bluuebunny/crossref_metadata_2025 huggingface dataset:
Noninvasive Induction of Muscle Fiber Hypertrophy and Hyperplasia: Effects of High-Intensity Focused Electromagnetic Field Evaluated in an In-Vivo Porcine Model: A Pilot Study
Authors: Duncan Diane , Dinev Ivan
Published: October 2019

Background

High-intensity focused electromagnetic (HIFEM) field technology has been reported to increase muscle thickness and hypertrophy. However, this process has not yet been confirmed on a histologic level.

Objectives

The aim of this study was to evaluate in-vivo structural changes in striated porcine muscle tissue following HIFEM treatment.

Methods

Three Yorkshire pigs received four 30-minute HIFEM treatments applied to the biceps femoris muscle on 1 side only. The fourth pig served as a control subject. At baseline and 2 weeks after the last treatment, biopsy specimens of the muscle tissue were collected from the treatment site. The control pig underwent muscle biopsy from a similar but untreated site. Twenty-five histology slides were evaluated from each pig. A certified histopathologist analyzed sliced biopsy samples for structural changes in the tissue.

Results

Histologic analysis showed hypertrophic changes 2 weeks posttreatment. The muscle mass density increased by 20.56% (to a mean of 17,053.4 [5617.9] µm2) compared with baseline. Similarly, muscle fiber density (hyperplasia) increased: the average change in the number of fibers in a slice area of 136,533.3 µm2 was +8.0%. The mean size of an individual muscle fiber increased by 12.15% (to 332.23 [280.2] µm2) 2 weeks posttreatment. Control samples did not show any significant change in fiber density or hyperplasia.

Conclusions

Histopathologic quantification showed significant structural muscle changes through a combination of fiber hypertrophy and hyperplasia. Control biopsies showed a lack of similar changes. The data correlate with findings of other HIFEM research and suggest that HIFEM could be used for noninvasive induction of muscle growth.
Network-based multi-task learning models for biomarker selection and cancer outcome prediction
Authors: Wang Zhibo , He Zhezhi , Shah Milan , Zhang Teng , Fan Deliang , Zhang Wei
Published: October 2019

Motivation

Detecting cancer gene expression and transcriptome changes with mRNA-sequencing or array-based data are important for understanding the molecular mechanisms underlying carcinogenesis and cellular events during cancer progression. In previous studies, the differentially expressed genes were detected across patients in one cancer type. These studies ignored the role of mRNA expression changes in driving tumorigenic mechanisms that are either universal or specific in different tumor types. To address the problem, we introduce two network-based multi-task learning frameworks, NetML and NetSML, to discover common differentially expressed genes shared across different cancer types as well as differentially expressed genes specific to each cancer type. The proposed frameworks consider the common latent gene co-expression modules and gene–sample biclusters underlying the multiple cancer datasets to learn the knowledge crossing different tumor types.

Results

Large-scale experiments on simulations and real cancer high-throughput datasets validate that the proposed network-based multi-task learning frameworks perform better sample classification compared with the models without the knowledge sharing across different cancer types. The common and cancer-specific molecular signatures detected by multi-task learning frameworks on The Cancer Genome Atlas ovarian, breast and prostate cancer datasets are correlated with the known marker genes and enriched in cancer-relevant Kyoto Encyclopedia of Genes and Genome pathways and gene ontology terms.

Availability and implementation

Source code is available at: https://github.com/compbiolabucf/NetML.

Supplementary information

Supplementary data are available at Bioinformatics online.
CASPR, an analysis pipeline for single and paired guide RNA CRISPR screens, reveals optimal target selection for long non-coding RNAs
Authors: Bergadà-Pijuan Judith , Pulido-Quetglas Carlos , Vancura Adrienne , Johnson Rory
Published: October 2019

Motivation

CRISPR-Cas9 loss-of-function (LOF) pooled screening promises to identify which long non-coding RNAs (lncRNAs), amongst the many thousands to have been annotated so far, are capable of mediating cellular functions. The two principal LOF perturbations, CRISPR-inhibition and CRISPR-deletion, employ one and two guide RNAs, respectively. However, no software solution has the versatility to identify hits across both modalities, and the optimal design parameters for such screens remain poorly understood.

