bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgery for pathological T3a, T3b and lymph node positive, prostate cancer: surgical, functional and oncological outcomes
Authors: Gilliland Niall , Vennam Sarath , Geraghty Robert , Peacock Julian , Crockett Matthew , Kearley Samantha , Oxley Jon , Porter Tim , Waine Elizabeth , Aning Jonathan , Rowe Edward , Koupparis Anthony
Published: September 2020

Objective:

To investigate and document the surgical, functional and oncological outcomes following surgery for high-risk prostate cancer patients.

Patients and methods:

Patients with pathological T3a, T3b and N1 disease were extracted from our prospectively updated institutional database. Data include demographics, preoperative cancer parameters, short and long-term complications and functional results. Details of biochemical recurrence, type and oncological outcome of salvage treatments, cancer-specific and overall survival were also obtained.

Results:

A total of 669 patients were included; 58.9% had T3a disease, 35.9% had pT3b and 11.4% N1 disease. With a median follow-up of 66 months (8–129), overall survival was 94.3%, cancer-specific survival was 98.7% and biochemical recurrence was 45.6%. Average inpatient stay was 1 day and the overall complication rate was 9.1%; 54.2% experienced a biochemical recurrence and 90.3% went on to have one or more salvage treatments, which were varied. Significant predictors of biochemical recurrence included pathological stage, any positive margin and patient age ( P<0.005). A total of 44.9% had an immediate biochemical recurrence, with 90% receiving subsequent treatment and 20.5% having a durable response. None of the patients receiving prostate bed radiotherapy alone had a durable response. 54% had a delayed biochemical recurrence, with 63.5% receiving subsequent treatment and 44% having a durable response.

Conclusions:

Surgery is associated with encouraging surgical and functional outcomes, cancer-specific survival and overall survival rates in these patients. Pathological stage is a significant predictor of biochemical recurrence. The present analysis shows that long-term observation for certain patients with biochemical recurrence is appropriate and questions the effectiveness of further local salvage treatments in patients with an immediate biochemical recurrence postoperatively.

Level of evidence:

II
Physicians’ attitudes and perspectives regarding the uptake of psychosocial aspects and/or patient preferences during multidisciplinary team meetings in oncology
Authors: Baes S , Horlait M , Dhaene S , Leys M
Published: September 2020

Introduction

Coordinating cancer care is challenging because of its complexity. To partly encounter this complexity, multidisciplinary team meetings (MDTMs) were implemented to evaluate diagnosis, discuss treatment options and collectively decide upon the most optimal patient care and treatment plan. In cancer trajectories, medical professionals have a coordinating role and final decision responsibility. As a consequence patient-centred non-biomedical information are easily overlooked during discussions in MDTMs. This study aims to uncover physicians’ perceived barriers regarding the uptake of psychosocial aspects and/or patient preferences in the cancer treatment decision-making process during Multidisciplinary Oncology Consultations (MOCs), a specific type of MDTM in Belgium.

Methods

Between March 2019 and May 2019 semi-structured interviews were conducted with twenty medical professionals specialized in oncology. Grounded theory principles were used to detect and classify perceived barriers and patterns emerging regarding the uptake of psychosocial information in the cancer treatment decision-making process.

Results

Although physicians showed an open attitude towards taking into account psychosocial aspects and patient preferences in treatment decisions, the majority of respondents is not convinced the MOC is the best place to discuss these aspects. Physicians reported organisational, work process, and health system related barriers.

Discussion

The MOC emerges as a medicalized form of team discussion that, in its current form, does not reach its objective of truly integrated multidisciplinarity as cancer care is demanding. The working practices of the MOC can be optimized to evolve towards a truly interdisciplinary approach.
The formation of ‘gong-yi’ in modern China: A philological perspective
Authors: Wu Huanyu
Published: September 2020

The Chinese term ‘ gong-yi’ (公益), which is usually translated as ‘philanthropy’ or ‘public interest’ in English, has long been regarded as a new modern concept which originated from Japan in the early 20th century. This study, however, finds that it appeared in China no later than the middle of the Qing Dynasty. At that time, its usage had three major meanings: economic benefits; national interests; and local public affairs. The ‘national interest’ meaning of the term was most likely introduced into Japan and was brought back into China in the late 19th century along with the new thinking of the Meiji Restoration. ‘ Gong-yi’, with its newly coined meaning, was used as an ideological term to express ideas about reformation in early 20th century China. It was in this capacity that the Chinese ‘ gong-yi’ was swiftly popularized and often referred to the reformation as national interest. At the same time, the denotation of ‘ gong-yi’ was sometimes ambiguous, wavering between ‘the nation’ and ‘the local’. It reflected the volatile conflict between the state and the local over legitimate control of ‘public’ resources in a transitional period. In my view, the question of to what extent this interlock between the emergence of modern ‘ gong-yi’ and the nation’s modern transition might have shaped the historical formation of Chinese citizenship yields insights for the investigation of the nature of Chinese philanthropy and its essence in the public spirit.
Translation and Validation of the Danish Version of the Zurich Claudication Questionnaire
Authors: Bouknaitir Jamal Bech , Carreon Leah Y. , Brorson Stig , Andersen Mikkel Østerheden
Published: September 2020

Study Design:

Validation study.

