bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence of perceived stigma and self-blame and their associations with depression, emotional well-being and social well-being among advanced cancer patients: evidence from the APPROACH cross-sectional study in Vietnam
Authors: Pham Nguyen Tuong , Lee Jia Jia , Pham Nhu Hiep , Phan Thi Do Quyen , Tran Khoa , Dang Hoai Bao , Teo Irene , Malhotra Chetna , Finkelstein Eric A. , Ozdemir Semra
Published: July 2021

Background

There is very limited evidence on the existence of cancer-related perceived stigma and self-blame among patients with advanced cancer in Asia, and how they are associated with psychosocial outcomes. This study aimed to address the gap in the current literature by (1) assessing perceived stigma, behavioural self-blame and characterological self-blame among Vietnamese patients with advanced cancer, and (2) investigating the associations of perceived stigma and self-blame (behavioural and characterological) with depression, emotional well-being and social well-being.

Methods

This cross-sectional study involved 200 Vietnamese patients with stage IV solid cancer. Depression was measured using the Center for Epidemiologic Studies Depression (CES-D) Scale. Emotional well-being and social well-being were measured with the relevant domains of the Functional Assessment of Cancer Therapy-General (FACT-G) scale. Perceived stigma was assessed using the sense of stigma subscale of Kissane’s Shame and Stigma Scale. Behavioural self-blame and characterological self-blame were measured by the patients’ answers to the questions on whether their cancer was due to patient’s behaviour or character. Multivariable linear regressions were used to investigate the associations while controlling for patient characteristics.

Results

Approximately three-fourths (79.0%, n = 158) of the participants reported perceived stigma with an average score of 20.5 ± 18.0 (out of 100). More than half of the participants reported behavioural self-blame (56.3%, n = 112) or characterological self-blame (62.3%, n = 124). Higher perceived stigma was associated with lower emotional well-being (ß = -0.0; p = 0.024). Behavioural self-blame was not significantly associated with depressive symptoms, emotional well-being or social well-being. Patients who reported characterological self-blame reported greater depressive symptoms (ß = 3.0; p = 0.020) and lower emotional well-being (ß = -1.6; p = 0.038).

Conclusion

Perceived stigma and self-blame were common amongst Vietnamese advanced cancer patients. Perceived stigma was associated with lower emotional well-being while characterological self-blame were associated with greater depressive symptoms and lower emotional well-being. Interventions should address perceived stigma and self-blame among this population.
Trajectories of learning approaches during a full medical curriculum: impact on clinical learning outcomes
Authors: Piumatti Giovanni , Guttormsen Sissel , Zurbuchen Barbara , Abbiati Milena , Gerbase Margaret W. , Baroffio Anne
Published: July 2021

Background

No consensus exists on whether medical students develop towards more deep (DA) or surface learning approaches (SA) during medical training and how this impacts learning outcomes. We investigated whether subgroups with different trajectories of learning approaches in a medical students’ population show different long-term learning outcomes.

Methods

Person-oriented growth curve analyses on a prospective cohort of 269 medical students (Mage=21years, 59 % females) traced subgroups according to their longitudinal DA/SA profile across academic years 1, 2, 3 and 5. Post-hoc analyses tested differences in academic performance between subgroups throughout the 6-year curriculum until the national high-stakes licensing exam certifying the undergraduate medical training.

Results

Two longitudinal trajectories emerged: surface-oriented (n = 157; 58 %), with higher and increasing levels of SA and lower and decreasing levels of DA; and deep-oriented (n = 112; 42 %), with lower and stable levels of SA and higher but slightly decreasing levels of DA. Post hoc analyses showed that from the beginning of clinical training, deep-oriented students diverged towards better learning outcomes in comparison with surface-oriented students.

Conclusions

Medical students follow different trajectories of learning approaches during a 6-year medical curriculum. Deep-oriented students are likely to achieve better clinical learning outcomes than surface-oriented students.
The ethics of practicing defensive medicine in Jordan: a diagnostic study
Authors: Al-Balas Qosay A. E. , Al-Balas Hassan A. E.
Published: July 2021

Background

Defensive medicine (DM) practice refers to the ordering or prescription of unnecessary treatments or tests while avoiding risky procedures for critically ill patients with the aim to alleviate the physician’s legal responsibility and preserve reputation. Although DM practice is recognized, its dimensions are still uncertain. The subject has been highly investigated in developed countries, but unfortunately, many developing countries are unable to investigate it properly. DM has many serious ramifications, exemplified by the increase in treatment costs for patients and health systems, patients’ exposure to risks, and negative effects on the psychological health of both health providers and recipients. Ultimately, the most serious consequence is the ethical consequences.

Methods

This work is based on a review of the literature related to DM worldwide and a comparison with the available knowledge found in Jordan. It is qualitative with a descriptive nature, aiming to diagnose the current DM practice in Jordan.