Results

Here, we present CRISPR Analysis for Single and Paired RNA-guides (CASPR), a user-friendly, end-to-end screen analysis tool. CASPR is compatible with both CRISPRi and CRISPR-del screens, and balances sensitivity and specificity by generating consensus predictions from multiple algorithms. Benchmarking on ground-truth sets of cancer-associated lncRNAs demonstrates CASPR’s improved sensitivity with respect to existing methods. Applying CASPR to published screens, we identify two parameters that predict lncRNA hits: expression and annotation quality of the transcription start site. Thus, CASPR is a versatile and complete solution for lncRNA CRISPR screen analysis, and reveals principles for including lncRNAs in screening libraries.

Availability and implementation

https://judithbergada.github.io/CASPR/

Supplementary information

Supplementary data are available at Bioinformatics online.
YY1 is a cis-regulator in the organoid models of high mammographic density
Authors: Cheng Qingsu , Khoshdeli Mina , Ferguson Bradley S , Jabbari Kosar , Zang Chongzhi , Parvin Bahram
Published: October 2019

Motivation

Our previous study has shown that ERBB2 is overexpressed in the organoid model of MCF10A when the stiffness of the microenvironment is increased to that of high mammographic density (MD). We now aim to identify key transcription factors (TFs) and functional enhancers that regulate processes associated with increased stiffness of the microenvironment in the organoid models of premalignant human mammary cell lines.

Results

3D colony organizations and the cis-regulatory networks of two human mammary epithelial cell lines (184A1 and MCF10A) are investigated as a function of the increased stiffness of the microenvironment within the range of MD. The 3D colonies are imaged using confocal microscopy, and the morphometries of colony organizations and heterogeneity are quantified as a function of the stiffness of the microenvironment using BioSig3D. In a surrogate assay, colony organizations are profiled by transcriptomics. Transcriptome data are enriched by correlative analysis with the computed morphometric indices. Next, a subset of enriched data are processed against publicly available ChIP-Seq data using Model-based Analysis of Regulation of Gene Expression to predict regulatory transcription factors. This integrative analysis of morphometric and transcriptomic data predicted YY1 as one of the cis-regulators in both cell lines as a result of the increased stiffness of the microenvironment. Subsequent experiments validated that YY1 is expressed at protein and mRNA levels for MCF10A and 184A1, respectively. Also, there is a causal relationship between activation of YY1 and ERBB2 when YY1 is overexpressed at the protein level in MCF10A.

Supplementary information

Supplementary data are available at Bioinformatics online.
Development and Validation of HPTLC and Green HPLC Methods for Determination of a New Combination of Quinfamide and Mebendazole
Authors: Naguib Ibrahim A , Hassan Eman S , Emam Aml A , Abdelaleem Eglal A
Published: October 2019

Two selective and sensitive chromatographic methods were developed for simultaneous determination of new combination of quinfamide and mebendazole in bulk powder and in pharmaceutical formulation. The first method is HPTLC by which separation was obtained using silica gel HPTLC F254 plates and a simple mobile phase consisting of methanol:toluene (2:6, v/v) and the separated bands were scanned at 254 nm. The second method RP-HPLC that comprised isocratic separation of both drugs on a Phenomenex C18 column using a green mobile phase consisting of double distilled water:methanol (30:70, v/v) at a flow rate of 0.8 mL/min and UV detection at 254 nm. The developed methods were validated and proved to meet ICH guidelines. Successful application of the developed methods was carried out for determination of quinfamide and mebendazole in Vermox Plus® tablets. Statistical comparison between the developed chromatographic methods and the reported simultaneous equation spectrophotometric method showed that there was no significant difference between them, proving the ability of applying the proposed methods in quality control testing of the studied drugs. The developed methods are considered the first chromatographic methods for simultaneous determination of quinfamide and mebendazole; moreover, they offered sensitive and selective eco-friendly methods for analysis of the studied drugs.
Culture Conversion at 6 Months in Patients Receiving Delamanid-containing Regimens for the Treatment of Multidrug-resistant Tuberculosis
Authors: Seung Kwonjune J , Khan Palwasha , Franke Molly F , Ahmed Saman , Aiylchiev Stalbek , Alam Manzur , Putri Fauziah Asnely , Bastard Mathieu , Docteur Wisny , Gottlieb Gary , Hewison Catherine , Islam Shirajul , Khachatryan Naira , Kotrikadze Tinatin , Khan Uzma , Kumsa Andargachew , Lecca Leonid , Tassew Yoseph Melaku , Melikyan Nara , Naing Ye Yint , Oyewusi Lawrence , Rich Michael , Wanjala Stephen , Yedilbayev Askar , Huerga Helena , Mitnick Carole D
Published: October 2019

