bluuebunny/crossref_metadata_2025 huggingface dataset:
The Economic Stress Model in Emerging Adulthood: The Role of Social Relationships and Financial Capability
Authors: Ranta Mette , Punamäki Raija-Leena , Chow Angela , Salmela-Aro Katariina
Published: December 2019

Families mobilize psychosocial resources to attune negative consequences of economic hardship, but research is lacking among youth. We propose an Economic Stress Model in Emerging Adulthood ( ESM-EA) conceptualizing age-salient social relationships and financial capability as mediators between economic hardship and well-being. The ESM-EA was tested in a three-wave prospective study following the 2008 economic recession, as part of the Finnish Educational Transitions studies. The sample consisted of 551 emerging adults (55.5% female) who participated at ages 23, 25, and 28. Economic pressures and financial capability mediated the effect of economic hardship on well-being, whereas social relationships did not. Individuals with an unfavorable financial situation at age 25 were more likely to show lower life satisfaction and higher depressive symptoms at 28 when they reported a higher level of economic pressures and a lower level of financial capability. Findings emphasize emerging adults’ age-salient financial adjustments and management in enhancing well-being.
Financial Reforms, Capital Investment and Financial Intermediation in China
Authors: Ibhagui Oyakhilome
Published: December 2019

China has witnessed remarkable changes in its capital investment and financial system since initiating economic and financial sector reforms more than three decades ago. However, there is a dearth of studies examining what impact these reforms have had on financial intermediation, measured by credit growth, in the country. This article addresses this vacuum and investigates the effect of financial sector and capital investment reforms on credit growth in China between 1986 and 2016. We examine how real interest rate (the financial reform indicator) and gross fixed capital formation (the economic capital investment indicator) are linked with financial intermediation in China. Our empirical results suggest that although gross fixed capital formation positively influences credit growth, there is no evidence that real interest rates influence credit growth in China. The main message is that credit has grown in China, not because of financial intermediation but because of the increased need to finance growing fixed capital investment.

JEL Classification: E43, E44, F65
The Racialization of Ethnicity: The New Face of White Ethnicity in Postmillennial America
Authors: Torkelson Jason , Hartmann Douglas
Published: December 2019

In his landmark work, Richard Alba predicted that white ethnicity would fade into its twilight in the twenty-first century. Where direct inquiries into American white ethnicity have been scant since the millennium’s turn, the authors use recently collected (2014), nationally representative survey data to systematically assess “postmillennial” white ethnic identification. In particular, the authors explore the prevalence of whites identifying with ethnicity today, how this compares with other groups, and how drivers of white ethnic affiliation may have shifted in recent years. The data show that all ethnic claims have declined in the twenty-first-century United States, but the retreat from ethnicity has been accelerated among whites. By the authors’ estimates, only 8.4 percent of whites still claim ethnicity. The authors also find that white ethnic affiliation is now most substantively driven by racial ideology, experience, and perceived victimhood, though some demographic markers remain important. Further analyses show that remaining American white ethnic claimants now perceive white cultural advantages while simultaneously seeing themselves as victims of racial discrimination at rates that rival reports of nonwhites. In sum, these data suggest that white ethnicity has declined but not disappeared as a socially intelligible boundary claim in the postmillennial era and that it has developed as a racialized expression that holds implications for understandings of contemporary white identities, racisms, and resentments.
Environmental implications of middle to late Holocene plains pocket gophers in Southeast Missouri
Authors: Krakker James J , Krakker Linda A
Published: December 2019

Plains pocket gopher, Geomys bursarius, a grassland inhabitant, is common among the mammal taxa identified on the southeast Ozark margin at the Lepold site, 23RI59, Ripley County, Missouri. Its presence throughout the midden depth, whether an incidental inclusion or human prey, implies that a favorable habitat existed in the immediate vicinity. As radiocarbon dates indicate midden deposition began about 7500 radiocarbon years before present, grassland was a component of the local vegetation beginning in the middle Holocene, if not before.
From Out of Apathy to the post-political: The spatial politics of austerity, the geographies of politicisation and the trajectories of the Scottish left(s)
Authors: Featherstone David
Published: December 2019

This paper offers an alternative approach to some of the temporalising logics and imaginaries which have dominated debates around the post-political and post-democracy. It does this through engaging with the writings of figures associated with the ‘First New Left’ notably Stuart Hall and E.P. Thompson between 1956 and 1962. I argue that their essays in texts such as Out of Apathy bear some striking similarities with the claims of literatures relating to post-politics and post-democracy. Their work I argue repays substantive engagement; however, because through its attentiveness to emergent practices and geographies of antagonism, it offers a more generative and politically strategic resolution to some of the common discontents of consensus and marketisation of politics that has characterised work on post-politics. The paper develops these arguments through a discussion of how the uneven geographies of politicisation and trajectories of the Scottish left(s) in different parts of the post-war period have shaped and impacted on the spatial politics of austerity in significant ways.
Nof kdumim: Remaking the ancient landscape in East Jerusalem’s national parks
Authors: Braverman Irus
Published: December 2019

