bluuebunny/crossref_metadata_2025 huggingface dataset:
Firm Profitability and Adjustment of Capital Structure: Indian Evidence
Authors: Ghose Biswajit , Kabra Kailash Chandra
Published: August 2019

The present study investigates the relevance of capital structure dynamics in Indian context by examining the speed at which firms adjust towards their target capital structure. Apart from symmetric adjustment speed, the study also investigates the asymmetries in adjustment speed based on profitability of firms. Using partial adjustment framework on an unbalanced panel of 28,532 firm-year observations comprising 2,718 listed firms over a period of 2004–2005 to 2015–2016, the study finds that Indian firms maintain target leverage and adjust towards the same with a moderate annual adjustment speed of around 32 per cent. The study further observes that high-profitability firms, in general, adjust significantly faster than low-profitability firms which possibly indicate better accessibility in the financial market, lesser costs of adjustments and ability to adjust payout ratio for the former than the latter. Further investigation reveals that high-profitability firms make more adjustment in case of over-leverage, whereas low-profitability firms make more adjustment in case of under-leverage. These results possibly indicate the implications of availability of internally generated funds. Overall, the study concludes that adverse selection cost plays important role in the target adjustment process and hence, both trade-off theory and pecking order theory have relevance in Indian context.
Optimization for vertical stabilizers on flutter stability of streamlined box girders with mountainous environment
Authors: Guo Junjie , Tang Haojun , Li Yongle , Wu Lianhuo , Wang Zewen
Published: August 2019

Wind environment in mountainous areas is very different from that in coastal and plain areas. Strong winds always show large angles of attack, affecting the flutter stability of long-span bridges which is one of the most important design factors. The central vertical stabilizer has been demonstrated to be an effective aerodynamic measure to improve the flutter stability, and this article optimizes the stabilizer to improve its applicability in mountainous areas. Computational fluid dynamics simulations are first performed to analyze the effects of stabilizers with different positions and forms on the flutter stability of an ideal box girder, and the aerodynamic mechanism is discussed based on the static and the dynamic flow fields, respectively. Wind tunnel tests are then carried out to test the critical flutter wind speed of a real box girder equipped with different stabilizers, and the change in its flutter stability is further analyzed. The results show that the vertical stabilizer with appropriate positions and heights can improve the participation level of structural heaving vibration, and thereby increases the flutter stability. At large angles of attack, the big vortex on the leading edge which may drive the bridge to flutter instability is gradually weakened with the increase in stabilizer’s height. Compared with a single stabilizer, double vertical stabilizers, in the midst of which exists a negative pressure region, could achieve better effects.
An Ecology of Transformative Learning: A Shift From the Ego to the Eco
Authors: Bainbridge Alan , Del Negro Gaia
Published: August 2019

This article argues that the phenomenon of a genetic/cultural “adaptive-lag” is both the motive for the human predisposition to engage in transformative learning and the origin of anxiety and associated ego-defences that mitigate against the likelihood of transforming epistemic assumptions. Dodds’ (2011) ecopsychoanalytic interpretation of Winnicott’s concept of a holding environment provides the conditions to reduce the impact of ego-defences by containing anxiety and therefore supporting the transformation of epistemic assumptions. Such holding environments are conceived to extend from intimate familial and social relationships to include wider ecological interconnectedness. Narratives, literature, and evidence from clinical psychedelic drug studies highlight how an increased sensitivity towards the natural nonhuman world diminishes ego-defences, enhancing the possibility for transformative learning. The implications for educational settings are that complex and difficult learning should not be ameliorated and that conditions enabling learners to recognize and manage their own anxieties will enhance epistemic transformation.
An Application of Two-Eyed Seeing to Community-Engaged Research With Indigenous Mothers
Authors: Wright A. L. , Gabel C. , Bomberry R. , Wahoush O.
Published: August 2019

The Two-Eyed Seeing framework advocates viewing the world with one eye grounded in Indigenous knowledges while the other eye is grounded in Westernized knowledges. Research funding bodies have recently advocated for its use in research with Indigenous peoples, yet its interpretation and application in the literature has been inconsistent. To contribute to its maturation as a framework, this article describes the application of Two-Eyed Seeing to a community-engaged study aimed at understanding how Indigenous mothers experience using health care to meet the health needs of their infants in Hamilton, Ontario, Canada. Two-Eyed Seeing was applied to the research while applying the four R’s as suggested by Kirkness and Barnhardt’s: relevance, respect, responsibility, and reciprocity. While providing practical applications of this framework to research with Indigenous mothers and infants in an urban off-reserve setting, this article also contributes an approach to data analysis that incorporates Indigenous and Western knowledges within interpretive description methodology.
A novel deep capsule neural network for remaining useful life estimation
Authors: Ruiz-Tagle Palazuelos Andrés , Droguett Enrique López , Pascual Rodrigo
Published: August 2019

