bluuebunny/crossref_metadata_2025 huggingface dataset:
Real-world clinical course of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Japan
Authors: Tsutsumi Shuntaro , Sato Tomoo , Yagishita Naoko , Yamauchi Junji , Araya Natsumi , Hasegawa Daisuke , Nagasaka Misako , Coler-Reilly Ariella L. G. , Inoue Eisuke , Takata Ayako , Yamano Yoshihisa
Published: October 2019

Background

As human T-cell leukemia virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a rare chronic neurological disease, large scale studies to collect continuous clinical data have been difficult to conduct. Therefore, the incidence of comorbidities and drug utilization data remain unknown. When conducting trials to develop new drugs in rare disease such as HAM/TSP, historical control data obtained from registry studies would be useful, as cohorts in rare disease tend to be small. Long-term follow-up of patients with a chronic disease can also be challenging. In this study, we addressed the following two goals using registry data on patients (n = 486) enrolled in the Japanese HAM/TSP patient registry “HAM-net” from 2012 to 2016: 1) to clarify the epidemiological information of HAM/TSP such as the incidence of comorbidities and drug utilization and 2) to provide the real-world data on changes in lower limb motor dysfunction.

Results

In HAM-net-registered patients, common comorbidities were fractures, herpes zoster, and uveitis, with incidences of 55.5, 10.4, and 6.5, respectively, per 1000 person-years. Every year, oral steroid treatment was administered in 48.2–50.7% of the HAM-net-registered patients and interferon-α treatment was used in 2.6–3.5% of patients. The median dose of oral prednisolone was low at 5.0 mg/day. The incidence of fractures and herpes zoster tended to be higher in the steroid-treated group than in the untreated group (fractures: 61.0 vs. 48.3, herpes zoster: 12.7 vs. 8.8, per 1000 person-years). The analysis of chronological change in Osame motor disability score (OMDS) indicated that the mean change in OMDS was + 0.20 [95% confidence intervals (CI): 0.14–0.25] per year in the one-year observation group (n = 346) and + 0.57 (95% CI: 0.42–0.73) over four years in the four-year observation group (n = 148). Significant deterioration of OMDS was noted in all subgroups with varying steroid use status.

Conclusions

This study revealed the incidence of comorbidities and drug utilization data in patients with HAM/TSP using registry data. Furthermore, this study provided real-world data on chronological changes in lower limb motor dysfunction in patients with HAM/TSP, indicating the utility of these data as historical controls.
Hidden biodiversity revealed by integrated morphology and genetic species delimitation of spring dwelling water mite species (Acari, Parasitengona: Hydrachnidia)
Authors: Blattner Lucas , Gerecke Reinhard , von Fumetti Stefanie
Published: October 2019

Background

Water mites are among the most diverse organisms inhabiting freshwater habitats and are considered as substantial part of the species communities in springs. As parasites, Hydrachnidia influence other invertebrates and play an important role in aquatic ecosystems. In Europe, 137 species are known to appear solely in or near springheads. New species are described frequently, especially with the help of molecular species identification and delimitation methods. The aim of this study was to verify the mainly morphology-based taxonomic knowledge of spring-inhabiting water mites of central Europe and to build a genetic species identification library.

Methods

We sampled 65 crenobiontic species across the central Alps and tested the suitability of mitochondrial (cox1) and nuclear (28S) markers for species delimitation and identification purposes. To investigate both markers, distance- and phylogeny-based approaches were applied. The presence of a barcoding gap was tested by using the automated barcoding gap discovery tool and intra- and interspecific genetic distances were investigated. Furthermore, we analyzed phylogenetic relationships between different taxonomic levels.

Results

A high degree of hidden diversity was observed. Seven taxa, morphologically identified asBandakia concretaThor, 1913,Hygrobates norvegicus(Thor, 1897),Ljania bipapillataThor, 1898,Partnunia steinmanniWalter, 1906,Wandesia racovitzaiGledhill, 1970,Wandesia thoriSchechtel, 1912 andZschokkea oblongaKoenike, 1892, showed high intraspecificcox1 distances and each consisted of more than one phylogenetic clade. A clear intraspecific threshold between 5.6–6.0% K2P distance is suitable for species identification purposes. The monophyly of Hydrachnidia and the main superfamilies is evident with different species clearly separated into distinct clades.cox1 separates water mite species but is unsuitable for resolving higher taxonomic levels.

Conclusions

Water mite species richness in springs is higher than has been suggested based on morphological species identification alone and further research is needed to evaluate the true diversity. The standard molecular species identification markercox1 can be used to identify species but should be complemented by a nuclear marker, e.g.28S, to resolve taxonomic relationships. Our results contribute to the taxonomical knowledge on spring inhabiting Hydrachnida, which is indispensable for the development and implementation of modern environment assessment methods, e.g. metabarcoding, in spring ecology.
Depression in ankylosing spondylitis and the role of disease-related and contextual factors: a cross-sectional study
Authors: Webers Casper , Vanhoof Laura , Leue Carsten , Boonen Annelies , Köhler Sebastian
Published: October 2019

Background

Patients with ankylosing spondylitis (AS) have a higher prevalence of depression compared to the general population. Comorbid depression in AS likely has a multifactorial origin. While several disease-related and contextual factors have been associated with depressive symptoms in AS, a comprehensive model of their interrelations is currently lacking. Such a model could help understand the mechanisms leading to, or maintaining, depression in AS. The objectives of the current study were to determine which factors are associated with depressive symptoms in AS and to understand their underlying relationships.

