bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal involvement and metabolic alterations in adults patients affected by cystic fibrosis
Authors: Lai Silvia , Mazzaferro Sandro , Mitterhofer Anna Paola , Bonci Enea , Marotta Paolo Giangreco , Pelligra Francesco , Murciano Manuel , Celani Camilla , Troiani Patrizia , Cimino Giuseppe , Palange Paolo
Published: November 2019

Background

Cystic fibrosis (CF) is one of the most frequent genetic diseases and the median survival of these patients has improved in the last few decades, therefore it becomes necessary to evaluate the long-term complications as renal and cardiovascular risk factors.

Aim of the study

To evaluate the incidence, the manifestations of renal disease and the possible association with metabolic and endothelial dysfunction markers in the CF population.

Materials and methods

We performed a cross-sectional, observational study on 226 CF patients. Clinical and laboratory instrumental parameters (metabolic, inflammatory and endothelial dysfunction markers) were evaluated.

Results

We showed 65 patients with chronic kidney disease (CKD) and 158 patients with a reduced value of forced expiratory volume in 1 s (FEV1), of which 58 patients with a severe reduction of FEV1. Moreover 28 patients had undergone lung transplantation and them had a significant lower estimated Glomerular Filtration Rate (eGFR) with respect to the non-transplanted patients (p < 0.001). We reported also a significant association between lower eGFR value and serum triglycerides, total cholesterol and low-density lipoproteins (LDL) (p = 0.005, p < 0.001, p = 0.040; respectively), with a significant negative correlation between eGFR and serum triglycerides (r = − 0.28; p < 0.01). Moreover we found a significant association between lower eGFR value and serum uric acid (SUA) (p = 0.005), while we did not found an association with 25-hydroxy-vitamin-D value, serum glucose and hemoglobin A1c levels.

Conclusions

Our study showed a high prevalence of CKD in CF patients. Moreover we showed an increase of endothelial dysfunction and metabolic indexes in patients with reduced renal function, as SUA, serum triglycerides and LDL, suggesting the need for an early and complete screening of the main metabolic indexes to reduce cardiovascular risk and progression of renal damage, in particular in patients with lung transplant.
BMI, irAE, and gene expression signatures associate with resistance to immune-checkpoint inhibition and outcomes in renal cell carcinoma
Authors: Labadie Brian W. , Liu Ping , Bao Riyue , Crist Michael , Fernandes Ricardo , Ferreira Laura , Graupner Scott , Poklepovic Andrew S. , Duran Ignacio , Maleki Vareki Saman , Balar Arjun V. , Luke Jason J.
Published: November 2019

Background

Clinical variables may correlate with lack of response to treatment (primary resistance) or clinical benefit in patients with clear cell renal cell carcinoma (ccRCC) treated with anti-programmed death 1/ligand one antibodies.

Methods

In this multi-institutional collaboration, clinical characteristics of patients with primary resistance (defined as progression on initial computed tomography scan) were compared to patients with clinical benefit using Two sample t-test and Chi-square test (or Fisher’s Exact test). The Kaplan–Meier method was used to estimate the distribution of progression-free survival (PFS) and overall survival (OS) in all patients and the subsets of patients with clinical benefit or primary resistance. Cox’s regression model was used to evaluate the correlation between survival endpoints and variables of interest. To explore clinical factors in a larger, independent patient sample, The Cancer Genome Atlas (TCGA) was analyzed. RNAseq gene expression data as well as demographic and clinical information were downloaded for primary tumors of 517 patients included within TCGA-ccRCC.

Results

Of 90 patients, 38 (42.2%) had primary resistance and 52 (57.8%) had clinical benefit. Compared with the cohort of patients with initial benefit, primary resistance was more likely to occur in patients with worse ECOG performance status (p = 0.03), earlier stage at diagnosis (p = 0.04), had no prior nephrectomy (p = 0.04) and no immune-related adverse events (irAE) (p = 0.02). In patients with primary resistance, improved OS was significantly correlated with lower International Metastatic RCC Database Consortium risk score (p = 0.02) and lower neutrophil:lymphocyte ratio (p = 0.04). In patients with clinical benefit, improved PFS was significantly associated with increased BMI (p = 0.007) and irAE occurrence (p = 0.02) while improved OS was significantly correlated with overweight BMI (BMI 25–30; p = 0.03) and no brain metastasis (p = 0.005). The cohort TCGA-ccRCC was examined for the correlations between gene expression patterns, clinical factors, and survival outcomes observing associations of T-cell inflammation and angiogenesis signatures with histologic grade, pathologic stage and OS.

Conclusions

Clinical characteristics including performance status, BMI and occurrence of an irAE associate with outcomes in patients with ccRCC treated with immunotherapy. The inverse association of angiogenesis gene signature with ccRCC histologic grade highlight opportunities for adjuvant combination VEGFR2 tyrosine kinase inhibitor and immune-checkpoint inhibition.
Instilling innovativeness, building character, and enforcing camaraderie through interest-driven challenge-based learning approach
Authors: Md. Khambari Mas Nida
Published: November 2019