With the availability of cheaper multi-sensor systems, one has access to massive and multi-dimensional sensor data for fault diagnostics and prognostics. However, from a time, engineering and computational perspective, it is often cost prohibitive to manually extract useful features and to label all the data. To address these challenges, deep learning techniques have been used in the recent years. Within these, convolutional neural networks have shown remarkable performance in fault diagnostics and prognostics. However, this model present limitations from a prognostics and health management perspective: to improve its feature extraction generalization capabilities and reduce computation time, ill-based pooling operations are employed, which require sub-sampling of the data, thus loosing potentially valuable information regarding an asset’s degradation process. Capsule neural networks have been recently proposed to address these problems with strong results in computer vision–related classification tasks. This has motivated us to extend capsule neural networks for fault prognostics and, in particular, remaining useful life estimation. The proposed model, architecture and algorithm are tested and compared to other state-of-the art deep learning models on the benchmark Commercial Modular Aero Propulsion System Simulation turbofans data set. The results indicate that the proposed capsule neural networks are a promising approach for remaining useful life prognostics from multi-dimensional sensor data.
Budget Impact of Improved Diabetes Management by Utilization of Glucose Meters With a Color-Range Indicator—Comparison of Five European Healthcare Systems
Authors: Fritzen Katharina , Basinska Kornelia , Stautner Constantin , Braun Karl F. , Rubio-Almanza Matilde , Nicolucci Antonio , Kennon Brian , Vergès Bruno , Hosny Yasser , Schnell Oliver
Published: August 2019

Background and Aim:

Costs for the treatment of diabetes and its comorbidities are a major international issue. A recent randomized clinical trial showed that the introduction of color range indicator (CRI)-based glucose meters (GMs) positively affects the HbA1c of patients with type 1 and type 2 diabetes, when compared to GMs without a CRI. This budget impact analysis aimed to translate this beneficial effect of CRI-based GMs, OneTouch Verio Flex and OneTouch Verio, into potential monetary impact for the healthcare systems of five European countries, Germany, Spain, Italy, France, and the United Kingdom.

Material and Methods:

Data from a randomized controlled trial, evaluating the effect of CRI-based GMs, were used to estimate the ten-year risk of patients for fatal myocardial infarction (MI) as calculated by the UK Prospective Diabetes Study (UKPDS) risk engine. On the basis of assessed risks for MI, the potential monetary impact for the healthcare systems in five European countries was modeled.

Results:

Based on a mean HbA1c reduction of 0.36%, as demonstrated in a randomized controlled trial, the UKPDS risk engine estimated a reduction of 2.4% of the ten-year risk of patients for fatal MI. When applied to our economic model, substantial potential cost savings for the healthcare systems of five European countries were calculated: €547 472 (France), €9.0 million (Germany), €6.0 million (Italy), €841 799 (Spain), and €421 069 (United Kingdom) per year.

Conclusion:

Improving metabolic control in patients with diabetes by the utilization of CRI-based GMs may have substantial positive effects on the expenditure of the healthcare systems of several European countries.
Bhoodān-based Land Acquisition (BhaLĀi): Creating Stakeholder Bhalai, Spiritually
Authors: Mohapatra Siddharth , Verma Pratima
Published: August 2019

Land acquisition for commercial purposes in India is mainly a top-down approach that employs instrumental means like fair market valuations. Market forces play a major role in the land transfer process. On many instances, these have led to sustainability challenges, poor stakeholder management, sustainability challenges and subpar business performance. Land since time immemorial has spiritual bearings in India. There have been numerous occasions in the past when land-related sustainability challenges were resolved through spiritual means—most notably the Bhoodān movement. This article is an attempt to offer a bottom-up and socioculturally aligned spiritual means to facilitate land acquisition based on voluntary land transfers. In particular, we conceptualize Bhoodān-based land acquisition ( BhaLĀi) which can facilitate voluntary land transfer, creating stakeholder bhalai (well-being in Hindi), spiritually. Implications for research and practice in this regard have been discussed.
Driving Audit Committee Disclosure: Legislation Versus Best Practice
Authors: Coetzee Philna , Erasmus Lourens J.
Published: August 2019

Stakeholders have no alternative than to rely on the credibility and effectiveness of governance and oversight structures within organizations, to protect their interest. This study investigates whether the expectation for expanded disclosure on audit committees has been adopted as part of organizational culture. The evolution of audit committee guidance in the King reports and prominent global reports were analyzed and compared to legislation governing all sectors within South Africa. A document analysis in the form of a structured content analysis was conducted to determine adherence to King guidance by South African organizations. Optimal scaling was applied to determine dimensions of disclosure, with respect to audit committee best practice. Finally, the level of adherence to legislation versus adherence to best practices is gauged within each dimension. Results support organizations to have generally increased disclosure on audit committees’ composition and role. The study adds to the body of knowledge on voluntary disclosure of audit committee best practice, to be considered by policy makers and management, on what may strengthen the credibility and effectiveness of audit committee oversight as perceived by the stakeholder. The result also presents a foundation for further research within this area.
Comparative Analysis of two Methods of Measuring Antiretroviral Therapy Adherence in HIV-Infected Omani Patients
Authors: Gaifer Zied , Boulassel Mohamed-Rachid
Published: August 2019

Background:

Antiretroviral therapy (ART) adherence is crucial to achieve HIV suppression and to prolong survival of HIV-infected patients. Although monitoring of ART adherence is standard of HIV care, there is yet no optimal method to measure ART adherence. Therefore, it is essential to compare the effectiveness of different adherence measurement tools to predict HIV suppression.