Results

This is the first published article that discusses DM in Jordan by diagnosing its ethical and economic consequences for the health system as well as for patients. Despite the knowledge of the reasons that support its practice, little is being done to solve this issue. The absence of agreeable medical malpractice law, the dearth of unified medical protocols, the overwhelming pressure imposed by patients on medical staff, and the deteriorating patient-physician relationship are some of the causes of DM practice. Surely, the solution to these issues is to focus on fortifying the ethical and humanitarian aspects on the side of both the physician and the patient to ensure positive collaboration. The ethical aim of the physician to treat the patient faithfully and do what is possible to help combined with the appreciation of the physician’s efforts and the choice to not take advantage of the physician through litigation could be the most reasonable solution in the near future.

Conclusion

Jordan is suffering from DM due to the limited financial expenditure on the health sector and the impracticality of medical malpractice law. The authors highlight that the cardinal step in solving this dilemma is restoring the ethical dimension of the patient-physician relationship.
Global incidence and prevalence of idiopathic pulmonary fibrosis
Authors: Maher Toby M. , Bendstrup Elisabeth , Dron Louis , Langley Jonathan , Smith Gerald , Khalid Javaria Mona , Patel Haridarshan , Kreuter Michael
Published: July 2021

Background

Idiopathic pulmonary fibrosis (IPF) is a progressive debilitating lung disease with considerable morbidity. Heterogeneity in epidemiologic studies means the full impact of the disease is unclear.

Methods

A targeted literature search for population-based, observational studies reporting incidence and/or prevalence of IPF from January 2009 to April 2020 was conducted. Identified studies were aggregated by country. For countries with multiple publications, a weighted average was determined. Incidence and prevalence data were adjusted for between-study differences where possible. The final model included adjusted estimates of incidence and prevalence per 10,000 of the population with 95% confidence intervals. As prevalence estimates vary depending on the definitions used, estimates were based on a specific case definition of IPF.

Results

Overall, 22 studies covering 12 countries met the inclusion criteria, with 15 reporting incidence and 18 reporting prevalence estimates. The adjusted incidence estimates (per 10,000 of the population) ranged from 0.35 to 1.30 in Asia–Pacific countries, 0.09 to 0.49 in Europe, and 0.75 to 0.93 in North America. Unadjusted and adjusted incidence estimates were consistent. The adjusted prevalence estimates ranged from 0.57 to 4.51 in Asia–Pacific countries, 0.33 to 2.51 in Europe, and 2.40 to 2.98 in North America. South Korea had the highest incidence and prevalence estimates. When prevalence estimates were compared to country-specific rare disease thresholds, IPF met the definition of a rare disease in all countries except South Korea. There were notable geographic gaps for IPF epidemiologic data.

Conclusions

Due to differences in study methodologies, there is worldwide variability in the reported incidence and prevalence of IPF. Based on the countries included in our analysis, we estimated the adjusted incidence and prevalence of IPF to be in the range of 0.09–1.30 and 0.33–4.51 per 10,000 persons, respectively. According to these prevalence estimates, IPF remains a rare disease. For consistency, future epidemiologic studies of IPF should take age, sex, smoking status, and the specificity of case definitions into consideration.
Synthesis of iridium-based nanocomposite with catalase activity for cancer phototherapy
Authors: Wu Hang , Jiang Qi , Luo Keyi , Zhu Chunping , Xie Mengmeng , Wang Shige , Fei Zhewei , Zhao Jiulong
Published: July 2021

The combination of photothermal therapy (PTT) and photodynamic therapy (PDT) has attracted attention due to its enhanced tumor therapy effect. This study proposes a novel nanoenzyme-based theranostic nanoplatform, IrO2@MSN@PDA-BSA(Ce6), for the combined PTT and PDT of tumors. IrO2 was prepared by a simple hydrolysis method and coated with a thin layer of mesoporous silica (MSN) to facilitate the physical adsorption of Chlorin e6 (Ce6). The PDA coating and IrO2 NPs of the nanoplatform demonstrated an improved photothermal conversion efficiency of 29.8% under NIR irradiation. Further, the Ce6 loading imparts materials with the ability to produce reactive oxygen species (ROS) under 660 nm NIR laser irradiation. It was also proved that the IrO2 NPs could catalyze the hydrogen peroxide (H2O2) in the tumor microenvironment (TME) to generate endogenous oxygen (O2), thereby enhancing the efficiency of PDT. The in vitro and in vivo experiments indicated that the nanocomposite was highly biocompatible and could produce a satisfactory tumor therapeutic effect. Thus, the findings of the present study demonstrate the viability of using theranostic nanoenzymes for translational medicine.
Cross-sectional study of changes in physical activity behavior during the COVID-19 pandemic among US adults
Authors: Watson Kathleen B. , Whitfield Geoffrey P. , Huntzicker George , Omura John D. , Ussery Emily , Chen Tiffany J. , Fanfair Robyn Neblett
Published: July 2021

Background

Physical activity (PA) provides numerous health benefits relevant to the COVID-19 pandemic. However, concerns exist that PA levels may have decreased during the pandemic thus exacerbating health disparities. This study aims to determine changes in and locations for PA and reasons for decreased PA during the pandemic.

Methods

Reported percentage of changes in and locations for PA and reasons for decreased PA were examined in 3829 US adults who completed the 2020 SummerStyles survey.