Delamanid should be effective against highly resistant strains of Mycobacteriumtuberculosis, but uptake has been slow globally. In the endTB (expand new drug markets for TB) Observational Study, which enrolled a large, heterogeneous cohorts of patients receiving delamanid as part of a multidrug regimen, 80% of participants experienced sputum culture conversion within 6 months.

Clinical Trials Registration. NCT03259269.
NutriGenomeDB: a nutrigenomics exploratory and analytical platform
Authors: Martín-Hernández Roberto , Reglero Guillermo , Ordovás José M , Dávalos Alberto
Published: October 2019

Habitual consumption of certain foods has shown beneficial and protective effects against multiple chronic diseases. However, it is not clear by which molecular mechanisms they may exert their beneficial effects. Multiple -omic experiments available in public databases have generated gene expression data following the treatment of human cells with different food nutrients and bioactive compounds. Exploration of such data in an integrative manner offers excellent possibilities for gaining insights into the molecular effects of food compounds and bioactive molecules at the cellular level. Here we present NutriGenomeDB, a web-based application that hosts manually curated gene sets defined from gene expression signatures, after differential expression analysis of nutrigenomics experiments performed on human cells available in the Gene Expression Omnibus (GEO) repository. Through its web interface, users can explore gene expression data with interactive visualizations. In addition, external gene signatures can be connected with nutrigenomics gene sets using a gene pattern-matching algorithm. We further demonstrate how the application can capture the primary molecular mechanisms of a drug used to treat hypertension and thus connect its mode of action with hosted food compounds.
Comparative outcomes of robot-assisted minimally invasive versus open esophagectomy in patients with esophageal squamous cell carcinoma: a propensity score-weighted analysis
Authors: Yun J K , Chong B K , Kim H J , Lee I-S , Gong C-S , Kim B S , Lee G D , Choi S , Kim H R , Kim D K , Park S-I , Kim Y-H
Published: October 2019

Robots are increasingly used in minimally invasive surgery. We evaluated the clinical benefits of robot-assisted minimally invasive esophagectomy (RAMIE) in comparison with the conventional open esophageal surgery. From 2012 to 2016, 371 patients with esophageal squamous cell carcinoma underwent an Ivor Lewis or McKeown procedure at our institution. Of these, 130 patients underwent laparoscopic gastric conduit formation followed by RAMIE, whereas 241 patients underwent conventional esophageal surgery, including laparotomy and open esophagectomy (OE). We compared the short- and long-term clinical outcomes of these patients using the propensity score-based inverse probability of treatment weighting technique (IPTW). Among the early outcomes, the OE group showed a higher incidence of pneumonia (P = 0.035) and a higher requirement for vasopressors (P = 0.001). Regarding the long-term outcomes, all-cause mortality was significantly higher (P = 0.001) and disease-free survival was lower (P = 0.006) in the OE group. Wound-related problems also occurred more frequently in the OE group (P = 0.020) during the long-term follow-up. There was no statistical intergroup difference in the recurrence rates (P = 0.191). The Cox proportional-hazard analysis demonstrated that wound problems (HR 0.16, 95% CI 0.02–0.57; P = 0.017), pneumonia (HR 0.23, 95% CI 0.06–0.68; P = 0.019), and use of vasopressors (HR 0.14, 95% CI 0.08–0.25; P = 0.001) were independent predictors of mortality. RAMIE could be a better surgical option for selected patients with esophageal squamous cell carcinoma.
Esophageal melanoma: a systematic review and exploratory recurrence and survival analysis
Authors: Schizas D , Mylonas K S , Bagias G , Mastoraki A , Ioannidi M , Kanavidis P , Hasemaki N , Karavokyros I , Theodorou D , Liakakos T
Published: October 2019