Methods:

In this study, we measured ART adherence using pharmacy refill prescription and self-reported adherence questionnaire. Both the methods were compared for predicting HIV suppression in adult Omani HIV-infected patients attending the outpatient clinics at Sultan Qaboos University Hospital.

Results:

A total of 141 HIV-infected patients were included. The pharmacy refill–based measure showed a median adherence rate of 98.90% (interquartile range [IQR]: 86%-99.45%). The self-report adherence questionnaire revealed a median adherence rate of 100% (IQR: 75-100). A significant positive correlation was found between the adherence rates measured by the 2 methods ( r = 0.32, P = .01). The pharmacy refill and self-report questionnaire adherence measures were both negatively correlated with plasma HIV RNA levels ( r = −0.20, P = .01 and r = −0.26, P = .04, respectively).

Conclusion:

Collectively, these findings suggest that pharmacy refill measure could serve as a valid and practical tool of ART adherence in routine clinical practice.
Is Fever a Red Flag for Bacterial Pneumonia in Children With Viral Bronchiolitis?
Authors: Elmore Dominique , Yaslam Balfaqih , Putty Krista , Magrane Thomas , Abadir Anthony , Bhatt Saloni , Frazier Marie , Flesher Susan
Published: August 2019

We hypothesized that fever in children with viral bronchiolitis indicates the need for consideration of superimposed bacterial pneumonia. We conducted a retrospective study of 349 children aged 2 years and younger with diagnoses of respiratory syncytial virus (RSV) and viral upper respiratory infection. Data were analyzed using Pearson χ2 test. One hundred seventy-eight children had RSV with no other identified virus. The majority of children (56%) who had only RSV were afebrile. Febrile children with RSV were over twice as likely to be diagnosed with bacterial pneumonia as those who were afebrile (60% vs 27%, P < .001). In the 171 children who had bronchiolitis caused by a virus other than RSV, 51% were afebrile. These children were 8 times more likely to be diagnosed with pneumonia than those who were afebrile (65% vs 8%, P < .001). Evaluation of febrile children with viral bronchiolitis may allow early diagnosis and treatment of secondary bacterial pneumonia.
Using Household Socioeconomic Indicators to Predict the Utilization of Maternal and Child Health Services Among Reproductive-Aged Women in Rural Yemen
Authors: Alosaimi Abdullah Nagi , Nwaru Bright , Luoto Riitta , Al Serouri Abdul Wahed , Mouniri Halima
Published: August 2019

Using principal component analysis (PCA) and integrating both individual and household factors, we had previously derived and proposed 3 socioeconomic indices (namely, wealth index, educational index, and housing quality index) that can be used to classify rural Yemeni women into different socioeconomic statuses (SES). In the current article, we examined whether the PCA-derived indices can be used to predict the use of maternal and child health care services in rural Yemen. We used data from subnational representative multistage sampling cross-sectional household survey conducted in rural Yemen in 2008-2009 among women (N = 6907) who had given birth. The resulting component scores for each SES index were divided into tertiles. Logistic regression was used to study the associations between the SES indices and 4 indicators of maternal health care use. Higher tertiles of each socioeconomic index increased the likelihood of adequate antenatal care use, delivery assistance, and contraceptive use, but decreased the likelihood of unmet need for contraception. Key maternal health indicators can be determined by socioeconomic indicators. Therefore, in planning maternal and child health interventions, considering disparities of care by socioeconomic factors should be taken into account.
Infrastructures of conservation: Provoking new natures with predator fencing
Authors: Hawkins Gay , Paxton Gillian
Published: August 2019

This paper examines the use of predator fences for conservation in Australia. It argues that these major infrastructures for enclosure act as a form of ‘provocative containment’ in which particular forms of nature are not simply protected but made to happen. The primary focus is Newhaven, a property in remote central Australia managed by the Australian Wildlife Conservancy, a non-profit organization with the biggest estate of privately managed land for conservation in the nation. At Newhaven, the first stage of an ambitious and expensive predator fencing programme has recently been completed, with a second phase under construction that will see the property become the site of the largest feral cat-free enclosure on the planet. In analysing this significant material infrastructure, and the practices and discourses that the Australian Wildlife Conservancy deploys to both justify and attract funding for it, it is possible to see a new conceptualization of conservation emerging in which nature is not simply offered sanctuary but actively stimulated and simulated. The Newhaven fence is much more than a passive material boundary between desired and undesired life. It is a reality-generating device with complex and contradictory biopolitical effects. The concept of provocation highlights how the fence emerges as a deliberate intervention into the dynamics of life. We examine how this is done in four distinct ways: through the sociotechnical design and construction of the fence as ‘cat-proof’, by enrolling Indigenous labour and tracking skills to kill cats, through the use of ecological surveys and baselines to make some life calculable, and via the translocation of species in order to allow them to be both protected and flourish. Each of these practices is essential to making new natures at Newhaven through the complex dynamics of provocation and containment. The issue is: what sort of nature?
Nix-mediated mitophagy regulates platelet activation and life span
Authors: Zhang Weilin , Ma Qi , Siraj Sami , Ney Paul A. , Liu Junling , Liao Xudong , Yuan Yefeng , Li Wei , Liu Lei , Chen Quan
Published: August 2019