This study aims to identify how student teachers were impacted by an interest-driven challenge-based instructional design of an Educational Technology course over three semesters. The instructional design of this course was foregrounded by the Interest-Driven Creator Theory, anchoring on the two out of three concepts, namely Interest and Creation. Over the course of 14 weeks, the learning activities in each class meeting started by applying the Interest Loop. This was done by inviting students to participate in bite-sized challenges, at the same time making sure that students can extend the newly constructed knowledge from the activities to their final project. The objective of such design was to let students learn by doing or completing the weekly challenges given to them during class. Then, the students were guided to complete their final project through a series of workshops and personal group consultation with the course instructor. A focus-group discussion was conducted to gather data from the students over the course of three semesters, centering on answering the question of: How does an interest-driven challenge-based framework for learning design of an Educational Technology course impact learners? Interviews were conducted qualitatively, and the findings of the analysis that emerged were (i) instilling innovativeness, (ii) building character, and (iii) enforcing camaraderie. These findings suggests that a mesh-up between the interest-driven creator theory and challenge-based learning framework, then named as InDeC framework for learning design, could furnish learners with skills that are beyond those targeted in the course outcome. Among others, learners’ heutagogical skills can be improved when they are given the opportunity to realize their capacities and stretch their capabilities. Implicitly, this research may benefit instructors in their emerging responsibility of producing and readifying learners for future demands and challenges.
Integration of electronic patient-reported outcomes into clinical workflows within the Epic electronic medical record.
Authors: Rosett Heather A , Herring Kris , Ratliff William , Koontz Bridget F. , Zafar Yousuf , LeBlanc Thomas William
Published: November 2019

102

Background: Electronic patient-reported outcome measures (ePROs) offer a new strategy for symptom assessment that can improve quality of life and prolong survival in routine cancer care. However, ePRO systems are often separate from existing electronic medical records (EMRs) and not well integrated into oncology clinics. In this pilot project, we assessed the feasibility and utility of integrating ePROs into our existing EMR and clinical workflows. Methods: The 10-question Edmonton Symptom Assessment Scale (ESAS) was integrated into the Epic EMR at three outpatient clinics in the Duke Cancer Institute. Patients with active MyChart accounts were offered the ESAS survey prior to their visit, via the patient portal. ePRO data were routed to clinicians in tabular and graphical formats. A “SmartPhrase” facilitated easy data integration into clinical notes. We subsequently interviewed clinicians and optimized workflows. Several patient engagement strategies were used, including automated messages, phone call reminders, and electronic tablets, to increase response rate. Results: It was feasible to quickly customize and activate an ePRO in Epic. Over 10 months, 161 patients completed 208 ePRO surveys. Initially, 10-20% of eligible patients completed the MyChart questionnaire. Patient engagement strategies, including phone calls and personalized MyChart messages, had little effect. Ultimately, tablets were introduced in the clinic check-in process, increasing response rates to >90%. Clinicians reported positive regard for the system, and an impact on patient symptom management. Clinician workflow optimization resulted in minimal “clicks” in the EMR, and the SmartPhrase was used in 128 clinical notes. Conclusions: Integration of ePROs into the clinical setting poses three challenges: technical implementation, workflow optimization, and patient engagement. While technical implementation is important, it was the easiest to solve, with patient engagement as the greatest barrier. Clinicians value an integrated ePRO system that automatically routes data to the clinical note. The key to successful ePRO integration is in ease of use for both patients and clinicians.
Efficacy of medical cannabis for cancer-related pain in the elderly: A single-center retrospective analysis.
Authors: Mupamombe Charles Tonderai , Nathan Rachel Andrea , Case Amy Allen , Walter Michelle , Hansen Eric
Published: November 2019

13

Background: Use of medical cannabis (MC) for cancer-related symptoms is growing, yet many prior studies used formulations not available in the United States (US). Clinical data on formulation, dosing and efficacy for formulations available in the US is limited. Furthermore, though interest is growing in the use of MC for elderly patients, data on safety and efficacy in this population is limited. We aimed to assess the clinical characteristics of elderly people using MC, formulations prescribed, and efficacy for cancer-related pain, insomnia and anxiety. Methods: We conducted a retrospective chart review of patients age 65 and older prescribed MC in the year 2018 in an outpatient palliative care clinic at a tertiary comprehensive cancer center. Pain intensity and anxiety were measured by numerical rating (0-10), and insomnia was assessed by self-reported hours of sleep per night, with data collected at consecutive clinic visits before and after MC use. Results: Eighty-three patients aged 65 and over were included in our analysis. Half of patients were age 65-70, while 12% were age 76 or older. Slightly more than half were male (58%), while the majority were Caucasian (92%). For patients with pain, two thirds were already prescribed opioids; 28% were using gabapentin/pregabalin, 22% duloxetine, and 7% nortriptyline/amitriptyline. Two-thirds (65%) reported never using cannabis previously. The most common MC product used was oil (35%), followed by vape (13%), pill (6%) and powder (3%). The most common initial concentrations were equal THC/CBD (41%) and high THC (43%); 8% of patients used high CBD, and 8% used a combination. The median delta pain score did not change with use of MC (delta pain = 0.0, p = 0.72), nor did anxiety (delta anxiety = -0.2, p = 1.00) nor insomnia (delta hours sleep = -0.1, p = 1.000). Conclusions: In this study of elderly patients prescribed MC, the majority of whom were cannabis naïve and already prescribed opioids, most were initially prescribed high THC or 1:1 THC/CBD, with oil and vape the most common formulations used. Use of MC was not associated with changes in pain, anxiety nor insomnia scores.
Long-term and late effects (LLEs), anxiety, and depression among long-term survivors of pediatric, adolescent, and young adult (P-AYA) cancer.
Authors: Jacobs Linda A. , Blauch Abigail N. , Pucci Donna A. , Palmer Steven C
Published: November 2019