This article explores two national parks in East Jerusalem and their legal administration as the focus of contradictory and complementary attempts at preservation, colonization, and normalization. Drawing on in-depth interviews with, and observations of, officials from the Israel Nature and Parks Authority and others, I expose the Judaizing of the landscape in Jerusalem. Nature never stands for itself; it is always an echo of a human presence and, in this case, of a Jewish past and its modern reunion. The project of imagining the natural landscape as one that embodies an ancient past—what Israeli officials have referred to in our interviews as nof kdumim—and the contemporary Jewish people as those who hold the key to its revival as such, is a central aspect of Israel’s colonial dispossession agenda in East Jerusalem and a prerequisite to the land becoming Jewish in practice. Focusing on the perspectives of Israel’s nature officials, this article highlights not only the imaginary but also the legal technologies of erasing and remaking the national park landscape and the tensions between personal and collective, inclusion and exile, and memory and erasure that it inhabits. Arguably, while the identity of the Jewish settler as a nature lover who has returned to her lost Indigenous land is strengthened by the ancient biblical landscape of nof kdumim, the Palestinian is only granted authenticity and Indigeneity when she does not engage in what Israel perceives as “refugee camp” landscaping, and when she is willing to practice traditional forms of farming (or adam ba’har) so as to normalize this place as a universal tourist recreation site. Even then, however, the Palestinian’s labor goes to support orientalist environmental imaginaries. The natural landscape of East Jerusalem is thus recruited, only to discover that it has always been Jewish.
Success Through Failure: Towards a Problem-Based Approach to Entrepreneurship
Authors: Dobson John Alver , Castro Nieto Yovani , Dobson Lisa , Moros Ochoa Andreina
Published: December 2019

Investments in entrepreneurial education have failed to develop educational programming that increases entrepreneurial activity. We hypothesize that foundational issues reside within the pedagogical approaches used in entrepreneurial education programming specifically as it relates to millennial students. Using the theory of planned behavior as a theoretical framework, we investigated the effectiveness of process-based learning such as courses that focus on developing business plans and models against problem-based learning that uses action-learning methodologies in the development and delivery of an Introduction Entrepreneurship course. We use both within-group and between-group research designs. We collected data at three points: at the start of the course (T1), mid-term (T2), and the end (T3). Results support our hypothesis. First, after exposing students to the challenges of entrepreneurship in the problem-based course that there is a statistically significant decrease in attitudes, subjective norms, perception of behavioral control, and intention to become an entrepreneur at midsemester (T2) and that scores will rebound by T3. Second, the students in the process-based course will have a statistically significant decline in attitudes, subjective norms, and intentions after the course. Implications for the design of entrepreneurship curricula are presented and discussed.
Decoding the Relationship of Service Operations Enablers in Healthcare Industry
Authors: Sharma Shilpa , Sharma Simta , Patel Nandini
Published: December 2019

The present study aims to decode the relationship among service operations enablers in healthcare industry. We identified the enablers with the help of literature and expert opinion through Delphi approach. Then, we conducted the semi-structured interview to finalize the scores of enablers in pairwise comparison matrix. We deployed the decision-making trail and evaluation laboratory (DEMATEL) in four steps to decode the degree of relationship and degree of effect and found that patient satisfaction does not directly depend on the professionalism of the staff. Location of the healthcare facility has the highest degree of relationship with other enablers, whereas the personal care abilities have a high impact on the service operations effectiveness. It is also noted that competency of pharmacist and doctor profile do not have a significant impact on service operations and thus on patient satisfaction and safety. The degree of relationship also has been presented in the form of a causal diagram toward the end of result. At the end of the study, the limitations and scope for future research are presented.
Optimized chemical preconditioning of Philippine natural zeolites
Authors: Olegario Eleanor M. , Taaca Kathrina Lois M. , Morillo John Christopher Lawrence , Mendoza Herman D.
Published: December 2019

Natural zeolites in the Aksitero sedimentary formation of the western Luzon area of the Philippines were evaluated. The natural washed zeolite (NW-Z) was preconditioned with acid to purify it and increase its surface area. Acid treatment with 3 M HCl for 12 h yielded optimum acid treatment of the NW-Z, causing increases in the Si/Al ratio, the specific surface area by 32.5% and the porosity of the acid-treated zeolite (HC-Z). The HC-Z was washed with 4 M NaCl for 3, 6, 12, 18, 24, 48 and 72 h to improve its cation-exchange capacity for copper. The sodium-treated zeolite (Na-Z) was immersed in 100 ppm CuSO4 solution to test the copper-uptake capacity. Pretreatment of HC-Z with 4 M NaCl for 24 h is optimal for sodium treatment of the preconditioned HC-Z. The preconditioning techniques did not significantly alter the structure and morphology of the zeolite samples. It is suggested that the preconditioned Philippine natural zeolite samples are readily available for further functionalization that will enhance their antibacterial, catalytic and adsorption properties, with various useful applications in the field of catalysis, biomedicine, environmental mitigation and wastewater treatment.
The genomic diversification of grapevine clones
Authors: Vondras Amanda M. , Minio Andrea , Blanco-Ulate Barbara , Figueroa-Balderas Rosa , Penn Michael A. , Zhou Yongfeng , Seymour Danelle , Ye Zirou , Liang Dingren , Espinoza Lucero K. , Anderson Michael M. , Walker M. Andrew , Gaut Brandon , Cantu Dario
Published: December 2019

Background

Vegetatively propagated clones accumulate somatic mutations. The purpose of this study was to better appreciate clone diversity and involved defining the nature of somatic mutations throughout the genome. Fifteen Zinfandel winegrape clone genomes were sequenced and compared to one another using a highly contiguous genome reference produced from one of the clones, Zinfandel 03.