Platelet activation requires fully functional mitochondria, which provide a vital energy source and control the life span of platelets. Previous reports have shown that both general autophagy and selective mitophagy are critical for platelet function. However, the underlying mechanisms remain incompletely understood. Here, we show that Nix, a previously characterized mitophagy receptor that plays a role in red blood cell maturation, also mediates mitophagy in platelets. Genetic ablation of Nix impairs mitochondrial quality, platelet activation, and FeCl3-induced carotid arterial thrombosis without affecting the expression of platelet glycoproteins (GPs) such as GPIb, GPVI, and αIIbβ3. Metabolic analysis revealed decreased mitochondrial membrane potential, enhanced mitochondrial reactive oxygen species level, diminished oxygen consumption rate, and compromised adenosine triphosphate production in Nix−/− platelets. Transplantation of wild-type (WT) bone marrow cells or transfusion of WT platelets into Nix-deficient mice rescued defects in platelet function and thrombosis, suggesting a platelet-autonomous role (acting on platelets, but not other cells) of Nix in platelet activation. Interestingly, loss of Nix increases the life span of platelets in vivo, likely through preventing autophagic degradation of the mitochondrial protein Bcl-xL. Collectively, our findings reveal a novel mechanistic link between Nix-mediated mitophagy, platelet life span, and platelet physiopathology. Our work suggests that targeting platelet mitophagy Nix might provide new antithrombotic strategies.
Phase II California Cancer Consortium Trial of Gemcitabine-Eribulin Combination in Cisplatin-Ineligible Patients With Metastatic Urothelial Carcinoma: Final Report (NCI-9653)
Authors: Sadeghi Sarmad , Groshen Susan G. , Tsao-Wei Denice D. , Parikh Rahul , Mortazavi Amir , Dorff Tanya B. , Kefauver Cheryl , Hoimes Christopher , Doyle Laurence , Quinn David I. , Newman Edward , Lara Jr Primo N.
Published: August 2019

PURPOSE

Patients with metastatic urothelial carcinoma are often ineligible for cisplatin-based treatments. A National Cancer Institute Cancer Therapy Evaluation Program–sponsored trial assessed the tolerability and efficacy of a gemcitabine-eribulin combination in this population.

METHODS

Patients with treatment-naïve advanced or recurrent metastatic urothelial carcinoma of the bladder, ureter, or urethra not amenable to curative surgery and not candidates for cisplatin-based therapy were eligible. Cisplatin ineligibility was defined as creatinine clearance less than 60 mL/min (but ≥ 30 mL/min), grade 2 neuropathy, or grade 2 hearing loss. Treatment was gemcitabine 1,000 mg/m2 intravenously followed by eribulin 1.4 mg/m2, both on days 1 and 8, repeated in 21-day cycles until progression or unacceptable toxicity. A Simon two-stage phase II trial design was used to distinguish between Response Evaluation Criteria in Solid Tumors, version 1.1 objective response rates of 20% versus 50%.

RESULTS

Between June 2015 and March 2017, 24 eligible patients with a median age of 73 years (range, 62 to 88 years) underwent therapy. Performance status of 0, 1, or 2 was seen in 11, 11, and two patients, respectively. Sites of disease included: lymph nodes, 16; lungs, nine; liver, seven; bladder, five; bones, two. Median number of cycles received was four (range, one to 16). Of 24 patients, 12 were confirmed responders; the observed objective response rate was 50% (95% CI, 29% to 71%). Median overall survival was 11.9 months (95% CI, 5.6 to 20.4 months), and median progression-free survival was 5.3 months (95% CI, 4.5 to 6.7 months). The most common treatment-related any-grade toxicities were fatigue (83% of patients), neutropenia (79%), anemia (63%), alopecia (50%), elevated AST (50%), and constipation, nausea, and thrombocytopenia (42% each).

CONCLUSION

Gemcitabine-eribulin treatment response and survival for cisplatin-ineligible patients compare favorably to other regimens. Additional research is needed.
The GH Axis in Relation to Accepting an Early Macronutrient Deficit and Outcome of Critically Ill Patients
Authors: Van Dyck Lisa , Derese Inge , Vander Perre Sarah , Wouters Pieter J , Casaer Michaël P , Hermans Greet , Van den Berghe Greet , Vanhorebeek Ilse
Published: August 2019

Context

Changes in the GH axis during critical illness resemble fasting in healthy adults and contribute to hypercatabolism, which potentially affects outcome. Accepting macronutrient deficits by withholding parenteral nutrition (PN) during the first week in the intensive care unit (ICU; late PN) reduced complications and accelerated recovery as compared with early use of PN (early PN).

Objective

To investigate how late PN affects the GH axis in relation to its clinical outcome benefits.

Design

Preplanned subanalysis of the Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients randomized controlled trial.

Participants

A total of 1128 patients for time-course study, 20 patients investigated for nocturnal GH pulsatility, and 600 patients investigated for muscle weakness, with early PN and late PN patients having comparable baseline characteristics.

Intervention

Withholding PN during the first ICU week (late PN) vs early PN.