Esophageal melanoma is a rare and poorly described malignancy. We sought to review all available data on the clinicopathological features, management options, and outcomes of patients with esophageal melanoma to guide clinicians working to treat these uncommon tumors. A systematic literature search of the PubMed, Embase, and Cochrane databases was performed. Exploratory recurrence and survival analyses were performed using previously-validated pooled Cox and logistic regression techniques for case reports and case series. Quality assessment of included studies was performed using the tools developed by the Joanna Briggs and the National Heart, Lung, and Blood Institutes. Fifty-nine studies were reviewed. A total of 93 patients with esophageal melanoma were identified. The mean patient age was 61.2 ± 10.6 years. Esophageal melanoma usually developed at the lower esophagus (48.4%). 90.3% of the patients were symptomatic at presentation, with dysphagia being the most common symptom (72%). Esophagectomy was performed in 91.4% of the patients. Postoperatively, 14 patients (15.1%) received adjuvant chemotherapy. Tumor recurrence was seen in 37 patients (39.8%). The median time to recurrence was 6 months. Disease-specific mortality was 43%. All-cause mortality was 46.1%. On multivariable Cox regression, older patient age (hazard ratio [HR] = 0.91, P = 0.008) and higher Melan-A expression (HR = 0.21; P = 0.029) were associated with a significantly lower risk of mortality. Higher S100 levels (HR = 37.4; P = 0.001) were predictive of poor survival. On logistic regression, large, ulcerated, lower esophageal tumors were significantly more likely to recur (P = 0.018, P = 0.013, and P = 0.027 respectively). Esophageal melanoma is a rare malignancy that tends to present with dysphagia. Most surgically-treated patients undergo esophagectomy. Large, ulcerated, lower esophageal lesions recur more frequently. Immunohistochemistry provides prognostic information regarding survival.
Complete reversal of constriction physiology with antitubercular treatment without steroid: a case report
Authors: Bagchi Avishek , Bhagwati Mohit , Rathi Rajeev Kumar
Published: October 2019

Background 

Constrictive pericarditis is a chronic inflammation of the pericardium leading to the thickening of the pericardium that restricts cardiac filling. Globally tuberculosis is the commonest aetiology of constrictive pericarditis. Though normally considered to be an irreversible pathology; which requires surgical pericardiectomy, in early stage of the disease antitubercular therapy (ATT) along with steroids and other anti-inflammatory therapy can reverse the pathology. But, complete reversal of constrictive physiology with ATT without any anti-inflammatory drugs is not documented.

Case summary 

Here, we describe a case where a 54-year-old lady presented with progressive dyspnoea and pedal oedema for 2 years along with anorexia and weight loss for two months. Two-dimensional echocardiography and computed tomography scan was suggestive of constrictive pericarditis. In view of systemic features and high acute phase reactants, patient was started on oral ATT without any steroids. After 4 months, constriction physiology was completely reversed.

Discussion 

Constriction physiology if treated timely can be largely reversed only with ATT without adjuvant anti-inflammatory therapy. Further studies are required to find out the specific indications of anti-inflammatory therapy in tubercular constrictive pericarditis.
Efficacy and safety of edoxaban compared with warfarin according to the burden of diseases in patients with atrial fibrillation: insights from the ENGAGE AF-TIMI 48 trial
Authors: Nicolau André M , Corbalan Ramon , Nicolau Jose C , Ruff Christian T , Zierhut Wolfgang , Kerschnitzki Michael , Duris Tibor , Juul-Möller Steen , Voitk Juri , Trevisan Marco , Nordio Francesco , Antman Elliott M , Giugliano Robert P
Published: October 2019

Aims

Non-vitamin K antagonist oral anticoagulants represent a new option for prevention of embolic events in patients with atrial fibrillation (AF). However, little is known about the impact of non-cardiac comorbidities on the efficacy and safety profile of these drugs.