Results

Overall, 30% reported less PA, and 50% reported no change or no activity during the pandemic; percentages varied across subgroups. Adults who were non-Hispanic Black (Black) or Hispanic (vs. non-Hispanic White, (White)) reported less PA. Fewer Black adults (vs. White) reported doing most PA in their neighborhood. Concern about exposure to the virus (39%) was the most common reason adults were less active.

Conclusions

In June 2020, nearly one-third of US adults reported decreased PA; 20% reported increased PA. Decreased activity was higher among Black and Hispanic compared to White adults; these two groups have experienced disproportionate COVID-19 impacts. Continued efforts are needed to ensure everyone has access to supports that allow them to participate in PA while still following guidance to prevent COVID-19 transmission.
Effectiveness of the mHealth intervention ‘MyDayPlan’ to increase physical activity: an aggregated single case approach
Authors: Degroote L. , De Paepe A. , De Bourdeaudhuij I. , Van Dyck D. , Crombez G.
Published: July 2021

Background

e- and mHealth interventions using self-regulation techniques like action and coping planning have the potential to tackle the worldwide problem of physical inactivity. However, they often use one-week self-regulation cycles, providing support toward an active lifestyle on a weekly basis. This may be too long to anticipate on certain contextual factors that may fluctuate from day to day and may influence physical activity. Consequently, the formulated action and coping plans often lack specificity and instrumentality, which may decrease effectiveness of the intervention. The aim of this study was to evaluate effectiveness of a self-regulation, app-based intervention called ‘MyDayPlan’. “MyDayPlan’ provides an innovative daily cycle in which users are guided towards more physical activity via self-regulation techniques such as goal setting, action planning, coping planning and self-monitoring of behaviour.

Methods

An ABAB single-case design was conducted in 35 inactive adults between 18 and 58 years (M = 40 years). The A phases (A1 and A2) were the control phases in which the ‘MyDayPlan’ intervention was not provided. The B phases (B1 and B2) were the intervention phases in which ‘MyDayPlan’ was used on a daily basis. The length of the four phases varied within and between the participants. Each phase lasted a minimum of 5 days and the total study lasted 32 days for each participant. Participants wore a Fitbit activity tracker during waking hours to assess number of daily steps as an outcome. Single cases were aggregated and data were analysed using multilevel models to test intervention effects and possible carry-over effects.

Results

Results showed an average intervention effect with a significant increase in number of daily steps from the control to intervention phases for each AB combination. From A1 to B1, an increase of 1424 steps (95% CI [775.42, 2072.32], t (1082) = 4.31,p < .001), and from A2 to B2, an increase of 1181 steps (95% CI [392.98, 1968.16], t (1082) = 2.94, p = .003) were found. Furthermore, the number of daily steps decreased significantly (1134 steps) when going from the first intervention phase (B1) to the second control phase (A2) (95% CI [− 1755.60, − 512.38], t (1082) = − 3.58, p < .001). We found no evidence for a difference in trend between the two control (95% CI [− 114.59, 197.99], t (1078) = .52, p = .60) and intervention phases (95% CI [− 128.79,284.22], t (1078) = .74, p = .46). This reveals, in contrast to what was hypothesized, no evidence for a carry-over effect after removing the ‘MyDayPlan’ app after the first intervention phase (B1).

Conclusion

This study adds evidence that the self-regulation mHealth intervention, ‘MyDayPlan’ has the capacity to positively influence physical activity levels in an inactive adult population. Furthermore, this study provides evidence for the potential of interventions adopting a daily self-regulation cycle in general.
The regulatory roles of motile cilia in CSF circulation and hydrocephalus
Authors: Kumar Vijay , Umair Zobia , Kumar Shiv , Goutam Ravi Shankar , Park Soochul , Kim Jaebong
Published: July 2021

Background

Cerebrospinal fluid (CSF) is an ultra-filtrated colorless brain fluid that circulates within brain spaces like the ventricular cavities, subarachnoid space, and the spine. Its continuous flow serves many primary functions, including nourishment, brain protection, and waste removal.

Main body

The abnormal accumulation of CSF in brain cavities triggers severe hydrocephalus. Accumulating evidence had indicated that synchronized beats of motile cilia (cilia from multiciliated cells or the ependymal lining in brain ventricles) provide forceful pressure to generate and restrain CSF flow and maintain overall CSF circulation within brain spaces. In humans, the disorders caused by defective primary and/or motile cilia are generally referred to as ciliopathies. The key role of CSF circulation in brain development and its functioning has not been fully elucidated.

Conclusions

In this review, we briefly discuss the underlying role of motile cilia in CSF circulation and hydrocephalus. We have reviewed cilia and ciliated cells in the brain and the existing evidence for the regulatory role of functional cilia in CSF circulation in the brain. We further discuss the findings obtained for defective cilia and their potential involvement in hydrocephalus. Furthermore, this review will reinforce the idea of motile cilia as master regulators of CSF movements, brain development, and neuronal diseases.
Loss of RANBP3L leads to transformation of renal epithelial cells towards a renal clear cell carcinoma like phenotype
Authors: Chernyakov Dmitry , Groß Alexander , Fischer Annika , Bornkessel Nicola , Schultheiss Christoph , Gerloff Dennis , Edemir Bayram
Published: July 2021

Background

Renal cell carcinomas (RCC) are characterized by the deregulation of several hundred hyperosmolality-responsive genes. High expression of a subset of these genes including the Ran binding protein 3 like (RANBP3L) is linked to a favorable prognostic outcome in RCC. However, the cellular function of RANBP3L remains largely unknown.