Methods

Data from a cross-sectional survey-based multicentre study were used. Potential determinants included both contextual and disease-related factors. Depressive symptoms were assessed by the Hospital Anxiety and Depression Subscale (HADS-D). Direct and indirect associations between risk factors and the latent depressive symptom outcome were explored using structural equation modelling. A final model was selected based on model fit criteria and clinical plausibility.

Results

Among 245 patients, median HADS-D score was 3 (interquartile range 1–6), and 44 patients (18%) had a HADS-D score ≥ 8, indicating possible depression. In the final model, contextual factors significantly associated with depressive symptoms were male gender, being employed, lower income, lower mastery and worse satisfaction with social role participation. Bath AS Disease Activity Index (BASDAI) was the only disease-related factor that was associated with depressive symptoms, acted only indirectly via mastery, and its standardized total effect on depressive symptoms was smaller than that of several contextual factors. Mastery had a central role in the path diagram and mediated the effects of BASDAI, income and satisfaction with social role participation on depressive symptoms. The final model explained 64% of the variance in the depression outcome.

Conclusions

Both contextual and disease-related factors are associated with depressive symptoms in AS. Mastery, the extent to which one feels in control over life and disease, has a key role in this process. Results support a relevance of self-efficacy in disease management and patient education. In order to improve patients’ mental health, research is warranted whether mastery and its relation with depression can be modified.
Very early MRI responses to therapy as a predictor of later radiographic progression in early rheumatoid arthritis
Authors: Conaghan Philip G. , Østergaard Mikkel , Troum Orrin , Bowes Michael A. , Guillard Gwenael , Wilkinson Bethanie , Xie Zhiyong , Andrews John , Stein Amy , Chapman Douglass , Koenig Andrew
Published: October 2019

Background

The objective of this study was to evaluate early changes in magnetic resonance imaging (MRI) and clinical disease activity measures as predictors of later structural progression in early rheumatoid arthritis (RA).

Methods

This was a post hoc analysis of data pooled across treatments from a three-arm (tofacitinib monotherapy, tofacitinib with methotrexate [MTX], or MTX monotherapy) trial of MTX-naïve patients with early, active RA. Synovitis, osteitis and erosions were assessed with the Outcome Measures in Rheumatology (OMERACT) RA MRI scoring system (RAMRIS) and RAMRIQ (automated quantitative RA MRI assessment system; automated RAMRIS) at months 0, 1, 3, 6 and 12. Radiographs were assessed at months 0, 6 and 12, and clinical endpoints were assessed at all timepoints. Univariate and multivariate analyses explored the predictive value of early changes in RAMRIS/RAMRIQ parameters and disease activity measures, with respect to subsequent radiographic progression.

Results

Data from 109 patients with a mean RA duration of 0.7 years were included. In univariate analyses, changes in RAMRIS erosions at months 1 and 3 significantly predicted radiographic progression at month 12 (both p <  0.01); changes in RAMRIQ synovitis and osteitis at months 1 and 3 were significant predictors of RAMRIS erosions and radiographic progression at month 12 (all p <  0.01). In subsequent multivariate analyses, RAMRIS erosion change at month 1 (p <  0.05) and RAMRIQ osteitis changes at months 1 and 3 (both p <  0.01) were significant independent predictors of radiographic progression at month 12. Univariate analyses demonstrated that changes in Clinical Disease Activity Index (CDAI) and Disease Activity Score in 28 joints, erythrocyte sedimentation rate (DAS28-4[ESR]) at months 1 and 3 were not predictive of month 12 radiographic progression.

Conclusions

MRI changes seen as early as 1 month after RA treatment initiation have the potential to better predict long-term radiographic progression than changes in disease activity measures.

Trial registration

ClinicalTrials.gov, NCT01164579.
Stimulating injury-preventive behaviour in sports: the systematic development of two interventions
Authors: Kemler E. , Valkenberg H. , Gouttebarge V.
Published: October 2019

Background

In addition to the beneficial health effects of being active, sports are also associated with a risk of sustaining injuries. To avoid the occurrence of sports injuries, preventive measures can be applied. The aim of the current article is to provide insight into the systematic developmental process of two evidence-based interventions designed to stimulate injury-preventive behaviour in runners and skiers, in which Intervention Mapping (IM) and Knowledge Transfer Scheme (KTS) are used as developmental protocols. However, the ultimate steps in the process are adjusted to meet requirements of the intervention and the target group.

Methods

Using a three-step process, we developed two interventions to stimulate injury-preventive behaviour in runners and skiers. Sports participants, sports experts and behaviour experts contributed throughout steps two and three of the developmental process.

Results

In step one we started with a problem statement in which we used information about the number and the burden of running-related and skiing-related injuries in the Netherlands. In step two, in-depth research was performed using four research strategies. During this step we tried to answer the following question: Which preventive measures or actions should be executed to prevent what injuries by whom, and how should we do that? A desk research/systematic review of the literature, expert meetings, target user surveys, and target user focus group meetings were conducted. In step three of product development, both interventions were developed. During the developmental process, co-creation sessions with target users were held. Before finalizing the interventions, pre-tests of the interventions were performed with target users.