Main Outcome Measures

Changes in serum GH, IGF-I, IGF-binding protein (IGFBP) 3, and IGFBP1 concentrations from ICU admission to day 4 or last ICU day for patients with a shorter ICU stay (d4/LD) and association in multivariable analyses with likelihood of earlier live ICU discharge, risk of new infection, and muscle weakness.

Results

Late PN attenuated a rise in serum GH and IGF-I (P < 0.0001), did not affect IGFBP3, and attenuated a decrease in IGFBP1 concentrations from admission to d4/LD (P < 0.0001) as compared with early PN. Late PN decreased nonpulsatile (P = 0.005), but not pulsatile, GH secretion. Adjusting the multivariable models for the observed GH axis alterations increased the independent benefit of late PN for all outcomes. GH axis alterations induced by late PN were independently associated with adverse outcomes (P ≤ 0.03).

Conclusion

Accepting macronutrient deficits early during critical illness further suppressed the GH axis, which statistically attenuated its clinical outcome benefits.
Age-Specific Serum Total and Free Estradiol Concentrations in Healthy Men in US Nationally Representative Samples
Authors: Chadid Susan , Barber John R , Rohrmann Sabine , Nelson William G , Yager James D , Kanarek Norma F , Bradwin Gary , Dobs Adrian S , McGlynn Katherine A , Platz Elizabeth A
Published: August 2019

Purpose

To report age-specific serum estradiol concentration in nonsmoking, lean US men without comorbidities. We provide concentrations from 30 and 15 to 20 years ago given previously described declines in serum estradiol in US men over time.

Methods

We used data from the Third National Health and Nutrition Examination Survey (NHANES III; 1988 to 1991) and continuous NHANES (1999 to 2004). Serum estradiol and SHBG were previously measured by competitive electrochemiluminescence immunoassays. Free estradiol was estimated from estradiol, SHBG, and albumin. By age, we calculated median concentrations overall and for nonsmoking, lean (body mass index <25 kg/m2 and waist <102 cm) men without diabetes, cardiovascular disease, or cancer.

Results

Overall, respective total estradiol medians for men ages 20 to 39, 40 to 59, and ≥60 years old were 37.0, 33.9, and 33.5 pg/mL in NHANES III and 31.3, 30.5, and 27.0 pg/mL in continuous NHANES. In nonsmoking, lean men without comorbidities, respective total estradiol medians were 32.0, 32.1, and 32.0 pg/mL in NHANES III and 29.1, 22.7, and 26.1 pg/mL in continuous NHANES. Overall, respective free estradiol medians were 0.82, 0.72, and 0.64 pg/mL in NHANES III and 0.67, 0.61, and 0.47 pg/mL in continuous NHANES. In nonsmoking, lean men without comorbidities, respective free estradiol medians were 0.64, 0.67, and 0.62 pg/mL in NHANES III and 0.58, 0.42, and 0.40 pg/mL continuous NHANES.

Conclusion

We report US nationally representative serum estradiol concentrations in healthy men, which could be used for targeting estradiol during testosterone supplementation and for general good health.
Altering integrin engagement regulates membrane localization of Kir2.1 channels
Authors: Sengupta Swarnali , Rothenberg Katheryn E. , Li Hanjun , Hoffman Brenton D. , Bursac Nenad
Published: August 2019

How ion channels localize and distribute on the cell membrane remains incompletely understood. We show that interventions that vary cell adhesion proteins and cell size also affect the membrane current density of inward-rectifier K+ channels (Kir2.1; encoded by KCNJ2) and profoundly alter the action potential shape of excitable cells. By using micropatterning to manipulate the localization and size of focal adhesions (FAs) in single HEK293 cells engineered to stably express Kir2.1 channels or in neonatal rat cardiomyocytes, we establish a robust linear correlation between FA coverage and the amplitude of Kir2.1 current at both the local and whole-cell levels. Confocal microscopy showed that Kir2.1 channels accumulate in membrane proximal to FAs. Selective pharmacological inhibition of key mediators of protein trafficking and the spatially dependent alterations in the dynamics of Kir2.1 fluorescent recovery after photobleaching revealed that the Kir2.1 channels are transported to the cell membrane uniformly, but are preferentially internalized by endocytosis at sites that are distal from FAs. Based on these results, we propose adhesion-regulated membrane localization of ion channels as a fundamental mechanism of controlling cellular electrophysiology via mechanochemical signals, independent of the direct ion channel mechanogating.
TCF3 mutually exclusive alternative splicing is controlled by long-range cooperative actions between hnRNPH1 and PTBP1
Authors: Yamazaki Takashi , Liu Lizhi , Manley James L.
Published: August 2019