Methods

We used CRISPR/Cas9-mediated gene editing to generate functional deletions of the Ranbp3l and nuclear factor of activated T cells 5 (Nfat5) gene loci in a murine renal cell line. The NFAT5-KO cells were used to assess the regulation of Ranbp3l by NFAT5 using immunofluorescence, RNA-Seq and promoter assays. RANBP3L-deficient cells were analyzed for changes in cell morphology, proliferation, migration and colony-forming capacity using immunofluorescence and live cell imaging. RANPB3L-dependent changes in gene expression were identified by RNA-Seq.

Results

We show that NFAT5 directly regulates Ranpb3l under hyperosmotic conditions by binding its promoter. Functional analysis of RANBP3L-deficient cells revealed a loss of epithelial structure, an increased cell migration behavior and colony forming capacity, accompanied by massive alterations in gene expression, all of which are hallmarks for tumor cells. Strikingly, a RANBP3L dependent signature of 60 genes separated samples with clear cell carcinoma (KIRC) from papillary (KIRP), chromophobe renal carcinoma (KICH) and healthy tissue.

Conclusions

Loss of RANBP3L induces a tumor like phenotype resembles RCC, especially KIRC, on the morphological and gene expression level and might promote tumor development and progression. Therapeutic reconstitution or elevation of osmoregulated RANBP3L expression might represent a novel treatment strategy for RCC or KIRC.
Fully automated pelvic bone segmentation in multiparameteric MRI using a 3D convolutional neural network
Authors: Liu Xiang , Han Chao , Wang He , Wu Jingyun , Cui Yingpu , Zhang Xiaodong , Wang Xiaoying
Published: July 2021

Background

Accurate segmentation of pelvic bones is an initial step to achieve accurate detection and localisation of pelvic bone metastases. This study presents a deep learning-based approach for automated segmentation of normal pelvic bony structures in multiparametric magnetic resonance imaging (mpMRI) using a 3D convolutional neural network (CNN).

Methods

This retrospective study included 264 pelvic mpMRI data obtained between 2018 and 2019. The manual annotations of pelvic bony structures (which included lumbar vertebra, sacrococcyx, ilium, acetabulum, femoral head, femoral neck, ischium, and pubis) on diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) images were used to create reference standards. A 3D U-Net CNN was employed for automatic pelvic bone segmentation. Additionally, 60 mpMRI data from 2020 were included and used to evaluate the model externally.

Results

The CNN achieved a high Dice similarity coefficient (DSC) average in both testing (0.80 [DWI images] and 0.85 [ADC images]) and external (0.79 [DWI images] and 0.84 [ADC images]) validation sets. Pelvic bone volumes measured with manual and CNN-predicted segmentations were highly correlated (R2 value of 0.84–0.97) and in close agreement (mean bias of 2.6–4.5 cm3). A SCORE system was designed to qualitatively evaluate the model for which both testing and external validation sets achieved high scores in terms of both qualitative evaluation and concordance between two readers (ICC = 0.904; 95% confidence interval: 0.871–0.929).

Conclusions

A deep learning-based method can achieve automated pelvic bone segmentation on DWI and ADC images with suitable quantitative and qualitative performance.
Aldo-keto reductase family 1 member C1 regulates the osteogenic differentiation of human ASCs by targeting the progesterone receptor
Authors: Liu Xuenan , Lian Xiaomin , Liu Xuejiao , Du Yangge , Zhu Yuan , Hu Menglong , Zhang Ping , Liu Yunsong , Zhou Yongsheng
Published: July 2021

Background

As a promising way to repair bone defect, bone tissue engineering has attracted a lot of attentions from researchers in recent years. Searching for new molecular target to modify the seed cells and enhance their osteogenesis capacity is one of the hot topics in this field. As a member of aldo-keto reductase family, aldo-keto reductase family 1 member C1 (AKR1C1) is reported to associate with various tumors. However, whether AKR1C1 takes part in regulating differentiation of adipose-derived mesenchymal stromal/stem cells (ASCs) and its relationship with progesterone receptor (PGR) remain unclear.

Methods

Lost-and-gain-of-function experiments were performed using knockdown and overexpression of AKR1C1 to identify its role in regulating osteogenic and adipogenic differentiation of hASCs in vitro. Heterotypic bone and adipose tissue formation assay in nude mice were used to conduct the in vivo experiment. Plasmid and siRNA of PGR, as well as western blot, were used to clarify the mechanism AKR1C1 regulating osteogenesis.

Results

Our results demonstrated that AKR1C1 acted as a negative regulator of osteogenesis and a positive regulator of adipogenesis of hASCs via its enzyme activity both in vitro and in vivo. Mechanistically, PGR mediated the regulation of AKR1C1 on osteogenesis.