Conclusions

Through a three-step approach, we developed two interventions to stimulate injury-preventive behaviour in runners and skiers. To develop an intervention that fits the needs of the target population, and will be used by them, it is necessary to involve this population as soon and as much as possible. Several steps in the IM and KTS protocols have thus been adjusted in order to establish an optimal fit between intervention and target group.
Development, validation and translation of cardiopulmonary resuscitation and automated external defibrillator training and placement bilingual questionnaire
Authors: Chew Keng Sheng , Liaw Siew Yee , Ahmad Zahedi Ahmad Zulkarnain , Wong Shirly Siew Ling , Singmamae Nariman , Kaushal Dev Nath , Chan Hiang Chuan
Published: October 2019

Objectives

This paper describes the development and translation of a questionnaire purported to measure (1) the perception of the placement strategy of automated external defibrillator, (2) the perception on the importance of bystander cardiopulmonary resuscitation and automated external defibrillator (3) the perception on the confidence and willingness to apply these two lifesaving interventions as well as (4) the fears and concerns in applying these two interventions. For construct validation, exploratory factor analysis was performed using principal axis factoring and promax oblique rotation and confirmatory factor analysis performed using partial least square.

Results

Five factors with eigenvalue > 1 were identified. Pattern matrix analysis showed that all items were loaded into the factors with factor loading > 0.4. One item was subsequently removed as Cronbach’s alpha > 0.9 which indicates redundancy. Confirmatory factor analysis demonstrated acceptable factor loadings except for one item which was subsequently removed. Internal consistency and discriminant validity was deemed acceptable with no significant cross-loading.
Khat chewing prevalence and correlates among university staff in Ethiopia: a cross-sectional study
Authors: Yeshaw Yigizie , Zerihun Muluken Fekadie
Published: October 2019

Objectives

Khat is an herbal cultivated plant growing mainly in Eastern Africa and Arabians. Chronic khat chewing leads to the development of liver toxicity, cardiovascular disease, sleeping disorder, psychosis, memory impairment, poor academic performance and variety of social and economic problems affecting the consumers and their families. Therefore, this study aimed to determine the prevalence of khat chewing and associated factors among Jimma university staff. An institution-based cross-sectional study was employed on 354 university staff. A self-administered questionnaire was used to collect the data. The analysis was done using Stata 14. A multivariable logistic regression model was used to identify associated factors of khat chewing among university staff. p ≤ 0.05 was employed to declare statistically significant factors.

Results

The lifetime prevalence of khat chewing among university staff was 41.0% (95% CI 35.9–46.1%). The odds of khat chewing was higher among males (AOR = 2.66 95%, CI 1.52–4.68), participants who had khat chewer friends (AOR = 2.15 95% CI 1.18–3.93), alcohol users (AOR = 9.02, 95% CI 4.96–16.42) and participants who had khat chewer family member (AOR = 4.03, 95% CI 1.16–13.99). Since a significant proportion of staff chew khat, appropriate measures need to be taken to reduce its prevalence and adverse social and health consequences.
Genotyping and characterization of prophage patterns in clinical isolates of Staphylococcus aureus
Authors: Dini Mahya , Shokoohizadeh Leili , Jalilian Farid Aziz , Moradi Abbas , Arabestani Mohammad Reza
Published: October 2019

Objective

Staphylococcus aureus is considered an important pathogen with a variety of virulence factors in communities and hospitals all around the world. Prophage typing is a practical technique for categorizing this bacterium. In this study, we focused on the detection of prophage patterns in methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) strains based on their virulence factors, antimicrobial resistance patterns, and molecular typing by rep-PCR.

Results

Out of 126 S. aureus isolates, 45 (35.7%) were identified as MRSA. In total, 17 different prophage types were detected and 112 strains out of 126 strains contained at least one prophage. There was a statistically significant relationship between hld, hlg, eta and SGA, SGA, and SGFb, respectively. The results of the rep-PCR analysis revealed 14 different patterns among the MRSA and MSSA isolates. In conclusion, the presence of different prophage-encoded virulence factors and antibiotic-resistant genes among MRSA strains enables them to produce a broad range of diseases. Thus, diverse MRSA strains which have these prophages can be considered as a potential threat to the patient’s health in either the hospital or the community.
Cholera hotspots and surveillance constraints contributing to recurrent epidemics in Tanzania
Authors: Hounmanou Yaovi M. G. , Mølbak Kåre , Kähler Jonas , Mdegela Robinson H. , Olsen John E. , Dalsgaard Anders
Published: October 2019

Objective

We described the dynamics of cholera in Tanzania between 2007 and 2017 and assessed the weaknesses of the current surveillance system in providing necessary data in achieving the global roadmap to 2030 for cholera control.