Results

Though most heterozygous variants were shared, somatic mutations accumulated in individual and subsets of clones. Overall, heterozygous mutations were most frequent in intergenic space and more frequent in introns than exons. A significantly larger percentage of CpG, CHG, and CHH sites in repetitive intergenic space experienced transition mutations than in genic and non-repetitive intergenic spaces, likely because of higher levels of methylation in the region and because methylated cytosines often spontaneously deaminate. Of the minority of mutations that occurred in exons, larger proportions of these were putatively deleterious when they occurred in relatively few clones.

Conclusions

These data support three major conclusions. First, repetitive intergenic space is a major driver of clone genome diversification. Second, clones accumulate putatively deleterious mutations. Third, the data suggest selection against deleterious variants in coding regions or some mechanism by which mutations are less frequent in coding than noncoding regions of the genome.
Transcriptome analysis reveals mechanism underlying the differential intestinal functionality of laying hens in the late phase and peak phase of production
Authors: Wang Wei-wei , Wang Jing , Zhang Hai-jun , Wu Shu-geng , Qi Guang-hai
Published: December 2019

Background

The compromised performance of laying hens in the late phase of production relative to the peak production was thought to be associated with the impairment of intestinal functionality, which plays essential roles in contributing to their overall health and production performance. In the present study, RNA sequencing was used to investigate differences in the expression profile of intestinal functionality-related genes and associated pathways between laying hens in the late phase and peak phase of production.

Results

A total of 104 upregulated genes with 190 downregulated genes were identified in the ileum (the distal small intestine) of laying hens in the late phase of production compared to those at peak production. These upregulated genes were found to be enriched in little KEGG pathway, however, the downregulated genes were enriched in the pathways of PPAR signaling pathway, oxidative phosphorylation and glutathione metabolism. Besides, these downregulated genes were mapped to several GO clusters in relation to lipid metabolism, electron transport of respiratory chain, and oxidation resistance. Similarly, there were lower activities of total superoxide dismutase, glutathione S-transferase and Na+/K+-ATPase, and reductions of total antioxidant capacity and ATP level, along with an elevation in malondialdehyde content in the ileum of laying hens in the late phase of production as compared with those at peak production.

Conclusions

The intestine of laying hens in the late phase of production were predominantly characterized by a disorder of lipid metabolism, concurrent with impairments of energy production and antioxidant property. This study uncovers the mechanism underlying differences between the intestinal functionality of laying hens in the late phase and peak phase of production, thereby providing potential targets for the genetic control or dietary modulation of intestinal hypofunction of laying hens in the late phase of production.
Transcriptome sequencing of Saccharina japonica sporophytes during whole developmental periods reveals regulatory networks underlying alginate and mannitol biosynthesis
Authors: Shao Zhanru , Zhang Pengyan , Lu Chang , Li Shaoxuan , Chen Zhihang , Wang Xiuliang , Duan Delin
Published: December 2019

Background

Alginate is an important cell wall component and mannitol is a soluble storage carbon substance in the brown seaweed Saccharina japonica. Their contents vary with kelp developmental periods and harvesting time. Alginate and mannitol regulatory networks and molecular mechanisms are largely unknown.

Results

With WGCNA and trend analysis of 20,940 known genes and 4264 new genes produced from transcriptome sequencing of 30 kelp samples from different stages and tissues, we deduced that ribosomal proteins, light harvesting complex proteins and “imm upregulated 3” gene family are closely associated with the meristematic growth and kelp maturity. Moreover, 134 and 6 genes directly involved in the alginate and mannitol metabolism were identified, respectively. Mannose-6-phosphate isomerase (MPI2), phosphomannomutase (PMM1), GDP-mannose 6-dehydrogenase (GMD3) and mannuronate C5-epimerase (MC5E70 and MC5E122) are closely related with the high content of alginate in the distal blade. Mannitol accumulation in the basal blade might be ascribed to high expression of mannitol-1-phosphate dehydrogenase (M1PDH1) and mannitol-1-phosphatase (M1Pase) (in biosynthesis direction) and low expression of mannitol-2-dehydrogenase (M2DH) and Fructokinase (FK) (in degradation direction). Oxidative phosphorylation and photosynthesis provide ATP and NADH for mannitol metabolism whereas glycosylated cycle and tricarboxylic acid (TCA) cycle produce GTP for alginate biosynthesis. RNA/protein synthesis and transportation might affect alginate complex polymerization and secretion processes. Cryptochrome (CRY-DASH), xanthophyll cycle, photosynthesis and carbon fixation influence the production of intermediate metabolite of fructose-6-phosphate, contributing to high content of mannitol in the basal blade.

Conclusions

The network of co-responsive DNA synthesis, repair and proteolysis are presumed to be involved in alginate polymerization and secretion, while upstream light-responsive reactions are important for mannitol accumulation in meristem of kelp. Our transcriptome analysis provides new insights into the transcriptional regulatory networks underlying the biosynthesis of alginate and mannitol during S. japonica developments.
Radical radiotherapy in patients with cervix uteri carcinoma: experience of Ondokuz Mayis University
Authors: Serarslan Alparslan , Gursel Bilge , Meydan Deniz , Ozbek Okumus Nilgun
Published: December 2019

Background

Radical radiotherapy is the standard treatment for patients with locally advanced cervix uteri carcinoma (FIGO stage IB2–IVA). Worldwide, incidence and mortality rates vary among regions because of differences in lifestyles and treatment standards. Herein, we evaluated the outcomes of radical radiotherapy in patients with locally advanced cervix uteri carcinoma from the middle Black Sea region of Turkey.