TCF3, also known as E2A, is a well-studied transcription factor that plays an important role in stem cell maintenance and hematopoietic development. The TCF3 gene encodes two related proteins, E12 and E47, which arise from mutually exclusive alternative splicing (MEAS). Since these two proteins have different DNA binding and dimerization domains, this AS event must be strictly regulated to ensure proper isoform ratios. Previously, we found that heterogeneous nuclear ribonucleoprotein (hnRNP) H1/F regulates TCF3 AS by binding to exonic splicing silencers (ESSs) in exon 18b. Here, we identify conserved intronic splicing silencers (ISSs) located between, and far from, the two mutually exclusive exons, and show that they are essential for MEAS. Further, we demonstrate that the hnRNP PTBP1 binds the ISS and is a regulator of TCF3 AS. We also demonstrate that hnRNP H1 and PTBP1 regulate TCF3 AS reciprocally, and that position-dependent interactions between these factors are essential for proper TCF3 MEAS. Our study provides a new model in which MEAS is regulated by cooperative actions of distinct hnRNPs bound to ISSs and ESSs.
Intensity modulated radiotherapy in combination with endocrinotherapy in the treatment of middle and advanced Prostatic Cancer
Authors: Zhang Sumei , Zhao Shufen , Fu Xinzhen
Published: August 2019

Objective: To evaluate the clinical efficacy of intensity modulated radiation therapy and endocrinotherapy for middle and advanced prostate cancer.

Methods: Total 104 elderly patients with middle and advanced prostate cancer who were admitted to our hospital from November 2014 to August 2015 were selected using random number table method. They were divided into intensity-modulated radiotherapy combined with endocrinotherapy group (observation group) and conventional radiotherapy combined with endocrinotherapy group (control group), 52 each. The serum levels of prostate specific antigen (PSA) and free prostate antigen (f PSA) were measured three months after treatment. The short-term efficacy and toxic and side effects of the patients were observed, and the survival rate was recorded through three-year follow up.

Results: The clinical effective rate of the observation group was 92.68%, and that of the control group was 70.73%; there was a significant difference between the two groups (P<0.05). The serum PSA and f PSA levels of the two groups were similar before treatment, but there was no significant difference (P>0.05). The serum PSA and f PSA levels after treatment were significantly lower than before treatment. The incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05). The one-year and three-year survival rates of the two groups were significantly different (90.0 vs. 80.0%, 60.0 vs. 43.3%, P>0.05).

Conclusion: Intensity modulated radiotherapy combined with endocrinotherapy was safe and well tolerated in the treatment of middle and advanced prostate cancer. It can improve the short-term efficacy and effectively reduce the serum oncological index concentration of patients. It can be promoted in clinics.

doi: https://doi.org/10.12669/pjms.35.5.591

How to cite this:Zhang S, Zhao S, Fu X. Intensity modulated radiotherapy in combination with endocrinotherapy in the treatment of middle and advanced Prostatic Cancer. Pak J Med Sci. 2019;35(5):1264-1269. doi: https://doi.org/10.12669/pjms.35.5.591

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Study on the correlation parameters of Class II malocclusion in child tooth dentition early stage by using 3D technique
Authors: Xiong Peiying , Sui Wen , He Wendan , Lei Qiaoling , Gao Wenli
Published: August 2019

Objective: To record the dentition, jaw and facial growth and development of children with class II malocclusion at the age of 7-8 years old in the early dental transitional stage with 3D technology and to provide the study basis for the growth and development parameters of normal children and children with class II malocclusion.

Methods: Twenty-four children who were suffering class-II malocclusion in the early dental transitional stage and received treatment between July 2016 and July 2017 in our hospital were selected as the study group, and 20 healthy children were selected as the control group in the same period. SIRONA CEREC dentition scanning, 3D reconstruction of the lower mandible and 3d MD face scanning were performed on the children. Relevant data were recorded and compared.

Results: The dentition scanning results suggested that the study group had significantly larger anterior overbite and anterior overjet and smaller width of the upper arch than the control group; there was a significant difference between the two groups (P<0.05). The 3D reconstruction of the lower mandible suggested that the study group had smaller Go angle and SNB angle and shorter ANS-Me distance, Go-Me distance and N-Me distance compared to the control group; the differences had statistical significance (P<0.05). The face scanning results demonstrated that the nasolabial angle and facial convexity angle of the study group were significantly larger than those in the control group, and the difference was statistically significant (P<0.05).

Conclusion: The dentition scanning results suggested that the study group had significantly larger anterior overbite and anterior overjet and smaller width of the upper arch than the control group; there was a significant difference between the two groups (P<0.05). The 3D reconstruction of the lower mandible suggested that the study group had smaller Go angle and SNB angle and shorter ANS-Me distance, Go-Me distance and N-Me distance compared to the control group; the differences had statistical significance (P<0.05). The face scanning results demonstrated that the nasolabial angle and facial convexity angle of the study group were significantly larger than those in the control group, and the difference was statistically significant (P<0.05).

doi: https://doi.org/10.12669/pjms.35.5.592

How to cite this:Xiong P, Sui W, He W, Lei Q, Gao W. Study on the correlation parameters of Class II malocclusion in child tooth dentition early stage by using 3D technique. Pak J Med Sci. 2019;35(5):1290-1294. doi: https://doi.org/10.12669/pjms.35.5.592

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Social engagement after stroke – is it relevant to cognitive function? A cross-sectional analysis of UK Biobank data
Authors: Drozdowska Bogna A. , Celis-Morales Carlos A. , Lyall Donald M. , Quinn Terence J.
Published: August 2019

Background:Findings from studies in older adult populations suggest that measures of social engagement may be associated with health outcomes, including cognitive function. Plausibly the magnitude and direction of this association may differ in stroke.  The disabling nature of stroke increases the likelihood of social isolation and stroke survivors are at high risk of cognitive decline. We assessed the association between social engagement and cognitive function in a sample of stroke survivors.