Results

The Poisson-based spatial scan identified cholera hotspots in mainland Tanzania. A zero-inflated Poisson regression investigated the relationship between the incidence of cholera and available demographic, socio-economic and climatic exposure variables. Four cholera hotspots were detected covering 17 regions, home to 28 million people, including the central regions and those surrounding the Lakes Victoria, Tanganyika and Nyaza. The risk of experiencing cholera in these regions was up to 2.9 times higher than elsewhere in the country. Regression analyses revealed that every 100 km of water perimeter in a region increased the cholera incidence by 1.5%. Due to the compilation of surveillance data at regional level rather than at district, we were unable to reliably identify any other significant risk factors and specific hotspots. Cholera high-risk populations in Tanzania include those living near lakes and central regions. Successful surveillance require disaggregated data available weekly and at district levels in order to serve as data for action to support the roadmap for cholera control.
The John–Nirenberg inequality in ball Banach function spaces and application to characterization of BMO
Authors: Izuki Mitsuo , Noi Takahiro , Sawano Yoshihiro
Published: October 2019

Our goal is to obtain the John–Nirenberg inequality for ball Banach function spaces X, provided that the Hardy–Littlewood maximal operator M is bounded on the associate space $X'$

X
′

by using the extrapolation. As an application we characterize BMO, the bounded mean oscillation, via the norm of X.
Higher integrability for weak solutions to a degenerate parabolic system with singular coefficients
Authors: Dong Yan , Du Guangwei , Zhang Kelei
Published: October 2019

In this paper, we study the degenerate parabolic system
$$ u_{t}^{i} + X_{\alpha }^{*} \bigl(a_{ij}^{\alpha \beta }(z){X_{\beta }} {u^{j}}\bigr) = {g_{i}}(z,u,Xu) + X_{\alpha }^{*} f_{i}^{\alpha }(z,u,Xu), $$

u
t
i

+

X
α
∗

(

a

i
j

α
β

(
z
)

X
β

u
j

)

=

g
i

(
z
,
u
,
X
u
)
+

X
α
∗

f
i
α

(
z
,
u
,
X
u
)
,
where $X=\{X_{1},\ldots,X_{m} \}$
X
=
{

X
1

,
…
,

X
m

}
is a system of smooth real vector fields satisfying Hörmander’s condition and the coefficients $a_{ij}^{\alpha \beta }$

a

i
j

α
β

are measurable functions and their skew-symmetric part can be unbounded. After proving the $L^{2}$

L
2

estimates for the weak solutions, the higher integrability is proved by establishing a reverse Hölder inequality for weak solutions.
Exploration during early life: distribution, habitat and orientation preferences in juvenile king penguins
Authors: Orgeret F. , Péron C. , Enstipp M. R. , Delord K. , Weimerskirch H. , Bost C. A.
Published: October 2019

Background

The early life of marine apex predators is poorly known, particularly for diving species. The orientation and foraging skills are presumably less developed in juveniles than in adults, especially during their first year at sea when juveniles might disperse further than adults.

Methods

Over two years of monitoring, we tracked the movements of 17 juvenile king penguins (Aptenodytes patagonicus,~ 1 year old) using satellite relay tags from Crozet Archipelago (Southern Indian Ocean), starting when birds left their natal colony for the first time. For comparison we also tagged 6 non-breeding adults, which at that stage, similar to juveniles, are unhampered by reproductive constraints and might roam further than breeders. We used a combination of cluster analysis and habitat modelling to investigate and compare the movement patterns and habitat use of experienced (non-breeding adults) and non-experienced (juveniles) individuals.

Results

While juvenile penguins and non-breeding adults followed similar routes, the movements by adults started later in the season and ranged over a considerably smaller area than juveniles. Net squared displacement analysis revealed that both groups did not move to a specific wintering area. Changes in direction of juveniles in respect to their departure island were similar and synchronous for both years. Habitat models revealed that foraging behaviour was affected by environmental variables such as wind or current speeds, sea surface temperature, or oceanic productivity, for both stages. Analysis of tracks revealed that birds moved predominately perpendicular or against the main direction of the Antarctic Circumpolar Current and the prevailing wind during austral summer (juveniles only) and autumn (juveniles and non-breeding adults). However, both juveniles and adults were more likely to move against the prevailing winds if productivity increased along their trajectories.

Conclusions

The exceptional duration of our tracking study provided unprecedented insights into the distribution, habitat preferences and orientation of two poorly known life history stages of an expert avian diver. Our study suggests that juveniles might use both innate and learnt skills to reach profitable foraging areas during their first year at sea, which is critical in long-lived species.
The recurrence of colonic volvulus due to nonrotation after intestinal resection in adulthood: a case report
Authors: Sakimura Yusuke , Kitamura Hirotaka , Inaki Noriyuki , Bando Hiroyuki
Published: October 2019

Background

Intestinal nonrotation is a rare congenital condition that causes fatal colonic volvulus at any age. Once volvulus attack occurs, radical surgical therapy is required for treatment and the prevention of recurrence. This report describes the case of an adult female patient with a recurrence of cecum volvulus due to intestinal nonrotation after transverse colon resection for colonic volvulus.