Methods

We retrospectively reviewed the records of 64 consecutive patients with locally advanced cervix uteri carcinoma who were treated from January 2013 to 2016 in our radiation oncology department. All patients staging and radiotherapy planning were performed with modern imaging techniques including magnetic resonance imaging and positron-emission-tomography/computed tomography before radical radiotherapy. Thereafter, all of them were treated with external beam radiotherapy and concurrent cis-platinum-based chemotherapy followed by three-dimensional intra-cavitary high-dose-rate brachytherapy.

Results

The median age at diagnosis was 54.5 years. The median follow-up period was 21 months. Acute grade 3 toxicity was detected in 3.1% of patients. Late toxicity was not detected in any patient. The 1- and 3-year progression-free survival rates were 83.6 and 67.5%, respectively. The 1- and 3-year overall survival rates were 95.7 and 76.9%, respectively. The most important prognostic factor was the FIGO stage. Distant metastasis was the most common cause of death in patients with locally advanced cervix uteri carcinoma despite radical radiotherapy.

Conclusions

In patients with locally-advanced cervix uteri carcinoma from the middle Black Sea region of our developing country, acceptable toxicity and survival rates are achieved similar to the recent literature from developed countries with using of modern staging, planning and radical radiotherapy techniques. However, recurrence was mostly in the form of distant metastases and further investigations on systemic therapies are required.
Pharmacotherapy of borderline personality disorder: what has changed over two decades? A retrospective evaluation of clinical practice
Authors: Timäus Charles , Meiser Miriam , Bandelow Borwin , Engel Kirsten R. , Paschke Anne M. , Wiltfang Jens , Wedekind Dirk
Published: December 2019

Background

The purpose of this study was to assess the pharmacological treatment strategies of inpatients with borderline personality disorder between 2008 and 2012. Additionally, we compared pharmacotherapy during this period to a previous one (1996 to 2004).

Methods

Charts of 87 patients with the main diagnosis of borderline personality disorder receiving inpatient treatment in the University Medical Center of Goettingen, Germany, between 2008 and 2012 were evaluated retrospectively. For each inpatient treatment, psychotropic drug therapy including admission and discharge medication was documented. We compared the prescription rates of the interval 2008–2012 with the interval 1996–2004.

Results

94% of all inpatients of the interval 2008–2012 were treated with at least one psychotropic drug at time of discharge. All classes of psychotropic drugs were applied. We found high prescription rates of naltrexone (35.6%), quetiapine (19.5%), mirtazapine (18.4%), sertraline (12.6%), and escitalopram (11.5%). Compared to 1996–2004, rates of low-potency antipsychotics, tri−/tetracyclic antidepressants and mood stabilizers significantly decreased while usage of naltrexone significantly increased.

Conclusions

In inpatient settings, pharmacotherapy is still highly prevalent in the management of BPD. Prescription strategies changed between 1996 and 2012. Quetiapine was preferred, older antidepressants and low-potency antipsychotics were avoided. Opioid antagonists are increasingly used and should be considered for further investigation.
The trend of full vaccination coverage in infants and inequalities by wealth quintile and maternal education: analysis from four recent demographic and health surveys in Nepal
Authors: Acharya Kiran , Paudel Yuba Raj , Dharel Dinesh
Published: December 2019

Background

Despite policy intention to reach disadvantaged populations, inequalities in health care resource use and health outcomes persist in Nepal. The current study aimed to investigate the trend of full vaccination coverage among infants and its equity gaps between Nepal Demographic and Health Surveys (NDHS) 2001 and 2016.

Methods

Using data from NDHS conducted in 2001, 2006, 2011 and 2016, we investigated the trend of coverage of six antigens: Bacille Calmette Guerin (BCG), Diptheria, Pertussis, Tetanus (DPT), Polio, and Measles during their infancy among children aged 12–23 months. We presented trends and correlates of full vaccination coverage by different socio-demographic factors. We measured inequalities in full vaccination coverage by wealth quintile and maternal education using absolute measure (slope index of inequality) and relative measures (Relative index of inequality, concentration index) of inequalities.

Results

Full vaccination coverage among infants steadily increased from 65.6% in 2001 to 87.0% in 2011; however, it decreased to 77.8% in 2016. Province 2 had a significantly lower full vaccination coverage compared to Province1.Although decreasing over time, there were significant inequalities by household wealth quintiles and maternal educational status. The slope index of inequality (SII) for wealth quintiles decreased from − 32.3 [− 45.5,-19.1] in 2001 to an SII of-8.4 [− 18.6,-1.7] in 2016. Similarly, the SII for education decreased from − 61.8 [− 73.5,-50.1] in 2001 to an SII of − 30.5 [− 40.7,-20.2] in 2016. Similarly, the relative index of inequality (RII) also showed an improvement over time, indicating the narrowing equity gap. Additionally, concentration index on full vaccination coverage by wealth quintiles dropped from 0.21 (0.12–0.28) in 2001 to 0.054 (− 0.01–0.12) in 2016. Absolute and relative inequalities were persistently larger by maternal educational status compared to household wealth quintiles throughout the study period.