Methods:We included available data from stroke survivors in the UK Biobank (N=8776; age range: 40-72; 57.4% male). In a series of regression models, we assessed cross-sectional associations between proxies of social engagement (frequency of family/friend visits, satisfaction with relationships, loneliness, opportunities to confide in someone, participation in social activities) and performance on domain specific cognitive tasks: reaction time, verbal-numerical reasoning, visual memory and prospective memory. We adjusted for demographics, health-, lifestyle-, and stroke-related factors. Accounting for multiple testing, we set our significance threshold at p<0.003.

Results:After adjusting for covariates, we found independent associations between faster reaction times and monthly family visits as compared to no visit (standardised beta=-0.32, 99.7% CI: -0.61 to -0.03, N=4,930); slower reaction times and religious group participation (standardised beta=0.25, 99.7% CI 0.07 to 0.44, N=4,938); and poorer performance on both verbal-numerical reasoning and prospective memory tasks with loneliness (standardised beta=-0.19, 99.7% CI: -0.34 to -0.03, N=2,074; odds ratio=0.66, 99.7% CI: 0.46 to 0.94, N=2,188; respectively). In models where all proxies of social engagement were combined, no associations remained significant.

Conclusions:We found limited task-specific associations between cognitive performance and proxies of social engagement, with only loneliness related to two tasks. Further studies are necessary to confirm and improve our understanding of these relationships and investigate the potential to target psychosocial factors to support cognitive function in stroke survivors.
Differential pricing of medicines to improve access to medicines for hypertension and diabetes control in Ghana: The Ghana Access and Affordability Program, a multi-center prospective trial
Authors: Sarfo Fred Stephen , Mobula Linda M. , Arthur Lynda , Plange-Rhule Jacob , Burnham Gilbert , Sablah Jasper , Gavor Edith , Ansong Daniel , Sarfo-Kantanka Osei , Adu Gyamfi Rexford , Duah James , Abraham Bertha , Ofori-Adjei David
Published: August 2019

Background: Access to medicines for hypertension and diabetes mellitus (DM) management is challenging in resource-limited countries. We sought to assess whether differential pricing of medicines based on socio-economic status would improve affordability of antihypertensive and anti-diabetic medications. A quasi-experimental, prospective cohort study was implemented at five Ghanaian health facilities, using medicines differentially priced by three pharmaceutical companies.

Methods: Adult patients ≥18 years with hypertension or DM were enrolled and assigned to a lower tiered differential price (DP arm) or market price (MP arm) based on minimum wage earning or a score >6/18 on a multi-dimensional poverty index scale. Study medicines were purchased at either the DP or MP when prescribed. Participants were followed for 18 months to assess blood pressure (BP) and glycemic control. Predictors of ability to purchase study medicines were assessed using parsimonious logistic regression models.

Results: 3,296 participants were enrolled with mean age of 57±12.7 years, 76.6% females. 1,869 (56.7%) had hypertension, 422 (12.8%) had DM, and 1,005 (30.5%) with both hypertension and DM. Average follow-up was 14 months. There were prescriptions of study medications for 526 participants of which 238 (45.2%) were able to make purchases at DP 60.9% versus MP 39.1%. Independent predictors of purchasing ability were higher income, MP arm, willingness to purchase additional medicines, and being at tertiary level institution.

Conclusions: Approximately 45% of Ghanaians could afford prescribed study medicines provided at a differential pricing mechanism albeit at an unsustainable basis. Further price reductions are expected to enhance access to medicines for hypertension and DM control.
Prediction of mosquito species and population age structure using mid-infrared spectroscopy and supervised machine learning
Authors: González Jiménez Mario , Babayan Simon A. , Khazaeli Pegah , Doyle Margaret , Walton Finlay , Reedy Elliott , Glew Thomas , Viana Mafalda , Ranford-Cartwright Lisa , Niang Abdoulaye , Siria Doreen J. , Okumu Fredros O. , Diabaté Abdoulaye , Ferguson Heather M. , Baldini Francesco , Wynne Klaas
Published: August 2019

Despite the global efforts made in the fight against malaria, the disease is resurging. One of the main causes is the resistance that Anopheles mosquitoes, vectors of the disease, have developed to insecticides. Anopheles must survive for at least 10 days to possibly transmit malaria. Therefore, to evaluate and improve malaria vector control interventions, it is imperative to monitor and accurately estimate the age distribution of mosquito populations as well as their population sizes. Here, we demonstrate a machine-learning based approach that uses mid-infrared spectra of mosquitoes to characterise simultaneously both age and species identity of females of the African malaria vector species Anopheles gambiae and An. arabiensis, using laboratory colonies. Mid-infrared spectroscopy-based prediction of mosquito age structures was statistically indistinguishable from true modelled distributions. The accuracy of classifying mosquitoes by species was 82.6%. The method has a negligible cost per mosquito, does not require highly trained personnel, is rapid, and so can be easily applied in both laboratory and field settings. Our results indicate this method is a promising alternative to current mosquito species and age-grading approaches, with further improvements to accuracy and expansion for use with wild mosquito vectors possible through collection of larger mid-infrared spectroscopy data sets.
Regulationist Measures: Prostitution and Politics in the State of Mysore
Authors: Raj Jamuna
Published: August 2019