Case presentation

A 27-year-old female visited our emergency room (ER) with intermittent abdominal pain and nausea. Enhanced computed tomography (CT) showed enlargement of the level of the ascending and transverse colon and an obstruction with a whirlpool sign at the transverse colon. The small intestine was distributed on the right side of the abdominal cavity, and the large intestine occupied the left side. She was diagnosed with volvulus with intestinal nonrotation, and emergency surgery was performed. Surgical examination indicated that the ascending colon to the transverse colon was not fixed to the retroperitoneum, and the transverse colon was rotated 180° clockwise. The axis of the volvulus was a mesenteric adhesion of the transverse colon. The involved transverse colon was resected, and the intestine was reconstructed by functional end-to-end anastomosis (FEEA). Six years after the initial surgery, the patient presented to the ER with abdominal fullness and lower abdominal pain. Enhanced CT revealed that the cecum, ascending colon, and remaining transverse colon were dilated with an obstruction. The appendix was located in the left upper abdominal cavity. The clinical diagnosis was cecal volvulus with intestinal nonrotation. An emergency laparotomy revealed that the cecum was rotated 180° clockwise. The terminal ileum to the remaining transverse colon was resected, and FEEA was performed. Seven months later, she suffered obstruction of the intestine caused by an operative adhesion, and conservative treatment was successful. The patient has had no abdominal symptoms for one and a half years so far.

Conclusions

Surgeons should realize that nonrotation of the intestines induces volvulus in adulthood and should familiarize themselves with its clinical findings, appropriate treatment, and prognosis. Even after surgical treatment, awareness of the recurrence of volvulus should be maintained to avoid a late diagnosis.
Innovating public engagement and patient involvement through strategic collaboration and practice
Authors: Holmes Leah , Cresswell Katharine , Williams Susannah , Parsons Suzanne , Keane Annie , Wilson Cassie , Islam Safina , Joseph Olivia , Miah Jahanara , Robinson Emily , Starling Bella
Published: October 2019

Background

Patient and public involvement and engagement is an important and expected component of health-related research activity in the UK. Specifically within the health research sphere, public engagement (usually defined as raising awareness of research) and patient involvement (usually defined as actively involving people in research) have traditionally been seen as separate but have much to gain from working together towards a common goal of better health outcomes for all.

Methods

This paper describes a unique approach taken by the Public Programmes Team: a small interdisciplinary team of public engagement specialists, with backgrounds in science, community development, public engagement and involvement, policy, ethics, communications, industry, museums and creative practice, embedded within translational research infrastructure and delivery in Manchester in the North West of England. We propose a new model of professional practice – a 'cycle' of engagement and involvement – innovating across the complementary fields of public engagement and patient involvement, and working inclusively and in partnership with people in health research. Further, our approach capitalises on strategic collaboration offering economies of scale and a joined up way of working. Our ambition is to boldly experiment, learn and reflect, responsibly and based on evidence and partnerships, using methods of engagement that address issues of social justice.

Results

Here, we report on preliminary case studies exemplifying the impact of our approach, and data relating to achievements and learning between April 2017 and March 2018. Informed by our findings, we propose that our approach has the potential to be replicated elsewhere.

Conclusions

Our practice and the beginning of its evaluation lead us to believe that our way of working and model of professional practice – the ‘cycle’ of engagement and involvement – is effective in: addressing our vision of making health research relevant and inclusive for everyone; and embedding and joining up public involvement in a busy and fertile translational health research ecosystem.
Caring for healthcare practitioners
Authors: Williams Richard , Kemp Verity
Published: October 2019

Caring for people in distress or illness is emotionally draining and physically demanding. This article focuses on the experiences and needs of health service staff as professional carers. It overviews the current circumstances in the UK and links readers to the findings of: the Stevenson/Farmer Review of 2017; the report of the General Medical Council on the state of medical education and practice of 2018; and the British Medical Association survey of doctors and medical students published in 2019. We review the sources of stress that affects healthcare practitioners and introduce the concepts of emotional labour, psychological safety and psychosocial resilience. We draw attention to the vital importance of social support and leadership to protecting healthcare staff. We conclude this review of the topic by outlining a stepped model for actions that aim to: develop staff of healthcare services and help them to thrive at work; support staff who are struggling at work; and intervene to care for staff who are distressed or unwell whether they are continuing to work or not.
Mapping Geospatial Access to Comprehensive Cancer Care in Nigeria
Authors: Knapp Gregory C. , Tansley Gavin , Olasehinde Olalekan , Alatise Olusegun I. , Wuraola Funmilola , Olawole Moses O. , Arije Olujide O. , Gali Bata M. , Kingham T. Peter
Published: October 2019

PURPOSE

To address the increasing burden of cancer in Nigeria, the National Cancer Control Plan outlines the development of 8 public comprehensive cancer centers. We map population-level geospatial access to these eight centers and explore equity of access and the impact of future development.

METHODS

Geospatial methods were used to estimate population-level travel times to the 8 cancer centers. A cost distance model was built using open source road infrastructure data with verified speed limits. Geolocated population estimates were amalgamated with this model to calculate travel times to cancer centers at a national and regional level for both the entire population and the population living on < US$2 per day.

RESULTS

Overall, 68.9% of Nigerians have access to a comprehensive cancer center at 4 hours of continuous vehicular travel. However, there is significant variability in access between geopolitical zones ( P < .001). The North East has the lowest access at 4 hours (31.4%) and the highest mean travel times (268 minutes); this is significantly lower than the proportion with 4-hour access in the South East (31.4% v 85.0%, respectively; P < .001). The addition of a second comprehensive cancer center in the North East, in either Bauchi or Gombe, would significantly improve access to this underserved region.