Objectives:

To translate and validate the Zurich Claudication Questionnaire (ZCQ) into a Danish version of the disease-specific patient-reported outcome measure (PROM) for patients with lumbar spinal stenosis (LSS), which assesses symptom severity, physical function, and satisfaction after surgery.

Method:

Translation into a Danish version of the original questionnaire by back- and forward-translating the questionnaire and finally transforming a prefinal test version into a final and cross-cultural adapted version. Validation was performed as a cohort study assessing floor-ceiling effects, internal consistency, test-retest reproducibility, criterion validity, discriminant validity, and responsiveness to change.

Results:

Fifty-three patients were consecutively included in the study, 53 healthy controls were matched. Floor effect was seen in the postoperative data. Internal consistency, Cronbach’s alpha was good to excellent. Substantial test-retest reproducibility was found using Cohen’s weighted kappa. The Danish ZCQ showed moderate to strong association with similar domains of Oswestry Disability Index, Short Form 36, Euro QoL 5D, visual analogue scale–leg and back. The questionnaire showed significant responsiveness to change and a significant discriminant validity between LSS patients and healthy controls.

Conclusion:

This study shows the Danish translation of the original ZCQ to be well understood by Danish patients. The Danish version is furthermore a reliable and valid questionnaire, which is responsive to change.
Definitions of Return to Sport After Hip Arthroscopy: Are We Speaking the Same Language and Are We Measuring the Right Outcome?
Authors: Chona Deepak V. , Bonano John C. , Ayeni Olufemi R. , Safran Marc R.
Published: September 2020

Background:

Return to sport is a commonly studied outcome of hip arthroscopy that is relevant to both patients and providers. There exists substantial variability in criteria used to define successful return to sport.

Purpose:

To review and evaluate the definitions used in the literature so as to establish a single standard to enable comparison of outcomes in future studies.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

The PubMed, MEDLINE, and Embase databases were searched from inception to June 1, 2019, for studies relating to hip arthroscopy and return to sport. Articles included were those that met the following criteria: (1) contained 2 or more patients, (2) studied patients 18 years of age and older, (3) reported postoperative outcomes after hip arthroscopy, (4) clearly defined return to play, and (5) were written in English. Excluded articles (1) reported outcomes for nonoperative or open treatments, (2) did not clearly define return to play, or (3) were review articles, meta-analyses, or survey-based studies. Return-to-play definitions and additional metrics of postoperative performance and outcome were recorded.

Results:

A total of 185 articles were identified, and 28 articles were included in the final review, of which 18 involved elite athletes and 10 involved recreational athletes. Of articles studying elite athletes, 6 (33%) defined return to play as participation in regular or postseason competition, 3 (17%) extended the criteria to the preseason, and 2 (11%) used participation in sport-related activities and training. The remaining 7 (39%) reported rates of return to the preoperative level of competition but did not specify preseason versus regular season. All 10 articles evaluating recreational athletes defined return to play based on patient-reported outcomes. Four (40%) did so qualitatively, while 6 (60%) did so quantitatively.

Conclusion:

There exists significant variability in criteria used to define successful return to sport after hip arthroscopy, and these criteria differ among elite and recreational athletes. For elite athletes, return to the preoperative level of competition is most commonly used, but there exists no consensus on what type of competition—regular season, preseason, or training—is most appropriate. For recreational athletes, patient-reported data are most commonly employed, although there are clear differences between authors on the ways in which these are being used as well.
No Justice, No Peace? Protest Participation for People with Criminal Legal Contact
Authors: Eife Erin
Published: September 2020

Previous research shows that people who have criminal legal (CL) contact are less likely to vote, but there is little information about whether or not CL contact influences protest participation. While people with CL contact may be more likely to engage in critiques of the state, they are also more vulnerable to the risks associated with protesting. Because the CL system is highly racialized in the United States, race is central to an analysis of CL contact. In this article, I analyze the relationship between protest participation, CL contact, and race in Illinois. With survey data from the 2014 Chicago Area Study, I show how race and CL contact interact to increase the likelihood of protesting for Black respondents with CL contact, suggesting that one’s experience of a personal perceived injustice is a driving factor in deciding to protest. I also find that non-Black respondents with CL contact are equally as likely to participate in protests as their counterparts without CL contact. This article contributes to literature on political participation and criminology, showing how race and CL contact interact in a way that is associated with participation rates for protest.
Are We Involving Patients in Shared Decision-Making in Young Adult Hip Surgery? A Systematic Review of Patient Engagement Initiatives in Hip Preservation
Authors: Alokozai Aaron , Bernstein David N , Samuel Linsen T , Kamath Atul F
Published: September 2020