Conclusions

Collectively, our study suggested that AKR1C1 could serve as a regulator of osteogenic differentiation via targeting PGR and be used as a new molecular target for ASCs modification in bone tissue engineering.
Schwann cells promote prevascularization and osteogenesis of tissue-engineered bone via bone marrow mesenchymal stem cell-derived endothelial cells
Authors: Zhang Xinxin , Jiang Xiaorui , Jiang Shan , Cai Xiyu , Yu Shengji , Pei Guoxian
Published: July 2021

Background

Tissue-engineered bone grafts (TEBGs) that undergo vascularization and neurotization evolve into functioning bone tissue. Previously, we verified that implanting sensory nerve tracts into TEBGs promoted osteogenesis. However, the precise mechanisms and interaction between seed cells were not explored. In this study, we hypothesized that neurotization may influence the osteogenesis of TEBGs through vascularization.

Methods

We cultured rat Schwann cells (SCs), aortic endothelial cells (AECs), and bone marrow-derived mesenchymal stem cells (BM-MSCs) and then obtained BM-MSC-derived induced endothelial cells (IECs) and induced osteoblasts (IOBs). IECs and AECs were cultured in an SC-conditioned medium (SC-CM) to assess proliferation, migration, capillary-like tube formation, and angiogenesis, and the vascular endothelial growth factor (VEGF) levels in the supernatants were detected. We established an indirect coculture model to detect the expression of nestin and VEGF receptors in IECs and tissue inhibitor of metalloproteinase (TIMP)-2 in SCs. Then, SCs, IECs, and IOBs were labeled and loaded into a β-tricalcium phosphate scaffold to induce prevascularization, and the scaffold was implanted into a 6-mm-long defect of rat femurs. Three groups were set up according to the loaded cells: I, SCs, and IECs (coculture for 3 days) plus IOBs; II, IECs (culture for 3 days) plus IOBs; III, IOBs. Nestin and TIMP-2 expression and osteogenesis of TEBGs were evaluated at 12 weeks post-implantation through histological and radiological assessments.

Results

We found that SC-CM promoted IEC proliferation, migration, capillary-like tube formation, and angiogenesis, but no similar effects were observed for AECs. IECs expressed nestin extensively, while AECs barely expressed nestin, and SC-CM promoted the VEGF secretion of IECs. In the coculture model, SCs promoted nestin and VEGF receptor expression in IECs, and IECs inhibited TIMP-2 expression in SCs. The promotion of prevascularized TEBGs by SCs and IECs in group I augmented new bone formation at 6 and 12 weeks. Nestin expression was higher in group I than in the other groups, while TIMP-2 expression was lower at 12 weeks.

Conclusions

This study demonstrated that SCs can promote TEBG osteogenesis via IECs and further revealed the related specific characteristics of IECs, providing preliminary cytological evidence for neurotization of TEBGs.
Single-cell transcriptomic analysis of endometriosis provides insights into fibroblast fates and immune cell heterogeneity
Authors: Ma Junyan , Zhang Liqi , Zhan Hong , Mo Yun , Ren Zuanjie , Shao Anwen , Lin Jun
Published: July 2021

Background

Endometriosis is an oestrogen-dependent disease with an unclear aetiology and pathogenesis affecting 6–10% of the global female population, predominantly those of reproductive age. Herein, we profile the transcriptomes of approximately 55,000 single cells from three groups including ectopic endometrium, eutopic endometrium from women with endometriosis, and eutopic endometrium from healthy women to create a single-cell transcriptome atlas of endometriosis.

Results

We have identified 9 cell types and performed single-cell analysis of fibroblasts, and determined a potential developmental trajectory associated with endometriosis. We also identified fibroblast subpopulations related to endometriosis development and found that StAR played an important role in this process. Moreover, T cells in endometriosis were less activated or inflammatory with decreased effector CD8 + T cells, while the composition ratio of natural killer cells decreased and the percentage of monocytes/macrophages increased in endometriosis cysts. In addition, the effectiveness of immune cells in endometriosis lesions, eutopic endometrium from women with endometriosis, and eutopic endometrium from healthy women was distinct. Cell–cell interaction analyses highlighted the imbalanced immune environment in endometriosis lesions and immune cells in endometriosis could promote the development of the disease.

Conclusion

Our study provided a systematic characterisation of endometriosis and insights into the aetiology and pathology of endometriosis.
Recommendations to plan a national burden of disease study
Authors: Haneef Romana , Schmidt Jürgen , Gallay Anne , Devleesschauwer Brecht , Grant Ian , Rommel Alexander , Wyper Grant MA , Van Oyen Herman , Hilderink Henk , Ziese Thomas , Newton John
Published: July 2021

Background

The InfAct (Information for Action) project is a European Commission Joint Action on Health Information which has promoted the potential role of burden of disease (BoD) approaches to improve the current European Union-Health Information System (EU-HIS). It has done so by raising awareness of the concept, the methods used to calculate estimates and their potential implications and uses in policymaking. The BoD approach is a systematic and scientific effort to quantify and compare the magnitude of health loss due to different diseases, injuries, and risk factors with estimates produced by demographic characteristics and geographies for specific points in time. Not all countries have the resources to undertake such work, and may therefore start with a more restricted objective, e.g., a limited number of diseases, or the use of simple measures of population health such as disease prevalence or life expectancy. The main objective to develop these recommendations was to facilitate those countries planning to start a national burden of disease study.