CONCLUSION

The Federal Ministry of Health endorses investment in 8 public comprehensive cancer centers. Strengthening these centers will allow the majority of Nigerians to access the full complement of multidisciplinary care within a reasonable time frame. However, geospatial access remains inequitable, and the impact on outcomes is unclear. This must be considered as the cancer control system matures and expands.
The Creation of the Femme Fatale in Egyptian Cinema
Authors: Bracco Carolina
Published: October 2019

The appearance of the character of a femme fatale in Egyptian cinema in the mid-1950s is deeply intertwined with the new social and moral imprint made by the Nasserist regime. At a time when women’s participation in the public sphere was regulated, the portrayal of the evil woman was intended to define how the good woman should behave as well as the terrible fate in store for those who dared to flout the limits. This evil woman was embodied in the character of the Oriental dancer who was to be seen, from that time on, as a fallen woman. This article aims to discuss the mutation of the character of the dancer from a bint al balad (lit. “girl of the country”) to a femme fatale by analyzing three films starring two icons of the time, Hind Rustum and Tahia Carioca.
Gender and Nation Building in Qatar
Authors: Liloia Alainna
Published: October 2019

This article explores the relationship between gender and modern nation building in Qatar, with attention to how Qatari women negotiate the challenges of modern development and social change. The article analyzes Qatar’s strategic use of gendered nation-building initiatives, founded on representations of women as both symbols of tradition and markers of modernity, to facilitate modern development and construct a national identity. In addition, the article uncovers the myriad ways Qatari women respond to the state’s gendered initiatives and dualistic expectations, engage with state conceptualizations of modernity and tradition, and negotiate social and religious gender norms. The article argues that Qatari women’s views reflect their strategic negotiation, rather than uncritical submission or acceptance, of social and religious norms alongside increased expectations for participation in the workforce and higher education. The study, derived from fifteen qualitative interviews with Qatari women aged twenty-six to fifty-six, unearths certain trends in participant views on gender roles, modern development, and tradition. The participants express satisfaction with and a desire to maintain established gender paradigms. They simultaneously emphasize the positive aspects of modernization and express concern about a loss of traditional values.
Adenoviral-TMBIM6 vector attenuates ER stress - induced apoptosis in a neonatal hypoxic-ischemic rat model
Authors: Doycheva Desislava , Xu Ningbo , Kaur Harpreet , Malaguit Jay , McBride Devin William , Tang Jiping , Zhang John H.
Published: October 2019

Endoplasmic Reticulum (ER) stress is a major pathology encountered after hypoxic-ischemic (HI) injury. Accumulation of unfolded proteins triggers the unfolded protein response (UPR) resulting in the activation of pro-apoptotic cascades causing cells to die. Here we identified Bax Inhibitor-1 (BI-1), an evolutionary protein encoded by the Transmembrane Bax inhibitor Motif Containing 6 (TMBIM6) gene, as a novel modulator of ER stress-induced apoptosis after HI brain injury in a neonatal rat pup. The main objective of our study is to overexpress BI-1, via viral-mediated gene delivery of human adenoviral-TMBIM6 (Ad-TMBIM6) vector, to investigate its anti-apoptotic effects as well as to elucidate its signaling pathways in an in vivo neonatal HI rat model and in vitro oxygen-glucose deprivation (OGD) model.

Ten-day old unsexed Sprague-Daley rat pups underwent right common carotid artery ligation followed by 1.5h of hypoxia. Rat pups injected with Ad-TMBIM6 vector, 48h pre-HI, showed a reduction in percent infarcted area, attenuated neuronal degeneration and improved long-term neurological outcomes. Furthermore, silencing BI-1 or further activating the IRE1α branch of the UPR, with CRISPR activation plasmid, showed to reverse BI-1's protective effects. Based on our in vivo and in vitro data, BI-1's protective effects were shown to be mediated via inhibition of IRE1α signaling and in part via inhibition of the second stress sensor receptor, PERK. Overall, this study showed a novel role for BI-1 and ER stress in the pathophysiology of HI and could provide a basis for BI-1 as a potential therapeutic target.
Cul3 regulates cyclin E1 protein abundance via a degron located within the N-terminal region of cyclin E
Authors: Davidge Brittney , Rebola Katia Graziella de Oliveira , Agbor Larry N. , Sigmund Curt D. , Singer Jeffrey D.
Published: October 2019

Cyclin E and its binding partner Cdk2 control the G1/S transition in mammalian cells. Increased levels of cyclin E are found in some cancers. Additionally, proteolytic removal of the cyclin E N-terminus occurs in some cancers and is associated with increased cyclin E–Cdk2 activity and poor clinical prognosis. Cyclin E levels are tightly regulated and controlled in part through ubiquitin-mediated degradation initiated by one of two E3 ligases, Cul1 and Cul3. Cul1 ubiquitylates phosphorylated cyclin E, but the mechanism through which Cul3 ubiquitylates cyclin E is poorly understood. In experiments to ascertain how Cul3 mediates cyclin E destruction, we identified a degron on cyclin E that Cul3 targets for ubiquitylation. Recognition of the degron and binding of Cul3 does not require a BTB domain-containing adaptor protein. Additionally, this degron is lacking in N-terminally truncated cyclin E. Our results describe a mechanism whereby N-terminally truncated cyclin E can avoid the Cul3-mediated degradation pathway. This mechanism helps to explain the increased activity that is associated with the truncated cyclin E variants that occurs in some cancers.
Predatory chemical cues decrease attack time and increase metabolic rate in an orb-web spider
Authors: Ameri Mohammad , Kemp Darrell J. , Barry Katherine L. , Herberstein Marie E.
Published: October 2019