There are limited published studies on patient engagement, including shared decision-making, in adolescents and young adults with complex congenital or post-traumatic hip disorders. Despite the limited number of papers, we aim to clearly summarize what is currently available in the literature using a systematic review approach. We hope this serves as a call to action and catalyst for more work in this field. Future research must focus on awareness of what matters most to patients (values), and the development, implementation, and barriers to the use of decision aids and patient engagement optimization specific to hip disease in young adults.
Patient Stories Can Make a Difference in Patient-Centered Research Design
Authors: Novak Laurie Lovett , George Sheba , Wallston Kenneth A , Joosten Yvonne A , Israel Tiffany L , L Simpson Christopher , Vaughn Yolanda , Williams Neely A , Stallings Sarah , Ichimura Jabari S , Wilkins Consuelo H
Published: September 2020

Amid increasing interest in improving the patient-centeredness of research, new forms of engagement are emerging that enable researchers to get input from community members on research goals, methods, and implementation. This input often includes stories, which are useful for understanding lived experiences of illness and encounters with health care organizations, and for locating these experiences within larger meta-narratives of specific communities. We analyzed the stories in transcripts of 13 Community Engagement Studios and identified 4 major functions that the stories served in the sessions. Major functions included: (1) establishing mutual understanding, (2) adding expansion and depth, (3) characterizing abstract concepts, and (4) providing context for experience, with the latter being the most frequent. We assert that stories can serve to better communicate the complex contexts of patient experiences, helping to align research priorities and research design with community interests, leading to more patient-centered innovations in clinical practice.
Sex differences in treatment, radiological features and outcome after intracerebral haemorrhage: Pooled analysis of Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials 1 and 2
Authors: Sandset Else Charlotte , Wang Xia , Carcel Cheryl , Sato Shoichiro , Delcourt Candice , Arima Hisatomi , Stapf Christian , Robinson Thompson , Lavados Pablo , Chalmers John , Woodward Mark , Anderson Craig S
Published: September 2020

Introduction

Reports vary on how sex influences the management and outcome from acute intracerebral haemorrhage. We aimed to quantify sex disparities in clinical characteristics, management, including response to blood pressure lowering treatment, and outcomes in patients with acute intracerebral haemorrhage, through interrogation of two large clinical trial databases.

Patients and Methods

Post-hoc pooled analysis of the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials 1 and 2, where patients with a hypertensive response (systolic, 150–220 mmHg) after spontaneous intracerebral haemorrhage (<6 h) were randomised to intensive (target <140 mmHg <1 h) or guideline-recommended (<180 mmHg) blood pressure lowering treatment. The interaction of sex on early haematoma growth (24 h), death or major disability (modified Rankin scale scores 3–6 at 90 days), and effect of randomised treatment were determined in multivariable logistic regression models adjusted for baseline confounding variables.

Results

In 3233 participants, 1191 (37%) were women who were significantly older, had higher baseline National Institutes of Health Stroke Scale scores and smaller haematoma volumes compared to men. Men had higher three-month mortality (odds ratio 1.48, 95% confidence interval 1.10–2.00); however, there was no difference between women and men in the combined endpoint of death or major disability. There were no significant sex differences on mean haematoma growth or effect of randomised blood pressure lowering treatment.

Discussion

Men included in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials had more comorbidities, larger baseline haematoma volumes and higher mortality after adjustment for age, as compared with women.

Conclusion

Men included in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials had a greater odds of dying after intracerebral haemorrhage than women, which could not be readily explained by differing casemix or patterns of blood pressure management.

Clinical trial registration

The Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trials studies are registered with ClinicalTrials.gov (NCT00226096 and NCT00716079).
Broadening democracy against environmental justice: The example of Montreal borough councils
Authors: Patsias Caroline
Published: September 2020

In this reflection, through observation of citizen participation in several local Montreal municipal councils, I examine whether and how people discuss environmental issues. More specifically, I seek to determine whether the politicization of environmental issues favours the expression of environmental justice. I use this term to refer to the social dimension of environmental questions, given that people of different social classes or identities are not affected by environmental issues in the same way. Does the politicization of environmental issues reproduce an unjust social order or does it encourage the struggle against inequalities? The answer reached here underlines the predominance of politicization through the challenging of democratic processes rather than a substantive politicization (where citizens debate the content of issues and discuss values or identities), which hinders the emergence of environmental justice. This study makes two contributions. First, it points out that, beyond conflict, addressing the avenues that conflict takes is vital. Second, while most analyses consider environmental justice within civil society organizations and on the “margins”, this reflection tackles environmental justice within institutions themselves, namely the favoured places of production of social norms. Apprehending the role of institutions in the politicization of environmental issues is, thus, crucial to highlighting some aspects of social framing and the place of environmental issues in society.
Pipe dreams? Practices of everyday governance of heterogeneous configurations of water supply in Baruipur, a small town in India
Authors: Kundu Ratoola , Chatterjee Suchismita
Published: September 2020