Results

These recommendations could be considered as minimum requirements for those countries planning to start a BoD study and includes following elements: (1) Define the objectives of a burden of disease study within the context of your country, (2) Identify, communicate and secure the benefits of performing national burden of disease studies, (3) Secure access to the minimum required data sources, (4) Ensure the minimum required capacity and capability is available to carry out burden of disease study, (5) Establish a clear governance structure for the burden of disease study and stakeholder engagement/involvement, (6) Choose the appropriate methodological approaches and (7) Knowledge translation. These were guided by the results from our survey performed to identify the needs of European countries for BoD studies, a narrative overview from four European countries (Belgium, Germany, The Netherlands and Scotland) and the summary of a comparative study of country health profiles with national health statistics.

Conclusions

These recommendations as minimum requirements would facilitate efforts by those European countries who intend to perform national BoD studies.
Impact and cost–benefit analysis: a unifying approach
Authors: Scandizzo Pasquale Lucio
Published: July 2021

This paper presents a methodology to integrate cost–benefit analysis and SAM-CGE-based impact evaluation. While the two types of analysis have developed in parallel and without a clear connection, there is growing consensus that the two approaches should be integrated for complex investment projects, since their economic evaluation cannot rely solely on the partial equilibrium assumptions of cost–benefit (CB) analysis. Unlike CB analysis, impact evaluation looks at the economy as a complete system of interdependent components (industries, households, investors, government, importers, exporters). By integrating project accounting into a SAM-CGE framework, the methodology developed presents several properties that make it fit to the purpose of providing a reliable assessment of project contribution to the economy.
Seasonal migratory patterns of Pacific cod (Gadus macrocephalus) in the Aleutian Islands
Authors: Bryan David R. , McDermott Susanne F. , Nielsen Julie K. , Fraser Dave , Rand Kimberly M.
Published: July 2021

Background

Pacific cod (Gadus macrocephalus) is an ecologically important species that supports a valuable commercial fishery throughout Alaska waters. Although its life history includes seasonal movement for spawning and feeding, little is known about its movement ecology. Here, we present results from the first study to use pop-up satellite archival tags (PSATs) to track the within-year movements of Pacific cod to understand their potential seasonal movement patterns within the Aleutian Islands. This study was part of a cooperative research project; tagging was conducted onboard commercial vessels during the winter fishing season while Pacific cod were aggregated to spawn in the central Aleutian Islands.

Results

Of the 36 PSATs deployed, we were able to obtain movement data from 13 Pacific cod that were at liberty between 60 and 360 days. We determined that three tagged Pacific cod were predated on by marine mammals and three were recaptured by the commercial fishery. Geolocation models were produced for four migrating individuals. Eight Pacific cod moved to a productive foraging ground near Seguam Island located 64 to 344 km from their release site and presumed spawning ground within a few weeks of their release. These movements indicate that some Pacific cod in the Aleutian Islands undergo seasonal migration. Three Pacific cod remained near their release locations (within 50 km) for more than 75 days suggesting the existence of partial migration in the population. Two Pacific cod undertook larger movements (378 and 394 km) during which they swam over deep passes and crossed several management boundaries highlighting the potential connectedness of Pacific cod throughout the Aleutian Islands.

Conclusions

This study provided important initial insights into the seasonal movement patterns of Pacific cod in the Aleutian Islands. Most tracked Pacific cod (77%) undertook migrations in the middle of March (64–394 km) from their winter spawning areas to summer foraging areas, but a few individuals remained in their capture location suggesting a partial migration strategy. Their ability to cross deep passes that were previously seen as potential barriers to movement has expanded our understanding of population connectivity.
Epidemiological trends of women’s cancers from 1990 to 2019 at the global, regional, and national levels: a population-based study
Authors: Yi Ming , Li Tianye , Niu Mengke , Luo Suxia , Chu Qian , Wu Kongming
Published: July 2021

Background

Every year around the world, more than 2 million women are diagnosed with breast cancer and genital tract cancers. However, there are rare studies comprehensively describing the global and regional trends of incidence and mortality of women’s cancers.

Methods

To study the burden and trend of women’s cancers, we conducted this cross-sectional study based on the epidemiologic data of Global Burden of Disease 2019. In this study, female patients with breast cancer, cervical cancer, ovarian cancer, and uterine cancer worldwide from 1990 to 2019 were involved. The incidence, death, and disability-adjusted life-year (DALY) were used to measure the outcomes of women’s cancers. The estimated annual percentage change (EAPC) was calculated to assess the changing trend of cancer burden.