Methods and results

In a post hoc analysis of the ENGAGE AF-TIMI 48 trial, we analysed 21 105 patients with AF followed for an average of 2.8 years and randomized to either a higher-dose edoxaban regimen (HDER), a lower-dose edoxaban regimen, or warfarin. We used the updated Charlson Comorbidity Index (CCI) to stratify the patients according to the burden of concomitant disease (CCI = 0, 1, 2, 3, and ≥4). The treatment groups were then compared for safety, efficacy, and net clinical outcomes across CCI categories. There were 32.0%, 7.3%, 42.1%, 12.7%, and 6.0% of patients with CCI scores of 0, 1, 2, 3, and ≥4, respectively. A CCI score ≥4 was associated with significantly higher rates of thromboembolic events, bleeding, and death compared to CCI = 0 (P < 0.05 for each). The annualized rates of the primary net clinical outcome (stroke/systemic embolism, major bleeding, or death) for CCI = 0, 1, 2, 3, or ≥4 were 5.9%, 8.7%, 6.6%, 10.3%, and 13.6% (Ptrend < 0.001). There were no significant interactions between treatment with HDER vs. warfarin and efficacy, safety, and net outcomes across the CCI groups (P-interaction > 0.10 for each).

Conclusion 

Although increasing CCI scores are associated with worse outcomes, the efficacy, safety, and net clinical outcomes of edoxaban vs. warfarin were independent of the degree of comorbidity present.
Class II treatment in early mixed dentition with the eruption guidance appliance: effects and long-term stability
Authors: Keski-Nisula Katri , Keski-Nisula Leo , Varrela Juha
Published: October 2019

Objectives

Our aim was to analyse dentoskeletal effects and long-term stability of Class II treatment carried out with an eruption guidance appliance (EGA) in early mixed dentition.

Materials and methods

Sixty-five Class II patients (38 females and 27 males), treated with an EGA in early mixed dentition, were compared with 58 children (26 females and 32 males) with untreated Class II malocclusion. The mean age in the treatment group at the start (T1) and end of treatment (T2) was 5.4 years (±0.4) and 8.5 years (±0.9), respectively, and at the final examination in the early permanent dentition (T3) 16.7 years (±0.4). In the control group, the mean age at T1 and T2 were 5.1 years (±0.5) and 8.4 years (±0.5), respectively. The independent and dependent sample t-tests, Chi-square test, and Fisher’s test were used in the statistical evaluation.

Results

In the treatment group, the frequency of Class II decreased from 100 to 14% during the treatment (T1–T2) and a significant correction took place in all occlusal variables. At T2, the treatment and control groups showed statistically significant differences (P < 0.05) in all occlusal variables. In the treated children, mandibular length increased 5 mm more (P < 0.001) from T1 to T2 compared to the control children, and the ANB angle became significantly smaller (P = 0.006). During the post-treatment period (T2–T3), the frequency of Class II in the treatment group decreased from 14 to 2% (P < 0.05), overbite increased from 2.2 to 3.1 mm (P < 0.05), and lower crowding increased from 2to 14% (P < 0.05). Post-treatment changes in overjet and upper crowding were not statistically significant. At T3, the mean values of the SNA, SNB, and ANB angles were 83.0° (SD 3.9°), 81.3° (SD 3.8°), and 2.4° (SD 1.5°), respectively.

Conclusions

A clinically significant correction of the molar relationship, overjet, overbite, incisor alignment, and growth enhancement of the mandible were observed after treatment in early mixed dentition. The treatment results remained largely stable in the early permanent dentition. However, an increase was observed in overbite and lower crowding. None of the children treated in early mixed dentition needed a second treatment phase.
Geographical variation in palliative cancer care in a tax-based healthcare system: drug reimbursement in Denmark
Authors: Daugaard Cecilie , Neergaard Mette Asbjoern , Vestergaard Anne Høy Seemann , Nielsen Mette Kjærgaard , Goodman David C , Johnsen Søren P
Published: October 2019

Background

In Denmark, a tax-based universal healthcare setting, drug reimbursement for terminal illness (DRTI) should be equally accessible for all terminally ill patients. Examining DRTI status by regions provides new knowledge on inequality in palliative care provision and associated factors. This study aims to investigate geographical variation in DRTI among terminally ill cancer patients.