This article compares a networked and a non-networked artefact and the diverse practices of everyday governance around these localised configurations of water infrastructure in Baruipur, a peripheral and rapidly urbanising small town in the Kolkata Metropolitan Area. Plagued by arsenic contamination, the state has been pushing to expand and consolidate a networked piped infrastructure bringing in treated surface water. This shift threatens to reconfigure the existing diverse infrastructure configurations that are fragmented, incremental in nature. We examine the scholarship on the situated and embodied forms of Urban Political Ecology to understand how everyday social relations and plural practices at the level of the town, the ‘para’ (roughly neighbourhood), and the household shape socio-material artefacts. The shift in the socio-technical configurations, in turn, lead to new forms of power coalitions, network conflicts, and collaborations. Through an in-depth qualitative examination, we conclude that heterogeneous infrastructure configurations and everyday practices are not only gendered but also intricately embedded within intersections of social affinity, intimate geographies, and embodied class power relations in the ‘para’.
Vitreous Seed Classification and Regression Patterns in Eyes With Retinoblastoma
Authors: Rishi Pukhraj , Attiku Yamini , Manchegowda Pradeep T. , Agarwal Ashutosh , Sharma Minal
Published: September 2020

Purpose:

This work subclassifies retinoblastoma vitreous seeds and evaluates the efficacy, regression patterns, and adverse effects of combination intravitreal melphalan and topotecan chemotherapy for resistant and recurrent vitreous seeds.

Methods:

A retrospective review of medical records was conducted of patients with retinoblastoma and resistant or recurrent vitreous seeds who were treated with intravitreal melphalan and topotecan injections from August 2014 to July 2018. Main outcome measures included regression pattern, time for regression, time for recurrence of seeds, treatment outcomes, and ocular toxicity.

Results:

Nineteen eyes received 138 intravitreal injections over 74 treatment sessions (mean, 7.26 injections per eye); vitreous seeds regressed in 18 eyes. Of cloud vitreous seeds, curvilinear (n = 2) and sphero-linear (n = 2) subtypes were observed. During regression, some sphere seeds showed an intermediary streak-like pattern and took longer to regress (mean, 11.13 ± 14.05 months and 11.67 ± 8.62 injections) than those without the intermediary streak-like pattern (mean, 3.55 ± 2.57 months and 4.2 ± 1.87 injections). Mean follow-up was 34.87 ± 21.09 months (median, 35 months; range, 11-96 months). Anterior segment toxicity was seen in 10 (53%) eyes and posterior segment toxicity in 5 (26%) eyes. Kaplan-Meier survival estimates for globe salvage at 2 years was 94% and 73% at 5 years. Kaplan-Meier survival for vitreous seed–free status was 94% at 2 years and 65% at 5 years.

Conclusions:

An expanded vitreous seed classification system that further subcategorizes hitherto unrecognized vitreous seed morphology is needed. An intermediate streaking process results in a prolonged regression time for sphere vitreous seeds.
Peripheral Leakage on Ultra-Widefield Fluorescein Angiography in Patients With Inherited Retinal Degeneration
Authors: Park Elli A. , Huckfeldt Rachel M. , Comander Jason I. , Sobrin Lucia
Published: September 2020

Purpose:

This report illustrates that peripheral vascular leakage on ultra-widefield fluorescein angiography (FA) can occur in patients with inherited retinal degeneration (IRD) without evidence of a separate cause of leakage.

Methods:

We searched the electronic medical records of the Massachusetts Eye and Ear Infirmary from 2010 to 2019 for patients with an IRD diagnosis and examination with an ultra-widefield FA. Images from FAs were evaluated in masked fashion by 2 retina specialists. Documentation of an evaluation for alternative causes of vascular leakage was recorded, as well as results from electroretinography, Goldmann perimetry, and genetic testing.

Results:

A total of 305 patients with an IRD diagnosis and FA procedure code were identified. Of these, 26 patients had both a clinical diagnosis of IRD and ultra-widefield FA on detailed medical-record review. Three patients had FA to evaluate a Coats-like response and were excluded. Of the remaining 23, 4 patients (17%) had significant peripheral leakage on FA. Of these, 1 had pericentral retinitis pigmentosa (for which the genetic cause of disease was undefined), 1 had Refsum disease with confirmed biallelic PHYH mutations, 1 had a CRB1-associated macular dystrophy, and 1 had CERKL-associated macular dystrophy. There was no evidence of ocular inflammation from history, examination, or laboratory testing to account for the FA findings. Of the 19 patients without significant leakage, 4 had minimal leakage and 15 had no peripheral leakage.

Conclusions:

Peripheral retinal vascular leakage can be seen on ultra-widefield FA in patients with IRD that is likely due to the IRD disease process itself rather than to an additional, distinct eye condition.
Explaining public risk acceptance of a petrochemical complex: A delicate balance of costs, benefits, and trust
Authors: Verbeek Thomas
Published: September 2020

Communities adjacent to polluting industrial facilities understand and evaluate risk in often ambivalent and contextualized ways, not only balancing economic and environmental concerns but also reflecting cultural practices, social worldviews, and trust relationships. In this case study of the Antwerp petrochemical complex, the largest in Europe, a residents’ survey and interviews are used to examine how two middle-class communities coexist with the nearby petrochemical plants. The findings show that citizens in both communities are generally aware of the environmental impact and public health risk but are predominantly accepting of the industry. For both communities, the most important factor explaining acceptance is the perceived socio-economic benefit for the community, while a direct individual benefit in terms of employment does not play a significant role. In one community, risk acceptance is further strengthened by trust in companies’ risk management, while in the other community, trust in regulators is more critical. The different results for both communities stress the importance of a socio-cultural perspective on risk and underline the criticality of relationships of trust. The article further discusses the implications of these findings for environmental decision-making, considering the delicate balance and the significant minority of the population who is less accepting. The present study adds to the risk perception literature by providing one of the first quantitative analyses explaining industrial risk acceptance, instead of perception, using the increasingly contested petrochemical industry as an exemplary case.
The environments of environmental impact assessment: Transforming neoliberal environmental governance from within
Authors: Snow Andrew
Published: September 2020