Conclusion

Full vaccination coverage in Nepal increased from 2001 until 2011 but saw a significant decrement away from the national target after 2011. However, the equity gap by household wealth quintile and maternal education status has narrowed over time. National Immunization programs need to give higher emphasis to infants born to mothers with less education, those born in the poorer wealth quintile households, and those living in Province 2.
Migration analysis of a metaphyseal-anchored short femoral stem in cementless THA and factors affecting the stem subsidence
Authors: Schaer Michael O. , Finsterwald Michael , Holweg Iris , Dimitriou Dimitris , Antoniadis Alexander , Helmy Naeder
Published: December 2019

Background

Early femoral stem subsidence following a cementless THA is correlated with aseptic loosening of the femoral component. The short femoral stems allow bone sparing and implantation through a minimally invasive approach; however, due to their metaphyseal anchoring, they might demonstrate different subsidence pattern than the conventional stems.

Methods

In this prospective single-center study, a total of 68 consecutive patients with an average age of 63 years, and a minimum follow-up of 5 years following a cementless THA with a metaphyseal-anchored short femoral stem were included. The femoral stem subsidence was evaluated using “Ein Bild Roentgen Analyse” (EBRA).

Results

Average stem migration was 0.96 +/− 0.76 mm at 3 months, 1.71 +/− 1.26 mm at 24 months, and 2.04+/− 1.42 mm at last follow-up 60 months postoperative. The only factor that affected migration was a stem size of 6 or more (r2 = 5.74;p = 0.039). Subdivision analysis revealed, that only in females migration appeared to be affected by stem size irrespective of weight but not in men (female stem size of 6 or more vs. less (Difference = − 1.48 mm, R2 = 37.5;p = 0.001). Migration did not have an impact on clinical outcome measures.

Conclusions

The examined metaphyseal-anchored short femoral stem showed the highest subsidence within the first 3 months postoperative, the implant began to stabilize at about 24 months but continued to slowly migrate with average total subsidence of 2.04 mm at 5 years following the THA. The amount of stem subsidence was not associated with worse clinical outcomes such as HHS, patient satisfaction, or pain.
Is diverting loop ileostomy necessary for completion proctectomy with ileal pouch-anal anastomosis? A multicenter randomized trial of the GETAID Chirurgie group (IDEAL trial): rationale and design (NCT03872271)
Authors:   GETAID Chirurgie group, Beyer-Berjot Laura , Baumstarck Karine , Loubière Sandrine , Vicaut Eric , Berdah Stéphane V. , Benoist Stéphane , Lefèvre Jérémie H.
Published: December 2019

Background

There is no quality evidence of the benefit of defunctioning ileostomy (DI) in ileal pouch-anal anastomoses (IPAAs) performed for inflammatory bowel disease (IBD), but most surgical teams currently resort to DI. In the case of a staged procedure with subtotal colectomy first, completion proctectomy with IPAA is performed for healthy patients, namely, after nutritional support, inflammation reduction and immunosuppressive agent weaning. Therefore, the aim of this trial is to assess the need for systematic DI after completion proctectomy and IPAA for IBD.

Methods/design

This is a multicenter randomized open trial comparing completion proctectomy and IPAA without (experimental) or with (control) DI in patients presenting with ulcerative colitis or indeterminate colitis. Crohn’s disease patients will not be included. The design is a superiority trial. The main objective is to compare the 6-month global postoperative morbidity, encompassing both surgical and medical complications, between the two groups. The morbidity of DI closure will be included, as appropriate. The sample size calculation is based on the hypothesis that the overall 6-month morbidity rate is 30% in the case of no stoma creation (i.e., experimental group) vs. 55% otherwise (control group). With the alpha risk and power are fixed to 0.05 and 0.80, respectively, and considering a dropout rate of 10%, the objective is set to 194 patients. The secondary objectives are to compare both strategies in terms of morbi-mortality at 6 months and functional results as well as quality of life at 12 months, namely, the 6-month major morbidity and unplanned reoperation rates, 6-month anastomotic leakage rate, 6-month mortality, length of hospital stay, 6-month unplanned readmission rate, quality of life assessed 3 and 12 months from continuity restoration (i.e., either IPAA or stoma closure), functional results assessed 3 and 12 months from continuity restoration, 12-month pouch results, 12-month cost-utility analysis, and 12-month global morbidity.

Discussion

The IDEAL trial is a nationwide multicenter study that will help choose the optimal strategy between DI and no ileostomy in completion proctectomy with IPAA for IBD.

Trial registration

ClinicalTrial.gov: NCT03872271, date of registration March 13th, 2019.
Self-care habits among people who inject drugs with skin and soft tissue infections: a qualitative analysis
Authors: Gilbert Andrew R. , Hellman Julia L. , Wilkes Michael S. , Rees Vaughan W. , Summers Phillip J.
Published: December 2019

Background

Injection drug use is on the rise in the USA, and skin and soft tissue infections (SSTI) are a common complication, resulting in significant morbidity and mortality. Due to structural barriers to care-seeking, many people who inject drugs avoid formal care and resort to self-care techniques, but little is known about the nature of these techniques, or more generally about the accuracy or breadth of this population’s knowledge of SSTIs.