143

Background: Adult P-AYA cancer survivors report numerous LLEs, as well as potential decrements in psychological well-being. The relationship between LLEs and psychological well-being, however, has not been well described in this population. We examined this relationship and predictors of LLEs and well-being in a sample of adult survivors of P-AYA cancer. Methods: Survivors of P-AYA cancer > 2 years from end of treatment completed the Hospital Anxiety and Depression Scale (HADS) and a measure of presence and severity of 11 common LLEs following a survivorship visit. LLEs included fatigue, pain, insomnia, numbness, joint or muscle pain, difficulties with concentration or memory, body image concerns, decreased sexual interest, and weight. Results: Participants (N = 237) were predominately white (89%), college educated (76%), single (63%), and had an annual income of > $60,000 (69%). A plurality had diagnoses of leukemia (30%) or Hodgkin's lymphoma (29%) treated 17 years previously. Treatment included surgery (35%), chemotherapy (91%), XRT (59%), and BMT (17%). Anxiety (M = 6.02; SD = 3.07) and depression (M = 2.54; SD = 2.85) scores were generally low and below the cutpoint of 8 (all t < -7.8; all p < .001 ), although 21% and 9% screened positively for anxiety or depression, respectively. 91% of participants reported at least 1 LLE (M = 4.8, SD = 3.1), most commonly fatigue (73%), concentration (57%) and memory difficulties (53%), and body image problems (48%). Total number LLEs was associated with elevations in both anxiety and depression, as was severity for each individual LLE (all p < 0.001). Only one LLE, difficulty with body image, produced large effects for both anxiety and depression. Low income status were associated with both LLEs and elevations in anxiety and depression (all p < 0.01). Conclusions: Most P-AYA survivors report LLEs. Although anxiety and depression are modest, elevations occur in a substantial number of survivors. Presence of LLEs is associated with worse psychosocial outcomes, particularly difficulties with body image. Lower income individuals and those with body image concerns may be at particular risk of poorer psychosocial outcomes.
End-of-life palliative care resource utilization in cancer care: A focus on the urban-rural continuum.
Authors: Cerni Jessica , Rhee Joel , Hosseinzadeh Hassan
Published: November 2019

52

Background: Despite the advances in end-of-life cancer care, disparities exist in the availability, accessibility and use of palliative care services across the urban-rural continuum. This review explores this disparity by synthesising retrospective quantitative studies on palliative care patterns of resource use for adults during end-of-life cancer care. Methods: Five databases were searched and data analysed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria involved; a) original research; b) quantitative studies; c) English-language; d) study assessed palliative care related service use in adult (18yrs+) cancer patients with any malignancy excluding non-melanoma skin cancer; e) exclusive end of life focus and f) urban-rural focus. Narrative reviews and discussions were excluded. Results: After reviewing all titles and abstracts ( N= 816) and full text review ( N= 163) 44 studies met the inclusion criteria and were included in the analysis. End-of-life palliative care access and utilisation patterns varied across the geographical urban-rural continuum. Geographical region of residence had the strongest association with multiple ED visits and hospitalizations in rural or remote areas. Most common palliative care services used within the last 30 days of death were ED visits and hospital admissions. Two studies assessed palliative radiotherapy and one study assessed palliative care pharmacotherapy. The odds of palliative service use were lowest for males and individuals with a survival diagnosis (0-3months). The largest inequities were explained by individual level factors including gender as assessed in ( N= 44 studies), socioeconomic status ( N= 15), proximity to service ( N= 10) and survival time from cancer diagnosis ( N= 9). Conclusions: Rurality was an important predictor for poorer outcomes in the quality of end-of-life cancer care. Findings suggest that addressing the urban-rural continuum is critical for equitable, timely and efficient palliative cancer care. Further research is required to understand barriers to service usage to achieve optimal palliative care.
Integration of specialty palliative care in a phase I ovarian cancer population.
Authors: Moroney Marisa R , Hill Breana , Sheeder Jeanelle , Diamond Jennifer Robinson , Avella-Howell Melony , Corr Bradley , Lefkowits Carolyn
Published: November 2019

75

Background: ASCO guidelines recommend patients with advanced cancer receive early integrated specialty palliative care based on evidence of multiple clinical benefits. To our knowledge, there is no literature evaluating utilization of specialty palliative care in Phase I clinical trial patients, but there is limited data demonstrating underutilization of palliative care services in patients with life-threatening diseases including advanced cancer. Methods: A retrospective review of ovarian cancer patients enrolled in Phase I clinical trials at one institution from 2008 to 2018. Charts were reviewed for patient and disease characteristics including age, disease stage, number of chemotherapy regimens and date of death. Charts were also reviewed to determine if and when patients received specialty palliative care services. Results: A total of 121 patients with ovarian cancer were enrolled in Phase I clinical trials. Median age at time of Phase I enrollment was 59 years (range 33-88). 87% of patients had advanced stage disease: 60% Stage III and 27% Stage IV. Median number of chemotherapy regimens received prior to Phase I enrollment was 5 (range 1-13). Median survival was 311 days (95%CI 225.9-396.1). Of the 121 patients, 4 (3.3%) received specialty palliative care prior to Phase I enrollment, 7 (5.8%) within 30 days after enrollment, and 53 (43.8%) more than 30 days after enrollment. 57 patients (47.1%) never received specialty palliative care. Conclusions: Ovarian cancer patients enrolled in Phase I clinical trials have advanced cancer – defined by ASCO as disease that is late-stage and life limiting with a prognosis less than 24 months – and should therefore receive early integrated specialty palliative care. This study demonstrates that a significant portion of Phase I ovarian cancer patients are either receiving no or late integration of specialty palliative care. Further work needs to focus on increasing early integration of specialty palliative care in this population.
Integrating Touchscreen-Based Geriatric Assessment and Frailty Screening for Adults With Multiple Myeloma to Drive Personalized Treatment Decisions
Authors: Nathwani Nitya , Kurtin Sandra E. , Lipe Brea , Mohile Supriya Gupta , Catamero Donna D. , Wujcik Debra , Birchard Kristy , Davis Agnes , Dudley William , Stricker Carrie Tompkins , Wildes Tanya Marya
Published: November 2019