The transformation of neoliberal environmental governance is beset by conceptual and empirical complexity. Utilising a governmentality conceptual and analytical framework, this piece seeks to illustrate how, on their own terms, environmental governance interventions create the potential for change via a modality I have labelled the temporalised environment. Through a discourse analysis of select guidance and regulatory documents, a programmer’s view of environmental impact assessment in England and Wales is generated. As both an object and a technology of governmental power, I show how the environment can reinforce extant neoliberal logics (as ‘artefact’) or be productive of a new re-socialised, globalising form of biopower (as ‘aspiration’). I explore the risks posed to the transformative potential of the latter ‘aspirational’ environment in terms of difficulties distinguishing between its neoliberal and non-neoliberal effects, its capture by neoliberal institutions, and the scalability of its transformation from local to global. I argue that these can only be adequately mitigated if a continued critical disposition is adopted towards the defining features, purpose and functionality of an environment. I propose a series of straightforward questions to aid this process. Overall, this distinction between artefactual and aspirational environments is intended to be heuristic, orienting those strategising against neoliberal environmental governance towards the instabilities internal to the logic of specific interventions.
Post-Secondary Institution Level and Control: Effect on Women’s Proportion of Entrepreneurship Degrees
Authors: Mueller-Fichepain Desarae , McConnell Cheryl , Gartland Myles P.
Published: September 2020

This study examines the influence U.S. college/university level (2-year/4-year) and control (public/private) have on the female-awarded proportion of their entrepreneurship degrees and certificates (EDCs). It also examines trends over a decade, 2006-2016. Integrated Postsecondary Education Data System (IPEDS) data on U.S. institutions awarding Classification of Instructional Programs (CIP) 52.07 (Entrepreneurship and Small Business degrees/certificates) in 2006, 2011, and/or 2016 is analyzed using ANOVA/ANCOVA/repeated measures methods. Surprisingly, even with the growing focus on female entrepreneurship, results did not show significant increases in the female-awarded proportion of EDCs over the ten years. Closer examination of 2016 data shows 2-year public institutions confer a significantly larger percentage of their EDCs to women compared to both 4-year public and private institutions providing evidence that institution level and control influence the proportion and suggesting that 4-year institutions may still be gendered in terms of entrepreneurship. Entrepreneurship education has been empirically shown to augment entrepreneurial human and social capital, which is of key importance in entrepreneurship, particularly high-growth potential female businesses. For this reason, these results have important implications for post-secondary institution leaders and entrepreneurship educators, and serves as a call to action to pro-actively assess their environments and curriculum for potential gender biases. Suggestions provided.
Delivery of adoptive cell therapy in the context of the health-care system in the UK: challenges for clinical sites
Authors: Pillai Manon , Davies Michelle M. , Thistlethwaite Fiona C.
Published: September 2020

Advanced Therapy Medicinal Products (ATMPs) comprise novel cell, tissue and gene therapies and offer the potential of durable remissions for diseases where there is a high unmet clinical need. Once considered a niche area of academic research, ATMPs now represent one of the fastest-growing areas of clinical development. The field has seen a rapid expansion of academic and commercial entities successfully translating ATMP research into the clinic. This is reflected in projection that the global gene and cell therapy market will be worth US $11.96 billion by 2025. However, these treatments are complex to deliver and frequently do not fit naturally into established healthcare systems. In the United Kingdom (UK) there has been a long-standing interest in ATMP research and, in order to meet the ambition to act as an international hub of activity for delivery of ATMPs, a collaborative network of Advanced Therapy Treatment Centres (ATTCs) has been established. This review explores the challenges of delivery in the clinical setting, focussing on one form of ATMP, Adoptive Cell Therapy (ACT). We describe the strategy being implemented in the UK to optimise the roll-out of these exciting new therapies.
Variable resolution probabilistic modeling of residential exposure and vulnerability for risk applications
Authors: Pittore Massimiliano , Haas Michael , Silva Vitor
Published: September 2020

In risk assessment, the exposure component describes the elements exposed to the natural hazards and susceptible to damage or loss, while the vulnerability component defines the likelihood to incur damage or loss conditional on a given level of hazard intensity. In this article, we propose a novel adaptive approach to exposure modeling which exploits Dirichlet-Multinomial Bayesian updating to implement the incremental assimilation of sparse in situ survey data into probabilistic models described by compositions (proportions). This methodology is complemented by the introduction of a custom spatial aggregation support based on variable-resolution Central Voronoidal Tessellations. The proposed methodology allows for a more consistent integration of empirical observations, typically from engineering surveys, into large-scale models that can also efficiently exploit expert-elicited knowledge. The resulting models are described in a probabilistic framework, and as such allow for a more thorough analysis of the underlying uncertainty. The proposed approach is applied and discussed in five countries in Central Asia.
Seismic rehabilitation of concrete buildings after the 1985 and 2017 earthquakes in Mexico City
Authors: Murcia-Delso Juan , Alcocer Sergio M , Arnau Oriol , Martínez Yaneivy , Murià-Vila David
Published: September 2020