Methods

Semi-structured qualitative interviews were conducted with 12 people who inject heroin in two metropolitan areas: Sacramento and Boston, USA.

Results

These interviews reveal a robust and accurate knowledge base regarding skin infections, including the progression from simple cellulitis to an abscess, and acknowledgment of the possibility of serious infections. Nonetheless, there remains a reticence to seek care secondary to past traumatic experiences. A step-wise approach to self-care of SSTI infections was identified, which included themes of whole-body health, topical applications, use of non-prescribed antibiotics, and incision and drainage by non-medical providers.

Conclusions

The reported SSTI self-care strategies demonstrate resilience and ingenuity, but also raise serious concerns about inappropriate antibiotic consumption and complications of invasive surgical procedures performed without proper training, technique, or materials. Harm reduction agencies and health care providers should work to obviate the need for these potentially dangerous practices by improving healthcare access for this population. In the absence of robust solutions to meet the needs of this population, education materials should be developed to optimize the efficacy and minimize the harms of these practices, while empowering and supporting the autonomy of people who use drugs and providing clear guidance on when self-care should be abandoned in favor of formal medical care.
FKB327, an adalimumab biosimilar, versus the reference product: results of a randomized, Phase III, double-blind study, and its open-label extension
Authors: Genovese Mark C. , Glover Josephine , Greenwald Maria , Porawska Wieslawa , El Khouri Elias Chalouhi , Dokoupilova Eva , Vargas Juan Ignacio , Stanislavchuk Mykola , Kellner Herbert , Baranova Elena , Matsunaga Nobuhito , Alten Rieke
Published: December 2019

Objective

To compare the efficacy, serum drug concentrations, immunogenicity, and safety of FKB327 with the adalimumab reference product (RP) in combination with methotrexate in patients with moderate-to-severe, active rheumatoid arthritis (RA).

Methods

Patients were randomized 1:1 in a double-blind study (NCT02260791), received 40 mg of FKB327 or RP by subcutaneous injection every other week for 24 weeks (Period I), then re-randomized 2:1, remaining on the same study drug or switching to the other up to week 54 in an open-label extension (Period II, NCT02405780). Efficacy was evaluated using American College of Rheumatology (ACR20) response rate difference at week 24 with equivalence margins of ± 13% and − 12% to + 15% using 95% and 90% confidence intervals (CIs), respectively. Efficacy, serum drug concentrations, immunogenicity, and safety were compared at week 54.

Results

A total of 730 patients were randomized in Period I (n = 367 FKB327, n = 363 RP), and 645 transitioned to Period II (n = 216 FKB327–FKB327, n = 108 FKB327–RP, n = 108 RP–FKB327, n = 213 RP–RP). At week 24, ACR20 response rates were 74.1% with FKB327 versus 75.7% with RP. 95% and 90% CI of the response rate difference were − 7.9 to 4.7% and − 7.3 to 3.6%, respectively, meeting predefined equivalence margins. The ACR20 response rate remained over 70% of patients to week 54 with all treatment sequences. In Period I, mean trough serum drug concentrations were slightly higher for patients receiving FKB327 than those receiving RP. Mean concentrations were stable over time and reflected steady state in Period II. The proportions of patients with samples positive for neutralizing antidrug antibodies (ADAs) were comparable (57.7% with FKB327 vs. 55.5% with RP) at week 24, and no consistent difference in ADA were seen between continuous and switched treatments in Period II. Efficacy was slightly reduced in the small proportion of patients with high ADA titers in all treatment groups. No clinically significant differences were observed in the incidence of commonly reported treatment-emergent adverse events between the treatments across Periods I and II.

Conclusion

FKB327 was equivalent to RP in clinical efficacy and demonstrated comparable safety and immunogenicity in patients with moderate-to-severe RA. No effect of switching between FKB327 and RP was observed.

Trial registration

ClinicalTrials.gov, NCT02260791, Registered 29 July 2014.

ClinicalTrials.gov, NCT02405780, Registered 17 July 2015.
Dual time point [18F]FLT-PET for differentiating proliferating tissues vs non-proliferating tissues
Authors: Lovinfosse Pierre , Rousseau Caroline , Pierga Jean-Yves , Bouchet Francis , Cochet Alexandre , Alberini Jean-Louis , Girault Sylvie , Vera Pierre , Olivier Pierre , Uwer Lionel , Cachin Florent , Scarwell Benoit , Lemonnier Jérome , Fourme Emmanuelle , Mesleard Christel , Martin Anne-Laure , Lacœuille Franck , Couturier Olivier-François
Published: December 2019

Purpose

For differentiating tumor from inflammation and normal tissues, fluorodeoxyglucose ([18F]FDG) dual time point PET could be helpful. Albeit [18F]FLT is more specific for tumors than [18F]FDG; we explored the role of dual time point [18F]FLT-PET for discriminating benign from malignant tissues.

Methods

Before any treatment, 85 womens with de novo unifocal breast cancer underwent three PET acquisitions at 33.94 ± 8.01 min (PET30), 61.45 ± 8.30 min (PET60), and 81.06 ± 12.12 min (PET80) after [18F]FLT injection. Semiquantitative analyses of [18F]FLT uptake (SUV) were carried out on tumors, liver, bone marrow (4th thoracic vertebra (T4) and humeral head), descending thoracic aorta, muscle (deltoid), and contralateral normal breast. Repeated measures ANOVA tests and Tukey’s posttests were used to compare SUVmax of each site at the three time points.