Animals are able to assess the risk of predation and respond accordingly via behavioural and physiological changes. Web-building spiders are in the unique situation where they reside in the middle of their web and are therefore relatively exposed to predators. Thus, these spiders might moderate either their web-building behaviour or their behaviour on the web when exposed to the threat of predation. In this study, we experimentally explored how predatory chemical cues influence foraging behaviour and metabolic rate in female of the orb-web spider, Argiope keyserlingi. We found that female spiders restricted their foraging time budget when exposed to the predatory cues from a praying mantid: they responded 11 percent and 17 percent quicker to a vibratory stimulus compare to control and non-predator cues, respectively, and spent less time handling the prey. Moreover, spiders were less likely to rebuild the web under predatory cues. Female A. keyserlingi exposed to the praying mantid cue significantly elevated their metabolic rate compared to the control group. Our findings revealed short-term modifications over two weeks of the trials in foraging behaviour and physiology of female spiders in response to predator cues. This study suggests that under predator cues the spiders move quicker and this could be facilitated by elevation in metabolic rate. Reduced foraging activity and less frequent web repair/rebuilding would also reduce the spiders’ exposure to praying mantid predators.
Study of Pharmacokinetics of a New Radiopharmaceutical on the Basis of Technetium-99m Labeled Glucose
Authors: Зельчан Р. , Zel'chan R. , Синилкин И. , Sinilkin I. , Медведева А. , Medvedeva A. , Брагина О. , Bragina O. , Чернов В. , Chernov V.
Published: October 2019

Purpose: To study the features of the distribution and removal of a new radiopharmaceutical (RPH) on the basis of a labeled 99mTc glucose derivative for radionuclide diagnostics of oncological diseases in the body of experimental animals.

Material and methods: The main stage of the study was performed on 65 mature conventional outbred white rats and 9 rabbits of the Soviet Chinchilla breed. To study the dynamics of changes in the concentration of the studied RPH in the blood plasma and its distribution in the main organs and tissues, as well as to study the metabolic features of the drug and its excretion, the RPH studied was administered intravenously, once in activity of 20 MBq. Multiple introduction of the RPH was performed in order to study the cumulative properties of the study drug, and to elucidate the possibilities of predicting the cumulation processes from the data obtained with a single administration of RPH. For this purpose, intravenous RPH was administered at the same time 1 time / day for 5 days, at a dose of 20 MBq. To confirm the theory of linearity of the pharmacokinetics of the RFP studied, three groups of laboratory animals received the drug in three activity levels – 10, 20 and 40 MBq were used. After euthanasia, the animals were autopsied and removed the necessary organs and tissues. The prepared and washed organs were placed in tubes for further radiometry in order to study the concentrations of the RPH in the bioassay.

Results: It has been established that the RPH being studied practically does not accumulate in the main organs and tissues, accumulating mainly in the kidneys and bladder. The main organs of elimination of the test drug are the kidneys, and the main excreta are urine. The half-life of the drug from the blood was 10 minutes. Pharmacokinetics of the drug is linear and does not depend on the administered activity, and the drug itself does not possess cumulative properties.

Conclusion: A study of the pharmacokinetics of the RPH 99mTc-1-Thio-D-glucose showed that the preparation possesses optimal properties for the diagnostic agent. The drug stably does not accumulate in the main organs and tissues, which allows it to be reused, for example at the stages of dynamic observation of cancer patients.
Ethical and Legal Aspects of Regulating Genomic Research in International and Russian Practice
Authors: Калиниченко П. , Kalinichenko P. , Пономарева Д. , Ponomareva D.
Published: October 2019

Despite the UN efforts at the universal level, there are no legally binding instruments at this level devoted exclusively to biomedicine and genomic research. However, an experience in the field of protection against radiation exposure could be useful in this regard.

The active development of Biomedicine and genomic research has led to conflicts between ethics and law, which have been the subject of consideration in the higher courts, including at the supranational structures level, in particular, the Council of Europe and the European Court of human rights. Nevertheless, it should be noted that despite all the laws imperfections, Russia is building its approach within the existing system of international standards that allow for the national uniqueness of the regulation in the relevant sphere.
Process Approach in Medical Organizations (on the Example of the City Hospital of Tomsk)
Authors: Титенко Евгения , Titenko Evgeniya
Published: October 2019

The current global trend in healthcare is standardization and quality management issues. Tomsk region is one of the pilot regions in this matter. The article reflects the aspects of implementing a quality management system in healthcare. The issue of the implementation of the “Lean Polyclinic” project, as a QMS tool, is revealed. It was noted that in most organizations this project is far from being completed. The author identifies the main errors during the implementation of the project, and focuses on the process approach as the foundation of a quality management system. A properly built model of process interaction allows you to quickly and efficiently implement QMS in healthcare organizations. The author spelled out the steps for implementing the process approach, and also proposed a model of process management using the example of a medical organization.
Modeling of Discrete Creation Process Advertising Message
Authors: Поляков В. , Polyakov V. , Фомичева Ирина , Fomicheva Irina , Юдина О. , Yudina O.
Published: October 2019