The 19 September 2017 Puebla–Morelos earthquake provides a unique opportunity to (a) study the effectiveness of seismic rehabilitation methods implemented in Mexico City after 1985 and (b) collect large amounts of data on current building rehabilitation practices. This article presents and discusses seismic rehabilitation efforts conducted on concrete buildings after the 1985 and 2017 earthquakes. Building damage and vulnerabilities, code provisions for rehabilitation, and common repair and retrofit techniques used in these two periods of time are summarized. The performance of four buildings rehabilitated after 1985 is examined based on results from field investigations conducted after the 2017 event. These rehabilitations were effective in improving the performance of these buildings according to observed damages and estimated shaking intensities. To allow a more systematic assessment of seismic rehabilitations in future earthquakes, an inventory of rehabilitated buildings in Mexico City is currently under development. Preliminary data obtained from this inventory effort are presented and discussed.
JAK2S523L, a novel gain-of-function mutation in a critical autoregulatory residue in JAK2V617F− MPNs
Authors: Pastore Friederike , Krishnan Aishwarya , Hammarén Henrik M. , Silvennoinen Olli , Yan Benedict , Levine Ross L.
Published: September 2020

The SH2-JH2 linker domain of JAK2 has been implicated in the negative regulation of JAK2 activity. In 2 patients with myeloproliferative neoplasms (MPNs), we identified and characterized the novel JAK2 mutation S523L, which occurs in a key residue in the linker region. In 1 case, acquisition of JAK2S523L was associated with thrombocytosis and bone marrow megakaryocytic hyperplasia, and there were no other somatic alterations in this patient. The second patient with JAK2S523Lmutation presented with increased hematocrit and had concurrent mutations in RUNX1 and BCORL1. Consistent with the genetic and clinical data, expression of JAK2S523L causes interleukin-3–independent growth in Ba/F3 cells transduced with the erythropoietin receptor by constitutively active Jak2/Stat5 signaling.
National clinical audit for hospitalised exacerbations of COPD
Authors: Hurst John R. , Quint Jennifer K. , Stone Robert A. , Silove Yvonne , Youde Jane , Roberts C. Michael
Published: September 2020

Introduction

Exacerbations of COPD requiring hospital admission are burdensome to patients and health services. Audit enables benchmarking performance between units and against national standards, and supports quality improvement. We summarise 23 years of UK audit for hospitalised COPD exacerbations to better understand which features of audit design have had most impact.

Method

Pilot audits were performed in 1997 and 2001, with national cross-sectional audits in 2003, 2008 and 2014. Continuous audit commenced in 2017. Overall, 96% of eligible units took part in cross-sectional audit, 86% in the most recent round of continuous audit. We synthesised data from eight rounds of national COPD audit.

Results

Clinical outcomes were observed to change at the same time as changes in delivery of care: length of stay halved from 8 to 4 days between 1997 and 2014, alongside wider availability of integrated care. Process indicators did not generally improve with sequential cross-sectional audit. Under continuous audit with quality improvement support, process indicators linked to financial incentives (early specialist review (55–66%) and provision of a discharge bundle (53–74%)) improved more rapidly than those not linked (availability of spirometry (40–46%) and timely noninvasive ventilation (21–24%)).

Conclusion

Careful piloting and engagement can result in successful roll-out of cross-sectional national audit in a high-burden disease. Audit outcome measures and process indicators may be affected by changes in care pathways. Sequential cross-sectional national audit alone was not generally accompanied by improvements in care. However, improvements in process indicators were seen when continuous audit was combined with quality improvement support and, in particular, financial incentives.
Physical activity for cystic fibrosis: perceptions of people with cystic fibrosis, parents and healthcare professionals
Authors: Denford Sarah , Cox Narelle S. , Mackintosh Kelly A. , McNarry Melitta A. , O'Halloran Paul , Holland Anne E. , Tomlinson Owen W. , Barker Alan R. , Williams Craig A.
Published: September 2020

Background

The benefits of physical activity (PA) for people with cystic fibrosis (pwCF) are widely accepted, yet how PA is promoted and utilised by pwCF is unclear.

Method

An online questionnaire to explore attitudes, practices and promotion of PA in cystic fibrosis was completed by healthcare providers (HCP), pwCF and parents/caregivers.

Results

351 respondents (105 HCP, 120 pwCF, and 126 parents/caregivers) from 12 countries completed the survey. Importance of PA was rated highly by the majority of respondents. Physical (e.g.health), psychological (e.g.enjoyment) and social (e.g.social interaction) factors were motives for PA for 82%, 49% and 37% of pwCF, respectively, irrespective of country. Common barriers to PA included time (49% and 36%) and tiredness (61% and 7%) for pwCF and parents/carers, respectively. pwCF also reported psychosocial barriers (e.g.stigma, demoralisation), while parents/caregivers reported structural barriers (e.g.cost). Clinical teams varied substantially in terms of the emphasis placed on PA, facilities available, staff and training, and advice given to pwCF.