Results

There was a significant increase in SUVmax over time for breast lesions (5.58 ± 3.80; 5.97 ± 4.56; 6.19 ± 4.42; p < 0.0001) (m ± SD for PET30, PET60, and PET80, respectively), and bone marrow (for T4, 8.21 ± 3.17, 9.64 ± 3.66, 10.85 ± 3.63, p < 0.0001; for humeral head, 3.36 ± 1.79, 3.87 ± 1.89, 4.39 ± 2.00, p < 0.0001). A significant decrease in SUVmax over time was observed for liver (6.79 ± 2.03; 6.24 ± 1.99; 5.57 ± 1.74; p < 0.0001), muscle (0.95 ± 0.28; 0.93 ± 0.29; 0.86 ± 0.20; p < 0.027), and aorta (1.18 ± 0.34; 1.01 ± 0.32; 0.97 ± 0.30; p < 0.0001). No significant difference was observed for SUVmax in contralateral breast (0.8364 ± 0.40; 0.78 ± 0.38; 0.80 ± 0.35).

Conclusion

[18F]FLT-SUVmax increased between 30 and 80 min only in proliferating tissues. This could be helpful for discriminating between residual tumor and scar tissue.
Channel estimation for spatially/temporally correlated massive MIMO systems with one-bit ADCs
Authors: Kim Hwanjin , Choi Junil
Published: December 2019

This paper considers the channel estimation problem for massive multiple-input multiple-output (MIMO) systems that use one-bit analog-to-digital converters (ADCs). Previous channel estimation techniques for massive MIMO using one-bit ADCs are all based on single-shot estimation without exploiting the inherent temporal correlation in wireless channels. In this paper, we propose an adaptive channel estimation technique taking the spatial and temporal correlations into account for massive MIMO with one-bit ADCs. We first use the Bussgang decomposition to linearize the one-bit quantized received signals. Then, we adopt the Kalman filter to estimate the spatially and temporally correlated channels. Since the quantization noise is not Gaussian, we assume the effective noise as a Gaussian noise with the same statistics to apply the Kalman filtering. We also implement the truncated polynomial expansion-based low-complexity channel estimator with negligible performance loss. Numerical results reveal that the proposed channel estimators can improve the estimation accuracy significantly by using the spatial and temporal correlations of channels.
Hidden aspects of social entrepreneurs’ life: a content analysis
Authors: Pangriya Ruchita
Published: December 2019

Social entrepreneurship has been defined as entrepreneurship with a social goal; social entrepreneur is a change agent. Literature shows that social entrepreneurship is treated as a youthful field of study and needs thorough observational appraisals to develop, which proposes a plenitude of research openings (Hoogendoorn, Pennings, & Thurik, ERIM Report Series Reference No. ERS-2009-044-ORG, 2010; Hand & Lewis, Stanford Social Innovation Review, 2016). The work on social entrepreneurship is on the rise; however, little attention was given to the traits and motivational factors for social entrepreneurs. To fill this gap, this study explores the traits and motivations of social entrepreneurs. A content analysis technique has been used to analyse the data. The interviews, speeches and articles on nine social entrepreneurs were analysed. The results indicate education, global exposure, prior work experience, creativity, empathy, community roots and contentment were the main characteristics of a social entrepreneur. Self-transcendence, unique ideas and innovation to solve pain points, inspiration and personal experience motivate an individual to become a social entrepreneur. Findings of this study will contribute to the practical and research in the area of social entrepreneurship. The present research will contribute to the growing literature that attempts to explain the profile of a social entrepreneur and motivational factors.
Neuromuscular electrical stimulation in critically ill traumatic brain injury patients attenuates muscle atrophy, neurophysiological disorders, and weakness: a randomized controlled trial
Authors: Silva Paulo Eugênio , de Cássia Marqueti Rita , Livino-de-Carvalho Karina , de Araujo Amaro Eduardo Tavares , Castro Joana , da Silva Vinicius Maldaner , Vieira Luciana , Souza Vinicius Carolino , Dantas Lucas Ogura , Cipriano Jr Gerson , Nóbrega Otávio Tolêdo , Babault Nicolas , Durigan Joao Luiz Quagliotti
Published: December 2019

Background

Critically ill traumatic brain injury (TBI) patients experience extensive muscle damage during their stay in the intensive care unit. Neuromuscular electrical stimulation (NMES) has been considered a promising treatment to reduce the functional and clinical impacts of this. However, the time needed for NMES to produce effects over the muscles is still unclear. This study primarily aimed to assess the time needed and effects of an NMES protocol on muscle architecture, neuromuscular electrophysiological disorder (NED), and muscle strength, and secondarily, to evaluate the effects on plasma systemic inflammation, catabolic responses, and clinical outcomes.

Methods

We performed a randomized clinical trial in critically ill TBI patients. The control group received only conventional physiotherapy, while the NMES group additionally underwent daily NMES for 14 days in the lower limb muscles. Participants were assessed at baseline and on days 3, 7, and 14 of their stay in the intensive care unit. The primary outcomes were assessed with muscle ultrasound, neuromuscular electrophysiology, and evoked peak force, and the secondary outcomes with plasma cytokines, matrix metalloproteinases, and clinical outcomes.