PURPOSE:

Geriatric assessment (GA) results predict toxicity/survival in older adults, yet GA is not routinely used in care for patients with multiple myeloma (MM). We tested a tablet-based modified GA (mGA) providing real-time results to clinicians.

METHODS:

One hundred sixty-five patients with MM aged ≥ 65 years facing a treatment decision from 4 sites completed a tablet-based mGA with Katz Activities of Daily Living (ADL), Lawton Instrumental ADL, Charlson Comorbidity Index, and variables from the Cancer and Aging Research Group’s Chemotherapy Toxicity Calculator. Providers reviewed the assessment results at the treatment visit.

RESULTS:

Patients were white (72%; n = 86), mean age was 72 years (range, 65-85 years), and averaged 7.71 minutes (range, 2-17 minutes) for survey completion. Providers averaged 3.2 minutes (range, 1-10 minutes) to review mGA results. Using International Myeloma Working Group frailty score, patients were fit (39%; n = 64), intermediate fit (33%; n = 55), or frail (28%; n = 46). Providers selected more aggressive treatments in 16.3% of patients and decreased treatment intensity in 34% of patients; treatment intensification was more common for fit patients and milder treatments for frail patients (χ2 = 20.02; P < .0001). Transplant eligibility significantly correlated with fit status and transplant ineligibility with frail status ( P = .004). Outcomes on 144 patients 3 months post study visit showed 19.4% (n = 28) had grade ≥ 3 hematologic toxicities, 38.9% (n = 56) had dose modifications, and 18% (n = 26) had early therapy cessation.

CONCLUSION:

Limited patient time required for survey completion and provider time for results review show mGA can be easily incorporated into clinical workflow. Real-time mGA results indicating fit/frailty status influenced treatment decisions.
“It’s More Difficult…”: Clinicians’ Experience Providing Palliative Care to Adolescents and Young Adults Diagnosed With Advanced Cancer
Authors: Avery Jonathan , Geist Arielle , D’Agostino Norma Mammone , Kawaguchi Sarah K. , Mahtani Ramona , Mazzotta Paolo , Mosher Pamela J. , al-Awamer Ahmed , Kassam Alisha , Zimmermann Camilla , Samadi Mahsa , Tam Seline , Srikanthan Amirrtha , Gupta Abha
Published: November 2019

PURPOSE:

Adolescents and young adults (AYAs; age 15-39 years) with advanced cancer are a population in whom quality of life is uniquely affected because of their stage of life. However, training focused on palliative care for AYAs is not routinely provided for health care providers (HCPs) in oncology. This study aims to explore the experiences of HCPs involved in introducing and providing palliative care caring for AYAs with advanced cancer and their families to understand the unique challenges HCPs experience.

METHODS:

Using a qualitative descriptive design, semistructured interviews were conducted with medical and radiation oncologists, palliative care physicians, psychiatrists, and advanced practice nurses involved in caring for AYAs diagnosed with advanced cancer (N = 19). Interviews were transcribed verbatim and analyzed using thematic analysis in combination with constant comparative analysis and theoretical sampling.

RESULTS:

There were 19 participants, 9 men and 10 women, with a median age of 45 years (range, 24-67 years). Six were palliative care physicians, 5 medical oncologists, 4 nurse practitioners, and 2 each radiation oncologists and psychiatrists. Overall, participants perceived the provision of palliative care for AYAs to be more difficult compared with older adults. Four themes emerged: (1) challenges helping AYAs/families to engage in and accept palliative care, (2) uncertainty regarding how to involve the family, (3) HCP sense of tragedy, and (4) HCP sense of emotional proximity.

CONCLUSION:

Findings from this study support the development of dedicated training for HCPs involved in palliative care for AYA.
Activation of β-Catenin Signaling and its Crosstalk With Estrogen and Histone Deacetylases in Human Uterine Fibroids
Authors: Ali Mohamed , Shahin Sara Mahmoud , Sabri Nagwa Ali , Al-Hendy Ayman , Yang Qiwei
Published: November 2019

Context

Uterine fibroids (UF) are the most common benign tumor of the myometrium (MM) in women of reproductive age. However, the mechanism underlying the pathogenesis of UF is largely unknown.

Objective

To explore the link between nuclear β-catenin and UF phenotype and β-catenin crosstalk with estrogen and histone deacetylases (HDACs).

Design

Protein/RNA levels of β-catenin (CTNNB1 gene), its responsive markers cyclin D1 and c-Myc, androgen receptor (AR), p27, and class-I HDACs were measured in matched UF/MM tissues or cell populations. The effects of chemical inhibition/activation and genetic knockdown of CTNNB1 on UF phenotype were measured. The anti-UF effect of 2 HDAC inhibitors was evaluated.