Results

Among the four women’s cancers, the burden of female breast cancer was highest. During the past 30 years, the incidence, death, and DALY of female breast cancer kept increasing worldwide. In most regions especially developing countries, cervical cancer was the second most common women’s cancer. At the same time, ovarian cancer and uterine cancer occurred less frequently. Generally, the age-standardized incidence rates (ASIRs) of breast cancer, ovarian cancer, and uterine cancer were positively correlated to sociodemographic index (SDI) value. In contrast, the ASIR of cervical cancer was negatively correlated to SDI value.

Conclusions

Our study indicates that the incidence and mortality of women’s cancers have geographical variations and change along with SDI value. The results might be helpful to policy-makers to allocate healthy resources to control women’s cancers.
Preparing for a community-based agriculture-to-nutrition trial in rural Malawi: formative research to assess feasibility and inform design and implementation decisions
Authors: Chiutsi-Phiri Gabriella , Kalimbira Alexander A. , Banda Leonard , Nalivata Patson C. , Sanuka Marion , Kalumikiza Zione , Matandika Limbanazo , Mfutso-Bengo Joseph , Allen Elizabeth , Ferguson Elaine , Sturgess Joanna , Broadley Martin R. , Langley-Evans Simon , Millar Kate , Gashu Dawd , Joy Edward J. M.
Published: July 2021

Background

This study reports findings from formative research conducted to assess the feasibility and inform the design and implementation of the Addressing Hidden Hunger with Agronomy (AHHA) trial. The AHHA trial was a randomised, controlled trial conducted in rural Malawi, in which participants were given maize flour biofortified with selenium or control flour not biofortified with selenium for a period of 10 weeks, after which blood samples were taken to measure selenium status.

Methods

Formative research was conducted in villages near to the AHHA trial study site 1 year before the planned intervention. A short questionnaire with adult women (n = 50), focus group discussions with male (n groups = 3) and female (n groups = 3) community members, and in-depth key informant interviews (n = 7) were conducted to understand community practices and perceptions.

Findings

Meals were typically cooked and eaten at home in this community, while participants reported that maize flour would be less readily sold than maize grain – important considerations for the design of the trial. Regarding intervention delivery, we identified potential concerns around effects on fertility, links between blood sampling and witchcraft, and the potential for social stigma if community members considered participants lazy for receiving free flour. Participants reported that involvement of the Malawi government partners including health extension workers would increase trust.

Interpretation

Following the formative research, the AHHA trial appeared feasible. However, community sensitisation would be essential to address potential fears and concerns; effective sensitisation would support recruitment and treatment adherence, and would protect the safety and wellbeing of participants and researchers. People in positions of authority and trust including village headmen, religious leaders, health and agriculture extension workers, and community care groups should be involved in community sensitisation.
DAViS: a unified solution for data collection, analyzation, and visualization in real-time stock market prediction
Authors: Tuarob Suppawong , Wettayakorn Poom , Phetchai Ponpat , Traivijitkhun Siripong , Lim Sunghoon , Noraset Thanapon , Thaipisutikul Tipajin
Published: July 2021

The explosion of online information with the recent advent of digital technology in information processing, information storing, information sharing, natural language processing, and text mining techniques has enabled stock investors to uncover market movement and volatility from heterogeneous content. For example, a typical stock market investor reads the news, explores market sentiment, and analyzes technical details in order to make a sound decision prior to purchasing or selling a particular company’s stock. However, capturing a dynamic stock market trend is challenging owing to high fluctuation and the non-stationary nature of the stock market. Although existing studies have attempted to enhance stock prediction, few have provided a complete decision-support system for investors to retrieve real-time data from multiple sources and extract insightful information for sound decision-making. To address the above challenge, we propose a unified solution for data collection, analysis, and visualization in real-time stock market prediction to retrieve and process relevant financial data from news articles, social media, and company technical information. We aim to provide not only useful information for stock investors but also meaningful visualization that enables investors to effectively interpret storyline events affecting stock prices. Specifically, we utilize an ensemble stacking of diversified machine-learning-based estimators and innovative contextual feature engineering to predict the next day’s stock prices. Experiment results show that our proposed stock forecasting method outperforms a traditional baseline with an average mean absolute percentage error of 0.93. Our findings confirm that leveraging an ensemble scheme of machine learning methods with contextual information improves stock prediction performance. Finally, our study could be further extended to a wide variety of innovative financial applications that seek to incorporate external insight from contextual information such as large-scale online news articles and social media data.
Recreational cannabis legalization and alcohol purchasing: a difference-in-differences analysis
Authors: Calvert Collin M. , Erickson Darin
Published: July 2021

Background

Whether recreational cannabis legalization is associated with changes in alcohol consumption (suggesting a potential substitution or complementary relationship) is a key question as cannabis policy evolves, particularly given the adverse health and social effects of alcohol use. Relatively little research has explored this question.

Methods

This study examined the association between recreational cannabis legalization and alcohol purchasing in the USA using an interrupted time series design. We used data from the Nielsen Consumer Panel (2004–2017) from 69,761 households in all 50 states to calculate monthly milliliters of pure ethanol purchased for four beverage categories (beer, wine, spirits, and all alcohol products). We used difference-in-differences models and robust cluster standard errors to compare changes in milliliters of pure ethanol purchased. We fit models for each beverage category, comparing three “policy” states that have legalized recreational cannabis (Colorado, Oregon, and Washington) to states that had not legalized recreational cannabis. In one set of models, a single control state was selected that matched pre-policy purchasing trends in the policy states. In another set, policy states were compared to all states that had not legalized recreational cannabis.