The paper explores official policies towards Prostitution and the spread of Venereal Diseases in the Cantonment and Mysore Provinces. A medico-military discourse emerged in the Cantonment with the spread of Sexually Transmitted Diseases among white troopers. Transgressive sex was tolerated despite prostitutes being considered a receptacle of diseases. In not recognizing the dynamics of disease transmission, regulatory measures and race, sex, and class-bias blatantly vilified prostitutes. Though civilian spaces in the State of Karnataka were not as complex, regulations were enforced in tandem with the Cantonment during the colonial rule. Consequently, after the independence, the State’s measures were coincidental with the social purity movement’s censure of Devadasis.
India’s Agni Missile Systems: Strengthening India’s Nuclear Deterrence
Authors: Ghoshal Debalina
Published: August 2019

Over the years, India has been able to acquire a credible minimum nuclear deterrence. In this, the Agni missile system is integral to India‟s counter second-strike capability especially against China. The Agni category missiles are solid propelled ballistic missiles, ranging from short range missiles to intermediate range missiles (700-5000kms) with road and rail mobility providing greater chances of survivability during an enemy attack. This strengthens its scope of launching a counter/second strike. This makes India one of the few countries in the world with the ability to potentially decapitate its enemy by preserving its arsenal in the first attack from the enemy. This article provides a deep analysis of India‟s Agni missile systems.
Celebrity Endorsement as an Effective Tool for Destination Marketing among Occupation Groups in Bangalore
Authors: Mary Jolly Rosma , Mary Jolly Rosma , L Mynavathi
Published: August 2019

Celebrity  Endorsement  is  one  of  the  major  forms  of advertising in which a business organization makes use of famous individuals or well-known organizations in order to boost consumer interest in the product and/or services that  they  want  to  sell.  Now  a  day, every  company  is trying to bring in a brand ambassador for their brands. Slowly the trend of tying up with a celebrity in promoting has moved towards promoting tourism destinations. This paper tries to find out the effect of celebrity endorsement as an effective marketing destination tool. The  objectives  framed  to  reach  to  this  goal  were  to identify  whether  the  consumers  consider the  tourism advertisements  that  are  endorsed  by  celebrities and  to determine whether the use of celebrities have a greater effect than the use of non-celebrities when advertising a tourist  destination. Data  was  collected  from  250 respondents  from  Bangalore  through  a  questionnaire. Some of the tools that are been used to test the hypothesis are one sample t- test, ANOVA and Tukey test. The  major  findings  from  the  study  were  that  the respondents only get brand recognition and recall of the destination when the advertisement is done by a celebrity endorser; it was found that non-celebrity advertisements are more convincing and better choice makers. It was also found out that occupation of the consumers would have no impact in getting attracted to celebrity endorsers but students  were  one  category  that  loved  to  see  celebrity endorsers on screen.
Visa Policies and Visa Openness Scores in SADC – An Exclusion Element of Tourism Development in Southern Africa: A Critical Interjection
Authors: Woyo Erisher
Published: August 2019

The objective of this paper is to critically show how visa policies in Southern Africa affect tourism development. The paper adopted a regional perspective on the dynamics of visa policies affect tourist flows. This article also discusses the implications of visa policies on tourist arrivals. Government efforts in influencing the change in visa policies are also discussed in this paper. The study identified three main reasons why visa policies are pursued; namely, border security; minimising illegal immigration and reciprocity. The paper concludes that, while visa policies may help tourist destination within the region with revenue, they have a more deterring effect as it affects destination choice and visa openness scores, thus affecting tourism development.
Community-Based Waste Management: Backwater Tourism as a Case Example
Authors: K Joseph Emilda , K Kallarackal Tomy , Varghese Bindi
Published: August 2019

A healthy environment is essential for the growth of Tourism industry. The future of tourism is inevitably related to the environment. As important natural resources, backwaters should be preserved in a sustainable manner. SWM emerged as an essential for keeping tourist destination clean and livable. This paper analyses the community-based waste management process in one of the famous backwater tourist destinations of Kerala and explains the roles and activities of all stakeholders and their relationship at the community level.
A Neglected Dimension of Medical Tourism Destination Impacts: A Synthesis of Observations and Convictions
Authors: Joseph Sindhu
Published: August 2019

Medical tourism based on transnational journeys for health care, cure, and well-being is being widely discussed in the literature. As a fast-developing phenomenon, there are different views and perspectives on the concerns of medical tourists and various impacts created in destination areas. This paper critically observes the exertions of medical tourism on destination areas in the light of economic and socio-cultural influences. This paper tries to bring out the muddles of the phenomenon based on empirical research. The paper suggests that the socio-cultural impact of medical tourism on the health care of the poor local people must be viewed seriously and calls for rigid and efficient legislation from the authorities to enable and strengthen the public healthcare system.