Main Outcome Measure

β-catenin nuclear translocation in response to β-catenin inhibition/activation, estrogen, and HDAC inhibitors in UF cells.

Results

UF tissues/cells showed significantly higher expression of nuclear β-catenin, cyclin D1, c-Myc, and HDACs 1, 2, 3, and 8 than MM. Estradiol induced β-catenin nuclear translocation and consequently its responsive genes in both MM and UF cells, while an estrogen receptor antagonist reversed this induction effect. Treatment with β-catenin or HDAC inhibitors led to dose-dependent growth inhibition, while Wnt3a treatment increased proliferation compared with control. Chemical inhibition of β-catenin decreased cyclin D1 and c-Myc expression levels, while β-catenin activation increased expression of the same markers. Genetic knockdown of CTNNB1 resulted in a marked decrease in β-catenin, cyclin D1, c-Myc, and AR expression. Treatment of UF cells with HDAC inhibitors decreased nuclear β-catenin, cyclin D1, and c-Myc expression. Moreover, HDAC inhibitors induced apoptosis of UF cells and cell cycle arrest.

Conclusion

β-catenin nuclear translocation contributes to UF phenotype, and β-catenin signaling is modulated by estradiol and HDAC activity.
E3 ubiquitin ligase MDM2 acts through p53 to control respiratory progenitor cell number and lung size
Authors: Sui Pengfei , Li Rongbo , Zhang Yan , Tan Chunting , Garg Ankur , Verheyden Jamie M. , Sun Xin
Published: November 2019

The respiratory lineage initiates from the specification of NKX2-1+ progenitor cells that ultimately give rise to a vast gas-exchange surface area. How the size of the progenitor pool is determined and whether this directly impacts final lung size remains poorly understood. Here, we show that epithelium-specific inactivation of Mdm2, which encodes an E3 ubiquitin ligase, led to lethality at birth with a striking reduction of lung size to a single vestigial lobe. Intriguingly, this lobe was patterned and contained all the appropriate epithelial cell types. The reduction of size can be traced to the progenitor stage, when p53, a principal MDM2 protein degradation target, was transiently upregulated. This was followed by a brief increase of apoptosis. Inactivation of the p53 gene in the Mdm2 mutant background effectively reversed the lung size phenotype, allowing survival at birth. Together, these findings demonstrate that p53 protein turnover by MDM2 is essential for the survival of respiratory progenitors. Unlike in the liver, in which genetic reduction of progenitors triggered compensation, in the lung, respiratory progenitor number is a key determinant factor for final lung size.
Metabolic Effects of Three Different Activity Bouts during Sitting in Inactive Adults
Authors: MA SHENG-XIA , ZHU ZHENG , ZHANG LIN , LIU XIAO-MEI , LIN YAN-YU , CAO ZHEN-BO
Published: November 2019

Purpose

This study aimed to determine whether interrupting prolonged sitting with three different walking-bout schedules improves glycemic metabolism relative to continuous prolonged sitting in sedentary adults.

Methods

In a randomized, crossover trial, 16 inactive healthy adults (7 men, 24 ± 3 yr old) completed four 26-h laboratory sessions, including 22.5 h in an energy expenditure (EE)-testing calorimeter chamber. The four 9-h intervention periods were as follows: 9-h uninterrupted sitting (SIT), 30-min sitting/3-min brisk (60% V˙O2max) treadmill walk (WALK3), 45-min sitting/5-min (WALK5), or 60-min sitting/8-min (WALK8). Coprimary outcomes included the difference in the mean interstitial glucose concentration, total area under the curve (tAUC), and incremental area under the curve (iAUC) for the entire 26 and 9 h (intervention period) during three activity-bout conditions compared with SIT.

Results

Compared with SIT, the 26-h mean glucose concentration was attenuated in WALK8 (Δmean −0.22 mmol·L−1 [95% confidence interval = −0.43 to −0.001], P = 0.048) without adjustment for EE and attenuated in WALK3 (Δ−0.47 mmol·L−1 [−0.75 to −0.10]), WALK5 (Δ−0.47 mmol·L−1 [−0.83 to −0.10]), and WALK8 (Δ−0.53 mmol·L−1 [−0.92 to −0.13]) after adjustment for EE (all P < 0.01). The 26-h tAUC was reduced in WALK3 (Δ−11.18 mmol·L−1 per 26 h [−20.07 to −2.29]), WALK5 (2.12.67 mmol·L−1 per 26 h [−22.54 to −2.79]), and WALK8 (Δ−13.85 mmol·L−1 per 26 h [−24.60 to −3.10]) (all P < 0.01), as well as the iAUC (all P < 0.05), only after adjustment for EE. The 9-h mean glucose concentration, tAUC, and iAUC decreased in the three activity-break conditions regardless of EE adjustment (all P < 0.05).