Results

Sixty participants were randomized, and twenty completed the trial from each group. After 14 days, the control group presented a significant reduction in muscle thickness of tibialis anterior and rectus femoris, mean of − 0.33 mm (− 14%) and − 0.49 mm (− 21%),p < 0.0001, respectively, while muscle thickness was preserved in the NMES group. The control group presented a higher incidence of NED: 47% vs. 0% in the NMES group,p < 0.0001, risk ratio of 16, and the NMES group demonstrated an increase in the evoked peak force (2.34 kg/f,p < 0.0001), in contrast to the control group (− 1.55 kg/f,p < 0.0001). The time needed for the NMES protocol to prevent muscle architecture disorders and treat weakness was at least 7 days, and 14 days to treat NED. The secondary outcomes exhibited less precise results, with confidence intervals that spanned worthwhile or trivial effects.

Conclusions

NMES applied daily for fourteen consecutive days reduced muscle atrophy, the incidence of NED, and muscle weakness in critically ill TBI patients. At least 7 days of NMES were required to elicit the first significant results.

Trial registration

The trial was registered atensaiosclinicos.gov.brunder protocol RBR-8kdrbz on 17 January 2016.
MPL W515 L/K mutations in myeloproliferative neoplasms
Authors: Eldeweny Sohaila , Ibrahim Hosny , Elsayed Ghada , Samra Mohamed
Published: December 2019

Background

Myeloproliferative neoplasms (MPNs) describe a group of diseases involving the bone marrow (BM). Classical MPNs are classified into chronic myelogenous leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). This classification is based on the presence of Philadelphia (Ph) chromosome (BCR/ABL1). CML is BCR/ABL1-positive while PV, ET, and PMF are negative. JAK2 p. Val617Phe pathological variant is the most associated mutation in BCR/ABL1-negative MPNs. The frequency of JAK2 p. Val617Phe is 90–95% in PV patients, 50–60% in ET, and 40–50% in patients with PMF. Studies on MPL gene led to the revelation of a gain of function pathological variants in JAK2 p. Val617Phe-negative myeloproliferative neoplasms (MPNs). MPL p. W515 L/K pathological variants are the most common across all mutations in MPL gene. The prevalence of these pathological variants over the Egyptian population is not clear enough. In the present study, we aimed to investigate the prevalence of MPL p. W515 L/K pathological variants in the Philadelphia (Ph)-negative MPNs over the Egyptian population.

Results

We have tested 60 patients with Ph-negative MPNs for MPL p. W515 L/K pathological variants. Median age was 51 (22–73) years. No MPL p. W515 L/K pathological variants were detected among our patients. JAK2 p. Val617Phe in PV and PMF patients showed significantly lower frequency than other studies. Splenomegaly was significantly higher in ET patients compared to other studies.

Conclusion

MPL p. W515 L/K pathological variants are rare across the Egyptian Ph-negative MPNs, and further studies on a large number are recommended. MPN patients in Egypt are younger compared to different ethnic groups.
Randomized Phase III Study of Ganetespib, a Heat Shock Protein 90 Inhibitor, With Docetaxel Versus Docetaxel in Advanced Non–Small-Cell Lung Cancer (GALAXY-2)
Authors: Pillai Rathi N. , Fennell Dean A. , Kovcin Vladimir , Ciuleanu Tudor-Eliade , Ramlau Rodryg , Kowalski Dariusz , Schenker Michael , Yalcin Ilker , Teofilovici Florentina , Vukovic Vojo M. , Ramalingam Suresh S.
Published: December 2019

PURPOSE

Ganetespib, a highly potent heat shock protein 90 inhibitor, blocks multiple oncogenic pathways, resulting in antitumor activity. We evaluated the combination of ganetespib and docetaxel for second-line therapy of patients with advanced adenocarcinoma of the lung.

PATIENTS AND METHODS

In this international phase III trial, patients with stage IIIB or IV adenocarcinoma diagnosed > 6 months before study entry and 1 prior systemic therapy were randomly assigned (1:1) to ganetespib 150 mg/m2 on days 1 and 15 with docetaxel 75 mg/m2 on day 1 of a 21-day cycle or to docetaxel alone. The primary end point was overall survival (OS).

RESULTS

Of 677 enrolled patients, 335 were randomly assigned to ganetespib and docetaxel and 337 were assigned to docetaxel. The trial was stopped early as a result of futility at a planned interim analysis. The median OS time was 10.9 months (95% CI, 9.0 to 12.3 months) in the ganetespib and docetaxel arm compared with 10.5 months (95% CI, 8.6 to 12.2 months) in docetaxel arm (hazard ratio [HR], 1.11; 95% CI, 0.899 to 1.372; P = .329). Median progression-free survival was 4.2 months in the ganetespib and docetaxel arm and 4.3 months in the docetaxel arm (HR, 1.16; 95% CI, 0.96 to 1.403; P = .119). The addition of ganetespib did not improve outcomes compared with docetaxel alone for any secondary end point, including survival in the elevated lactate dehydrogenase or EGFR and ALK wild-type populations. The most common grade 3 or 4 adverse event in both arms was neutropenia (30.9% with ganetespib and docetaxel v 25% with docetaxel).

CONCLUSION

The addition of ganetespib to docetaxel did not result in improved survival for salvage therapy of patients with advanced-stage lung adenocarcinoma.