The concepts of mental, symbolic, analytical modeling of the development of advertising messages are considered. The features of the process of developing an advertising message are revealed. The approach of discrete process of advertising message creation in digital marketing is considered. The conjunctive–disjunctive model of expression of attributes of goods in the advertising message is offered. The process of modeling the image of a multiattributive product with the help of algebraic substitutions is considered. The authors developed two types of models to create benefits consumers in the advertising message and expressed in ad attributes.
Reform of Higher Education in the Russian Federation: Intentions and Reality
Authors: Фомичева Е. , Fomicheva E.
Published: October 2019

The article presents the shortcomings of the current situation in higher education. The results of the study of the Russian labour market are presented. The process of training highly qualified personnel is characterized.
Clinical Guideline Highlights for the Hospitalist: Initial Management of Acute Pancreatitis in the Hospitalized Adult
Authors: Jenkins Ashley , Shapiro Jordan
Published: October 2019

GUIDELINE TITLE

2018 American Gastroenterological Association (AGA) Institute Guideline on Initial Management of Acute Pancreatitis

RELEASE DATE

March 2018

PRIOR VERSION

Not applicable

DEVELOPER

AGA Clinical Practice Guideline Committee

FUNDING SOURCE

AGA Institute

TARGET POPULATION

Patients within first 48‐72 hours of admission with acute pancreatitis (AP)
Extração de Arsênio em lodo de esgoto através do processo de fitoextração
Authors: Alvarenga Anarelly Costa , Cardoso Paulo Henrique Silveira , Cunha Igor Geraldo Souza , GonÇalves Paula Wellen Barbosa , Sampaio Regynaldo Arruda
Published: October 2019

A presença de arsênio no lodo de esgoto pode limitar a utilização agrícola desse resíduo, pois esse elemento químico apresenta elevada periculosidade aos seres vivos, podendo entrar na cadeia alimentar e acumular-se ao longo dessa. Diante do exposto, a pesquisa teve como objetivo avaliar o potencial de fitoextração de As pelo capim elefante, cultivado em lodo de esgoto puro. Visando o desenvolvimento de uma tecnologia de baixa custo para retirada de As do lodo de esgoto. O experimento foi realizado em casa de vegetação do ICA/UFMG durante 150 dias, em delineamento blocos casualizados. Os tratamento corresponderam a 5 períodos do cultivo de P. purpureum em parcelas de lodo de esgoto (30; 60; 90; 120 e 150 dias a partir do plantio de estacas) e 2 testemunhas (parcelas de lodo não cultivado e plantio da gramínea em solo). O As foi detectado em concentrações de 0,41 e 0,37 mg kg-1 no lodo de esgoto e solo, respectivamente. O P. purpureum  foi capaz de absorver  e translocar quantidades consideráveis de As, média de 0,35  mg kg-1,  variando de acordo com os períodos de cultivo. No final do período experimental, houve decréscimo de 27,03% na concentração de As no lodo quando comparado aos valores iniciais.
CALIBRAÇÃO DE EQUIPAMENTO DE TDR EM CONDIÇÕES DE LABORATÓRIO E CAMPO PARA DOIS TIPOS DE TUBOS DE ACESSO
Authors: Amaral Clinimar Oliveira , Araújo Mário Sérgio Paiva , Sousa Elias Fernandes , Oliveira Flávio Gonçalves , Marciano Cláudio Roberto
Published: October 2019

A Reflectometria no Domínio do Tempo (TDR) se destaca entre as técnicas utilizadas para a determinação do conteúdo de água no solo devido a características como: alta precisão, manutenção da estrutura física do solo, facilidade de manuseio e portabilidade. Todavia, sua aplicação tem sido limitada à pesquisa devido ao alto custo do equipamento, tubos de acesso e a necessidade de calibração. Nesse sentido, objetivou-se com este trabalho calibrar o TDR, em condições de laboratório e em campo, com a utilização de tubos de acesso de TECANAT e de PVC. Os resultados em laboratório foram satisfatórios para todas as calibrações nos dois tipos de tubos, com a leitura do TDR sendo representativa para estimar a umidade do Cambissolo Háplico eutrófico. Os resultados em campo foram razoáveis, para calibração da constante dielétrica nos dois tubos estudados em Argissolo Vermelho-Amarelo Distrófico, isso devido a intempéries do ambiente, textura argilosa do solo e aderência do tubo ao solo. A utilização de tubos de TECANAT e PVC necessitam de calibrações para cada solo, ficando a viabilidade de seu uso dependente ainda da qualidade de sua instalação no solo.
Plastic recycling and waste reduction in the hospitality industry
Authors: Ramirez Abel , George Babu
Published: October 2019

Every year, the hospitality industry creates millions of tons of avoidable waste globally. While conspicuous consumption is the hallmark of the industry, leaders of the industry have come to the realization that it cannot go on forever. Added to that, the surge of eco-conscious guests and other pressure groups provide the industry players an increased level of impetus for introducing positive change in terms waste reduction and recycling. This paper addresses the current effort the hospitality industry is undertaking to reduce waste and recycle plastic goods and the challenges to be overcome in that process. To explain the contemporary practice, it brings in examples of hotels, resorts, and restaurants chains that are currently implementing recycling or reducing waste programs.