Conclusions

All three walking-bout conditions improved glycemic metabolism compared with SIT, independent of EE, in inactive, healthy adults.
Ad Networks and Consumer Tracking
Authors: D’Annunzio Anna , Russo Antonio
Published: November 2019

We study the role of ad networks in the online advertising market. Our baseline model considers two publishers that can outsource the sale of their ad inventories to an ad network, in a market where consumers and advertisers multi-home. The ad network increases total advertising revenue by tracking consumers across outlets and reduces competition between publishers by centralizing the sale of ads. Consequently, outsourcing to the ad network benefits the publishers, but may penalize the advertisers. We show that the ad network’s ability to track consumers may either expand or reduce the provision of ads, depending on consumers’ preferences for the publishers and how advertisers use tracking information. Specifically, tracking is more likely to expand (respectively, reduce) the provision of ads when consumers’ preferences for the publishers are positively (respectively, negatively) correlated. Tracking is also more likely to expand (respectively, reduce) the provision of ads when advertisers use tracking information to cap the frequency of impressions (respectively, target specific consumers). Furthermore, we study the implications of consumers’ choice to block tracking. Generally, blocking negatively impacts the advertising industry by making ad allocation less effective. Blocking also entails an externality on consumers, which is negative when tracking reduces the provision of ads. Given these conditions, regulatory restrictions on tracking may reduce consumer surplus as well as advertising revenue. These findings contrast with the presumption that regulation should make it easier for consumers to avoid tracking. We propose further extensions, including competing ad networks, more than two publishers, and networks that do not sell ads, but only tracking information to the advertisers.

This paper was accepted by Juanjuan Zhang, marketing.
PEMANASAN GLOBAL, EKSPLOITASI SUMBERDAYA PERIKANAN, DAN PENCEMARAN PESISIR SEBAGAI PENYEBAB UTAMA PERUBAHAN EKOLOGI LAUT DI INDONESIA
Authors: . Hadiyanto
Published: November 2019

GLOBAL WARMING, OVERFISHING, AND COASTAL POLLUTION AS MAJOR CAUSES OF MARINE ECOLOGICAL CHANGES IN INDONESIA. Changes in marine ecology are normal, because the earth is dynamic, and are getting worse and faster since human are involved in their processes, indicating the Anthropocene Era begins. Consequently, three parameters to measure the quality of the earth for living, i.e. climate changes, rate of biodiversity loss, and nitrogen cycles, have been over the maximum thresholds. In general, changes in marine ecology are caused by phenomena that are occuring in global scale (e.g. increasing of CO emission, global warming, and ocean acidification), regional scale (e.g. overfishing, and changes in oceagraphical processes, rain and storm), and local scale (e.g. eutrophication, sedimentation, pollution, biological invasions, herbivory, and diseases). Result of reviews shows that major causes of changes in marine ecology in Indonesia may be global warming, overfishing, and coastal pollution. As a result, species richness, abundance, distribution, and community structure of marine ecosystems in Indonesia change significantly.
Chronic Pancreatitis: Managing a Difficult Disease
Authors: Hart Phil A. , Conwell Darwin L.
Published: November 2019

Chronic pancreatitis is characterized by progressive, irreversible morphologic and functional changes that are most commonly attributed to environmental insults, particularly when there is a genetic or anatomic predisposition. Heavy alcohol use and cigarette smoking are the most common environmental risk factors, but both may be absent. Antecedent episodes of acute pancreatitis occur in about half of patients. Abdominal pain is the most common symptom and requires a tailored approach depending on the anatomic changes in the pancreas. Other clinical manifestations include diabetes mellitus, exocrine pancreatic insufficiency, metabolic bone disease, pancreatic cancer, and anatomic complications. Current disease management is centered on risk factor reduction and screening for and treating disease complications. There are no current therapies to delay or retard disease progression, but there are ongoing efforts to more fully understand the natural history of chronic pancreatitis and underlying mechanisms of disease. These studies are expected to provide insights that will transform our approach to disease management and provide increased hope to patients.
ASPECTOS GEOGRÁFICOS DAS CONSULTAS RECEBIDAS POR TENTATIVAS DE AUTOELIMINAÇÃO NA EMERGÊNCIA DO HOSPITAL VILARDEBO NA CIDADE DE MONTEVIDÉU, ENTRE 2014 E 2015
Authors: García Carlos Gonzalo Giraldez
Published: November 2019

Introdução. Nas últimas décadas, o número de suicídios e tentativas de auto-eliminação aumentou significativamente em todas as regiões do planeta. Sendo um fenômeno multifatorial, apresenta-se como um grave problema de saúde pública devido às suas consequências individuais, coletivas e de saúde. Por isso, desde o final do século XX, diferentes protocolos, regulamentos e regulamentações foram aprovados, os quais, juntamente com estratégias locais, visam preveni-los. Nesse sentido, a ciência geográfica tem contribuído em sua leitura, explicação e compreensão a partir de suas abordagens, metodologias e técnicas, propondo novos eixos estruturantes do processo saúde - doença. Objetivo geral. Identificar os aspectos geográficos das consultas recebidas pela tentativa de auto-eliminação na Emergência do Hospital Vilardebó da cidade de Montevidéu, entre 2014 e 2015. Metodologia. Aspectos exploratórios, descritivos e de correlação foram combinados sob delineamento retrospectivo, quantitativo, não-experimental, transversal. Uma análise geo-espacial da informação foi realizada com base na construção de um Sistema de Informação Geográfica. Síntese.  Uma proporção maior de consultas foi observada em mulheres com relação aos homens (59,7% e 40,3%, respectivamente), com uma média de idade menor nos homens do que nas mulheres (29,4 e 36,1 respectivamente). O R + 0,74 de Pearson foi determinado de acordo com aspectos sócio-territoriais e casos distribuídos de acordo com os bairros de Montevidéu. De acordo com o teste qui-quadrado, as variáveis ​​histórico de consulta e IAE registrado não são independentes. Por sua vez, os casos de IAE mapeados de acordo com os Centros de Saúde e suas áreas de referência mostraram uma distância média maior nos Centros localizados na periferia urbana da cidade.
SEKENEM DAN SEKEPAT Perlindungan terhadap Perempuan dalam Tradisi Budaya Masyarakat Terpencil di Kabupaten Lombok Tengah, Nusa Tenggara Barat
Authors: Munawirsazali Munawirsazali
Published: November 2019