Conclusion

Despite the majority of participants rating the importance of PA highly, substantial variability was evident regarding the facilities and clinical support available to them, as well as why and how people were active. There remains a need to identify what constitutes “best practice” for PA promotion within clinics.
SHP2 inhibitor PHPS1 ameliorates acute kidney injury by Erk1/2-STAT3 signaling in a combined murine hemorrhage followed by septic challenge model
Authors: Jiang Jihong , Hu Baoji , Chung Chun-Shiang , Chen Yaping , Zhang Yunhe , Tindal Elizabeth W. , Li Jinbao , Ayala Alfred
Published: September 2020

Background

Hypovolemic shock and septic challenge are two major causes of acute kidney injury (AKI) in the clinic setting. Src homology 2 domain-containing phosphatase 2 (SHP2) is one of the major protein phosphatase tyrosine phosphatase (PTPs), which play a significant role in maintaining immunological homeostasis by regulating many facets of immune cell signaling. In this study, we explored whether SHP2 signaling contributed to development of AKI sequential hemorrhage (Hem) and cecal ligation and puncture (CLP) and whether inactivation of SHP2 through administration of its selective inhibitor, phenylhydrazonopyrazolone sulfonate 1 (PHPS1), attenuated this injury.

Methods

Male C57BL/6 mice were subjected to Hem (a “priming” insult) followed by CLP or sham-Hem plus sham-CLP (S/S) as controls. Samples of blood and kidney were harvested at 24 h post CLP. The expression of neutrophil gelatinase-associated lipocalin (NGAL), high mobility group box 1 (HMGB1), caspase3 as well as SHP2:phospho-SHP2, extracellular-regulated kinase (Erk1/2): phospho-Erk1/2, and signal transducer and activator of transcription 3 (STAT3):phospho-STAT3 protein in kidney tissues were detected by Western blotting. The levels of creatinine (Cre) and blood urea nitrogen (BUN) in serum were measured according to the manufacturer’s instructions. Blood inflammatory cytokine/chemokine levels were detected by ELISA.

Results

We found that indices of kidney injury, including levels of BUN, Cre and NGAL as well as histopathologic changes, were significantly increased after Hem/CLP in comparison with that in the S/S group. Furthermore, Hem/CLP resulted in elevated serum levels of inflammatory cytokines/chemokines, and induced increased levels of HMGB1, SHP2:phospho-SHP2, Erk1/2:phospho-Erk1/2, and STAT3:phospho-STAT3 protein expression in the kidney. Treatment with PHPS1 markedly attenuated these Hem/CLP-induced changes.

Conclusions

In conclusion, our data indicate that SHP2 inhibition attenuates AKI induced by our double-hit/sequential insult model of Hem/CLP and that this protective action may be attributable to its ability to mitigate activation of the Erk1/2 and STAT3 signaling pathway. We believe this is a potentially important finding with clinical implications warranting further investigation.
Effects of residual lignin and cellulose swelling on the rate of enzymatic saccharification of softwood and hardwood acid sulfite pulps
Authors: Tanifuji Keishi , Nakagawa-izumi Akiko , Ohi Hiroshi
Published: September 2020

We estimated the effect of residual lignin and pulp swelling on the rate of enzymatic saccharification to increase production of ethanol from acid sulfite pulp (SP) by means of enzymatic treatment. The resolution ratio of hardwood (Acacia mearnsii) SP after the enzymatic treatment was lower compared to softwood (Larix leptolepis) SP even though lignin content of hardwood SP was lower. The pyrolysis–gas chromatography/mass spectrometry (Py-GC/MS) analysis revealed that the residual lignin in hardwood SP could more easily adsorb enzyme compared to softwood SP, and the residual lignin in hardwood SP should interfere with the binding of the enzyme to cellulose. The beating treatment of pulp increased the swelling of pulp. The enzymatic saccharification rate was increased by the beating treatment. On the other hand, the delignification treatment was more effective than the beating treatment at enhancing enzymatic saccharification of both hardwood and softwood SPs. We found that the delignification process should be considered a high-priority technique for enhancing enzymatic saccharification of SP.
Building stock market resilience through digital transformation: using Google trends to analyze the impact of COVID-19 pandemic
Authors: Ding Ding , Guan Chong , Chan Calvin M. L. , Liu Wenting
Published: September 2020

