients with femoral shaft fractures reduced with a fracture table; long, curved haemostatic forceps; and the lever principle was conducted. The operative effect was evaluated on the basis of the operative time, reduction time, fluoroscopy time, and intraoperative blood loss.

Results

All 20 cases were reduced in a closed fashion, and no conversions to open reduction were needed. The average operative time and fracture reduction time for all patients were 69.1 ± 13.5 min (range, 50–100 min) and 6.7 ± 1.9 min (range, 3–10 min), respectively. The fluoroscopy exposure time during the reduction process was 5–15 s, with an average time of 8.7 ± 2.7 s. The average intraoperative blood loss was 73.5 ± 22.5 mL (range, 50–150 mL). The patients exhibited excellent alignment in the injured limb after intramedullary nailing. Seventeen patients successfully completed a follow-up after fracture healing. The healing time ranged from 4 to 6 months.

Conclusions

Displaced femoral shaft fractures in adults can be treated by a labour-saving lever technique involving fragments, 2 haemostatic forceps and soft tissue envelope-assisted closed reduction and intramedullary nail fixation. This technique is easy to perform; reduces blood loss, the fluoroscopy time and the surgical time for intraoperative reduction; and leads to excellent fracture healing.
Australian Injury Comorbidity Indices (AICIs) to predict burden and readmission among hospital-admitted injury patients
Authors: Fernando Dasamal Tharanga , Berecki-Gisolf Janneke , Newstead Stuart , Ansari Zahid
Published: February 2021

Background

Existing comorbidity measures predict mortality among general patient populations. Due to the lack of outcome specific and patient-group specific measures, the existing indices are also applied to non-mortality outcomes in injury epidemiology. This study derived indices to capture the association between comorbidity, and burden and readmission outcomes for injury populations.

Methods

Injury-related hospital admissions data from July 2012 to June 2014 (161,334 patients) for the state of Victoria, Australia were analyzed. Various multivariable regression models were run and results used to derive both binary and weighted indices that quantify the association between comorbidities and length of stay (LOS), hospital costs and readmissions. The new and existing indices were validated internally among patient subgroups, and externally using data from the states of New South Wales and Western Australia.

Results

Twenty-four comorbidities were significantly associated with overnight stay, twenty-seven with LOS, twenty-eight with costs, ten with all-cause and eleven with non-planned 30-day readmissions. The number of and types of comorbidities, and their relative impact were different to the associations established with the existing Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Measure (ECM). The new indices performed equally well to the long-listed ECM and in certain instances outperformed the CCI.

Conclusions

The more parsimonious, up to date, outcome and patient-specific indices presented in this study are better suited for use in present injury epidemiology. Their use can be trialed by hospital administrations in resource allocation models and patient classification models in clinical settings.
ABCB1 and ABCG2 restricts the efficacy of gedatolisib (PF-05212384), a PI3K inhibitor in colorectal cancer cells
Authors: Liu Changfu , Xing Wenge , Yu Haipeng , Zhang Weihao , Si Tongguo
Published: February 2021

Background

Overexpression of ABC transporters is a big challenge on cancer therapy which will lead cancer cells resistance to a series of anticancer drugs. Gedatolisib is a dual PI3K and mTOR inhibitor which is under clinical evaluation for multiple types of malignancies, including colorectal cancer. The growth inhibitory effects of gedatolisib on colorectal cancer cells have been specifically studied. However, the role of ABC transporters on gedatolisib resistance remained unclear. In present study, we illustrated the role of ABC transporters on gedatolisib resistance in colorectal cancer cells.

Methods

Cell viability investigations of gedatolisib on colorectal cancer cells were determined by MTT assays. The verapamil and Ko143 reversal studies were determined by MTT assays as well. ABCB1 and/or ABCG2 siRNA interference assays were conducted to verify the role of ABCB1- and ABCG2-overexpression on gedatolisib resistance. The accumulation assays of gedatolisib were conducted using tritium-labeled paclitaxel and mitoxantrone. The effects of gedatolisib on ATPase activity of ABCB1 or ABCG2 were conducted using PREDEASY ATPase Kits. The expression level of ABCB1 and ABCG2 after gedatolisib treatment were conducted by Western blotting and immunofluorescence assays. The well-docked position of gedatolisib with crystal structure of ABCB1 and ABCG2 were simulated by Autodock vina software. One-way ANOVA was used for the statistics analysis.

Results

Gedatolisib competitively increased the accumulation of tritium-labeled substrate-drugs in both ABCB1- and ABCG2-overexpression colorectal cancer cells. Moreover, gedatolisib significantly increased the protein expression level of ABCB1 and ABCG2 in colorectal cancer cells. In addition, gedatolisib remarkably simulated the ATPase activity of both ABCB1 and ABCG2, suggesting that gedatolisib is a substrate drug of both ABCB1 and ABCG2 transporters. Furthermore, a gedatolisib-resistance colorectal cancer cell line, SW620/GEDA, was selected by increasingly treatment with gedatolisib to SW620 cells. The SW620/GEDA cell line was proved to resistant to gedatolisib and a series of chemotherapeutic drugs, except cisplatin. The ABCB1 and ABCG2 were observed overexpression in SW620/GEDA cell line.

Conclusions

These findings suggest that overexpression of ABCB1 and ABCG2 may restrict the efficacy of gedatolisib in colorectal cancer cells, while co-administration with ABC transporter inhibitors may improve the potency of gedatolisib.