This paper discusses about the concept of protecting women in the cultural tradition of isolated communities in Lombok Tengah. The results of research in this paper is that the sociocultural system of these isolated communities in Lombok Tengah uphold the dignity of local women. The protection of women in these isolated communities in Lombok Tengah has been done through what were locally called ‘sekenem’ and ‘sekepat’ as a place for a girl to receive her visitor. Each house is required to have ‘sekenem’ or ‘sekepat’ as a place for their daughter to receive her guest or friend. The system of the culture of isolated communities in Lombok Tengah can provide for the women morally and socially protected.
SISTEM SOSIALBUDAYA MASYARAKAT PESISIR Nelayan dan Bakul Ikan di Kampung Tambak Lorok, Kota Semarang
Authors: Kistanto Nurdien H
Published: November 2019

In accordance with the natural environment, namely coastal area, livelihood and employment of many people of Tambak Lorok are fishing, carried out by fishermen as husbands or household heads, and accompanying activities such as processing and selling of marine products, mainly fish, by female fish processors and/or traders. Based on the field data collection and reading the literature, this study analyzes functional interrelationships of fishermen and fish traders in the sociocultural system of Tambak Lorok community in north Semarang City.
Long-term Monocular Deprivation during Juvenile Critical Period Disrupts Binocular Integration in Mouse Visual Thalamus
Authors: Huh Carey Y.L. , Abdelaal Karim , Salinas Kirstie J. , Gu Diyue , Zeitoun Jack , Figueroa Velez Dario X. , Peach John P. , Fowlkes Charless C. , Gandhi Sunil P.
Published: November 2019

Study of the neural deficits caused by mismatched binocular vision in early childhood has predominantly focused on circuits in the primary visual cortex (V1). Recent evidence has revealed that neurons in mouse dorsolateral geniculate nucleus (dLGN) can undergo rapid ocular dominance plasticity following monocular deprivation (MD). It remains unclear, however, whether the long-lasting deficits attributed to MD during the critical period originate in the thalamus. Usingin vivotwo-photon Ca2+imaging of dLGN afferents in superficial layers of V1 in female and male mice, we demonstrate that 14 d MD during the critical period leads to a chronic loss of binocular dLGN inputs while sparing response strength and spatial acuity. Importantly, MD leads to profoundly mismatched visual tuning properties in remaining binocular dLGN afferents. Furthermore, MD impairs binocular modulation, reducing facilitation of responses of both binocular and monocular dLGN inputs during binocular viewing. As predicted by our findings in thalamic inputs, Ca2+imaging from V1 neurons revealed spared spatial acuity but impaired binocularity in L4 neurons. V1 L2/3 neurons in contrast displayed deficits in both binocularity and spatial acuity. Our data demonstrate that critical-period MD produces long-lasting disruptions in binocular integration beginning in early binocular circuits in dLGN, whereas spatial acuity deficits first arise from circuits further downstream in V1. Our findings indicate that the development of normal binocular vision and spatial acuity depend upon experience-dependent refinement of distinct stages in the mammalian visual system.

SIGNIFICANCE STATEMENTAbnormal binocular vision and reduced acuity are hallmarks of amblyopia, a disorder that affects 2%–5% of the population. It is widely thought that the neural deficits underlying amblyopia begin in the circuits of primary visual cortex. Usingin vivotwo-photon calcium imaging of thalamocortical axons in mice, we show that depriving one eye of input during a critical period in development chronically impairs binocular integration in thalamic inputs to primary visual cortex. In contrast, visual acuity is spared in thalamic inputs. These findings shed new light on the role for developmental mechanisms in the thalamus in establishing binocular vision and may have critical implications for amblyopia.
Cómo revelan las sociedades anónimas abiertas chilenas los impuestos diferidos en sus estados financieros
Authors: López Balmaceda Tania , Soto Guzmán Fabián
Published: November 2019

La globalización, junto con el deseo de crecer que poseen las empresas, representa un gran reto para la contabilidad. Lo anterior genera una gran variedad de transacciones que derivan en una mayor cantidad de información contable y que necesitan contar con nuevos parámetros que controlen su revelación. Las Normas Internacionales de Contabilidad (NIC) solucionan dicho problema y logran un lenguaje común en los negocios, pero ¿las compañías cumplen con todos los estándares descritos?El propósito de esta investigación es observar y analizar cómo revelan la información contable sobre impuestos diferidos las sociedades anónimas abiertas (SAA) chilenas en los estados financieros (EE.FF.), reglamentados por la NIC 12 “Impuesto a las ganancias”. Específicamente los objetivos son: examinar los criterios contables expuestos en la norma, comparar dichos criterios con la información presentada por las entidades en los EE.FF. y establecer características generales que posean las empresas.Al finalizar el estudio se espera encontrar una aplicación incompleta de la NIC 12 en los estados financieros y una disparidad entre la información revelada por las compañías, en consecuencia de que la norma no especifica una estructura concreta de cómo se debe presentar la información, evidenciando la práctica de comunicar el contenido mínimo exigido sin validar su utilidad.
Evasión tributaria, una revisión
Authors: Patiño Jacinto Ruth Alejandra , Mendoza Gómez Sandy Tatiana , Quintanilla Ortiz Diego Alexander , Díaz Montenegro José
Published: November 2019