As the 2019 novel coronavirus disease (COVID-19) pandemic rages globally, its impact has been felt in the stock markets around the world. Amidst the gloomy economic outlook, certain sectors seem to have survived better than others. This paper aims to investigate the sectors that have performed better even as market sentiment is affected by the pandemic. The daily closing stock prices of a total usable sample of 1,567 firms from 37 sectors are first analyzed using a combination of hierarchical clustering and shape-based distance (SBD) measures. Market sentiment is modeled from Google Trends on the COVID-19 pandemic. This is then analyzed against the time series of daily closing stock prices using augmented vector autoregression (VAR). The empirical results indicate that market sentiment towards the pandemic has significant effects on the stock prices of the sectors. Particularly, the stock price performance across sectors is differentiated by the level of the digital transformation of sectors, with those that are most digitally transformed, showing resilience towards negative market sentiment on the pandemic. This study contributes to the existing literature by incorporating search trends to analyze market sentiment, and by showing that digital transformation moderated the stock market resilience of firms against concern over the COVID-19 outbreak.
Identification of single nucleotide variants in the Moroccan population by whole-genome sequencing
Authors: Crooks Lucy , Cooper-Knock Johnathan , Heath Paul R. , Bouhouche Ahmed , Elfahime Mostafa , Azzouz Mimoun , Bakri Youssef , Adnaoui Mohammed , Ibrahimi Azeddine , Amzazi Saaïd , Tazi-Ahnini Rachid
Published: September 2020

Background

Large-scale human sequencing projects have described around a hundred-million single nucleotide variants (SNVs). These studies have predominately involved individuals with European ancestry despite the fact that genetic diversity is expected to be highest in Africa where Homo sapiens evolved and has maintained a large population for the longest time. The African Genome Variation Project examined several African populations but these were all located south of the Sahara. Morocco is on the northwest coast of Africa and mostly lies north of the Sahara, which makes it very attractive for studying genetic diversity. The ancestry of present-day Moroccans is unknown and may be substantially different from Africans found South of the Sahara desert, Recent genomic data of Taforalt individuals in Eastern Morocco revealed 15,000-year-old modern humans and suggested that North African individuals may be genetically distinct from previously studied African populations.

Results

We present SNVs discovered by whole genome sequencing (WGS) of three Moroccans. From a total of 5.9 million SNVs detected, over 200,000 were not identified by 1000G and were not in the extensive gnomAD database. We summarise the SNVs by genomic position, type of sequence gene context and effect on proteins encoded by the sequence. Analysis of the overall genomic information of the Moroccan individuals to individuals from 1000G supports the Moroccan population being distinct from both sub-Saharan African and European populations.

Conclusions

We conclude that Moroccan samples are genetically distinct and lie in the middle of the previously observed cline between populations of European and African ancestry. WGS of Moroccan individuals can identify a large number of novel SNVs and aid in functional characterisation of the genome.
Type IV choledochal cyst with polycystic kidney disease: a case report
Authors: He Yuxin , Yu Zhuwen , Chen Weichang
Published: September 2020

Background

Choledochal cysts are divided into 5 types. Physicians believe that Caroli disease (which refers to type V biliary cysts) is a special type of biliary cyst caused by a mutation in the PKHD1 gene and is associated with autosomal recessive polycystic kidney disease (ARPKD). There is currently no clear association between other types of choledochal cysts and polycystic kidney disease.

Case presentation

We report a 65-year-old male patient with jaundice, decreased appetite, and itchy skin. His biochemistry test results indicated obstructive jaundice disease. Cross-sectional imaging showed a type IVA choledochal cyst accompanied by autosomal dominant polycystic kidney disease (ADPKD). Due to economic difficulties, the patient achieved percutaneous transhepatic cholangial drainage (PTCD) instead of surgery.

Conclusion

To our knowledge, this is the second case report of the coexistence of type IVA choledochal cysts and ADPKD. We conclude that it is vital to be aware that the above condition is a possibility. This case report will aid earlier diagnosis and management and possibly prevent further damage to liver and kidney function.
Association of sleep duration with risk of all-cause mortality and poor quality of dying in oldest-old people: a community-based longitudinal study
Authors: Hou Chengbei , Lin Yinan , Zimmer Zachary , Tse Lap Ah. , Fang Xianghua
Published: September 2020

Background

While sleep duration has been shown to be associated with health outcomes, few studies have been conducted among the oldest old. In addition, the impact of sleep duration on quality of dying is unknown. We aimed to evaluate how sleep duration affects all-cause mortality and quality of dying in people aged 80 + .

Methods

This community-based longitudinal study was performed by using data from 15,048 individuals aged ≥80 with information on sleep duration in the Chinese Longitudinal Healthy Longevity Survey. Cox and logistic regression models with penalized splines were applied to explore the shape of the association between sleep duration and all-cause mortality and poor quality of dying respectively and identify the interval of sleep duration resulting in the lowest risk of both.

Results

During a median follow-up of 3.1 years, 11,582 deaths including 4116 individuals who experienced poor quality of dying were recorded. Sleep duration showed a U-shaped association with all-cause mortality and sleeping about 8 h had the minimum risk of death; a J-shaped association was found between sleep duration and poor quality of dying. Compared with sleep duration of 7–9 h, the adjusted hazard ratio of total deaths was 1.08 (95% CI 1.03–1.13) for short duration (< 7 h) and 1.12 (95% CI 1.07–1.17) for long duration (> 9 h); the adjusted odds ratio of poor QOD was 1.10 (95% CI 1.01–1.21) for long duration, but this association was restricted to those with baseline unhealthy status (P-interaction = 0.04).

Conclusions

Sleeping a little longer may be better for individuals over 80 years old, and sleep duration of 7–9 h per day is optimal for both survival and good quality of life near death.