Results

Compared to all other states that did not legalize recreational cannabis, Colorado households showed a 13% average monthly decrease in purchases of all alcoholic products combined (estimate, 0.87; CI, 0.77, 0.98) and a 6% decrease in wine (0.94; CI, 0.89, 0.99). Estimates in Washington were suggestive of an increase in spirits purchased in both the unrestricted (1.24; CI, 1.12, 1.37) and restricted sample (1.18; CI, 1.02, 1.36). Oregon showed a significant decrease in monthly spirits purchased when compared to its selected comparator state (0.87; CI, 0.77, 0.99) and to all other states without legalized recreational cannabis (0.85; CI, 0.77, 0.95).

Conclusions

Results suggest that alcohol and cannabis are not clearly substitutes nor complements to one-another. Future studies should examine additional states as more time passes and more post-legalization data becomes available, use cannabis purchase data and consider additional methods for control selection in quasi-experimental studies.
Breast Regional Anesthesia Practice in the Italian Public Health System (BRA-SURVEY): A Survey-Based National Study
Authors: Bonvicini Daniele , De Cassai Alessandro , Andreatta Giulio , Salvagno Michele , Carbonari Ilaria , Carere Anna , Fornasier Marcello , Iori Davide , Negrello Michele , Grutta Giuseppe , Navalesi Paolo
Published: July 2021

BACKGROUND:

Breast cancer is the most common malignancy in women. Surgery is a mainstay therapy unfortunately burdened by complications as severe postoperative pain. Regional anesthesia may play a role in a multimodal strategy for prevention and treatment of postoperative pain. The main purpose of this survey was to investigate the rate of use of regional anesthesia techniques in patients undergoing breast surgery in the Italian public hospital system.

METHODS:

We designed an online survey that consisted of 22 questions investigating the anesthesia management of breast surgery, particularly focused on regional anesthesia. The survey lasted from November 18, 2019 to February 28, 2020. Directors of anesthesia departments of 168 Italian public health system hospitals were contacted and invited to forward the survey to every anesthesiologist in their unit.

RESULTS:

A total of 935 anesthesiologists received the survey; among them 460 entered the final analysis. Regional anesthesia was not used by 44.6% of the anesthesiologists and lack of experience/training was the main cause (75.6%). Logistic regression models revealed that anesthesiologists with more than 15 years of experience (odds ratio [OR] = 0.55; 95% confidence interval [CI], 0.33–0.93) or working most of their days in intensive care unit (ICU) compared to operating theater (OR = 0.25; 95% CI, 0.14–0.43) were less likely to perform regional anesthesia techniques.

CONCLUSIONS:

Low implementation of regional anesthesia techniques in breast surgery emerges from our survey and the major reason cited is a lack of proper training. An improved training program in regional anesthesia, especially in residents’ curricula, could be useful to increase its rate of use and to standardize its practice.
Prediction of Early Recurrence After Surgery for Liver Tumor (ERASL): An International Validation of the ERASL Risk Models
Authors: Beumer Berend R. , Takagi Kosei , Vervoort Bastiaan , Buettner Stefan , Umeda Yuzo , Yagi Takahito , Fujiwara Toshiyoshi , Steyerberg Ewout W. , IJzermans Jan N. M.
Published: July 2021

Background

This study aimed to assess the performance of the pre- and postoperative early recurrence after surgery for liver tumor (ERASL) models at external validation. Prediction of early hepatocellular carcinoma (HCC) recurrence after resection is important for individualized surgical management. Recently, the preoperative (ERASL-pre) and postoperative (ERASL-post) risk models were proposed based on patients from Hong Kong. These models showed good performance although they have not been validated to date by an independent research group.

Methods

This international cohort study included 279 patients from the Netherlands and 392 patients from Japan. The patients underwent first-time resection and showed a diagnosis of HCC on pathology. Performance was assessed according to discrimination (concordance [C] statistic) and calibration (correspondence between observed and predicted risk) with recalibration in a Weibull model.

Results

The discriminatory power of both models was lower in the Netherlands than in Japan (C statistic, 0.57 [95% confidence interval {CI} 0.52–0.62] vs 0.69 [95% CI 0.65–0.73] for the ERASL-pre model and 0.62 [95% CI 0.57–0.67] vs 0.70 [95% CI 0.66–0.74] for the ERASL-post model), whereas their prognostic profiles were similar. The predictions of the ERASL models were systematically too optimistic for both cohorts. Recalibrated ERASL models improved local applicability for both cohorts.

Conclusions

The discrimination of ERASL models was poorer for the Western patients than for the Japanese patients, who showed good performance. Recalibration of the models was performed, which improved the accuracy of predictions. However, in general, a model that explains the East–West difference or one tailored to Western patients still needs to be developed.