El presente artículo tiene como temática la evasión tributaria, la cual es un problema mundial, de ahí su importancia y relevancia en investigación. En el presente artículo se realiza una revisión general sobre el comportamiento social, de valores y tributario de los contribuyentes y busca dar algunas explicaciones de los fenómenos de la corrupción y la evasión, casos específicos los paraísos fiscales y centros financieros extraterritoriales, evasión medida desde la información financiera de las entidades financieras y medición de la evasión con respecto al sistema fiscal.
The consistency of bootstrap and jackknife variance estimators for finite population L-statistics
Authors: Čiginas Andrius
Published: November 2019

For the linear combinations of order statistics (L-statistics), we present conditions sufficient for the consistency of their finite-population bootstrap variance estimator and the classical jackknife variance estimator.
Sequent systems for PLTL
Authors: Alonderis Romas , Pliuškevičius Regimantas
Published: November 2019

We consider three sequent calculi for propositional linear temporal logic (PLTL) which allow us to formalize the properties of operator “always”.  The main new results presented in the paper are: (1) introduction of the calculus withlooping axioms; (2) the direct proof that the presented calculi are equivalent; (3) the proof of completeness of the calculi with looping axioms and with invariant-like rule based on completeness of the calculus with the infinitary $\omega$-type rule.
Modeling of surfaces using 3D fractal interpolation
Authors: Landauskas Mantas
Published: November 2019

This paper discusses the concept of three-dimensional (3D) fractal interpolation and the possibility to use it in modeling 3D surfaces. It is important to notice that this paper treats fractal interpolation only as a numerical tool and not as a model. The purpose of the research is to create a methodology for obtaining models for the given 3D surface and making them similar to it to a certain degree. The set of models then can be investigated as required (3D graphical representation, simulation of particular technological process, quality assessment for bonded surfaces, etc.). Measuring a particular 3D surface and making a set of models is far more cost efficient than performing the measurements many times.
Modeling of gradual epidemic changes
Authors: Račkauskas Alfredas , Tamulis Aurelijus
Published: November 2019

The article is devoted to analysis of epidemic changes, when transition between regimes is gradual. The consistency of CUSUM, Uniform Increments (UI) and Dyadic Increments (DI) statistics is shown. The comparison of the size-adjusted power of the tests is presented graphically.
Investigation of the spectrum of the Sturm–Liouville problem with a nonlocal integral condition
Authors: Skučaitė Agnė , Štikonas Artūras
Published: November 2019

This paper presents some new results on the spectrum for the second order dif-ferential problem with one integral type nonlocal boundary condition (NBC). We investigate how the spectrum of this problem depends on the integral nonlocal boundary condition pa-rameters γ, ξ and the symmetric interval in the integral. Some new results are given on the complex spectra of this problem. Many results are presented as graphs of real and complex characteristic functions.
Eliciting opinions of experts using uncertainty
Authors: Podvezko Valentinas , Podviezko Askoldas
Published: November 2019

Multiple criteria decision-making (MCDM) methods designed for evaluation of attractiveness of available alternatives, whenever used in decision-aid systems, imply active participation of experts. They participate in all stages of evaluation: casting a set of criteria, which should describe an evaluated process or an alternative; estimating level of importance of each criterion; estimating values of some criteria and sub-criteria. Social and economic processes are prone to laws of statistics,which are described and could be forecasted using the theory of probability. Weights of criteria, which reveal levels of their importance, could rarely be estimated with the absolute level of precision. Uncertainty of evaluation is characterised by a probability distribution. Aiming to elicit evaluation from experts we have to find either a distribution or a density function. Statistical simulation method can be used for estimation of evaluation of weights and/or values of criteria by experts. Alternatively, character of related uncertainty can be estimated by an expert himself during the survey process. The aim of this paper is to describe algorithms of expert evaluation with estimation of opinion uncertainty, which were applied in practice. In particular, a new algorithm was proposed, where an expert evaluates criteria by probability distributions.
A discrete limit theorem for the periodic Hurwitz zeta-function
Authors: Rimkevičienė Audronė
Published: November 2019

In the paper, we prove a limit theorem of discrete type on the weak convergence of probability measures on the complex plane for the periodic Hurwitz zeta-function.
Bitcoin – a way to reach consensus in a completely decentralized manner
Authors: Bieliauskas Rytis , Paliokas Eugenijus
Published: November 2019

Bitcoin is a digital currency currently being legalized throughout the European  Union [2], whose operating  rinciples were published publicly [5], but not in scientific or mathematical sources. The goal of this report is to encourage discussions about decentralization and security of the Bitcoin system, as well as about reasonableness of the Bitcoin network fees. Bitcoin is a fully decentralized peer-to-peer electronic currency system, which lets its users to send transactions directly from one user to another, without any thirdparties. Electronic signature ensures that transaction is sent by the person who owns the money, but the main problem of such a system is to ensure, without any third-parties, that the same money could not be spent twice. This problem in the Bitcoin system is solved using a peer-to-peer network. The Bitcoin network timestamps all transactions, by grouping them to an ongoing chain of transaction blocks, where each block must have a hash (SHA256) result which would meet certain conditions, thus ensuring that in order to cancel or modify a past transaction, one would need to find more hashes which meet the required conditions than the whole Bitcoin network combined since the time of transaction. This allows users to leave and rejoin the network at will, and always be sure which transaction history is the correct one.