Methods

We linked socioeconomic and medical data from 135 819 Danish cancer decedents in the period 2007–15 to regional healthcare characteristics. We analyzed associations between region of residence and DRTI. Prevalence ratios (PR) for DRTI were estimated using generalized linear models adjusted for patient factors (age, gender, comorbidity and socioeconomic profile) and multilevel models adjusted for both patient factors and regional healthcare capacity (patients per general practitioner, numbers of hospital and hospice beds).

Results

DRTI allocation differed substantially across Danish regions. Healthcare capacity was associated with DRTI with a higher probability of DRTI among patients living in regions with high compared with low hospice bed supply (PR 1.13, 95% CI 1.10–1.17). Also, the fully adjusted PR of DRTI was 0.94 (95% CI 0.91–0.96) when comparing high with low number of hospital beds. When controlled for both patient and regional healthcare characteristics, the PR for DRTI was 1.17 (95% CI 1.14–1.21) for patients living in the Central Denmark Region compared with the Capital Region.

Conclusion

DRTI status varied across regions in Denmark. The variation was associated with the distribution of healthcare resources. These findings highlight difficulties in ensuring equal access to palliative care even in a universal healthcare system.
Present and future of the critically endangered Araucaria angustifolia due to climate change and habitat loss
Authors: Marchioro Cesar A , Santos Karine L , Siminski Alexandre
Published: October 2019

The critically endangered Brazilian pine, also called araucaria, (Araucaria angustifolia (Bertol.) Kuntze) is a key species of the Araucaria moist forest (AMF, Mixed Ombrophilous Forest). Illegal timber extraction, agricultural conversion and severe degradation have reduced the AMF to only 13 per cent of its original cover, with climate change imposing additional challenges for cold adapted species such as araucaria. Previous studies have assessed climate change impacts on A. angustifolia, but have been limited by analysis constraints. Here, we used a machine learning technique to understand how land use and climate change might affect the distribution of A. angustifolia, and to evaluate the effectiveness of existing protected areas (PAs) to conserve this species. Our results demonstrated that despite the recent efforts to conserve the Atlantic Forest, conversion of natural habitats into forest plantation still occurs within araucaria’s distribution range. Our model predicted a drastic reduction in environmentally suitable areas for this species of up to 77 per cent in the coming decades. Also, the existing PAs show low efficacy to protect suitable areas in the future. Combined, these results suggest that A. angustifolia will be under great threat within the next few decades and the development of conservation strategies to save this species is essential. Ideally, the conservation programs should integrate in situ and on farm approaches, including forest management strategies. Although in situ strategies play an important role as gene banks, on-farm strategies can be used to promote the restoration and expansion of A. angustifolia populations in the areas predicted as suitable.
Consulting Forester Timber Sale Practices in the US South
Authors: Grove Patrick M , Conrad Joseph L , Harris Thomas G , Dahlen Joseph
Published: October 2019

Private timber sale transactions are vital to the forest products industry in the US South. Consulting foresters often assist private landowners in administering timber sales, and their decisions and practices have a major impact on landowner compensation, satisfaction, and market efficiency. This study used a mixed-mode survey of consulting foresters in 11 southern states to examine contract terms, timber sale practices, and market conditions on private sales. Responses were received from 430 consultants, resulting in a 37 percent response rate. Final harvests are primarily offered to bidders, whereas thinnings are more likely to have timber prices negotiated. Pay-as-cut payment terms are typical for thinnings, but less common in the Mountains where lump sum is relatively more common. Well under 50 percent of firms from the Coastal Plain and Piedmont conduct presale inventories on thinnings, whereas nearly two-thirds of firms in the Mountains use inventories on these types of harvests. Fewer than 25 percent of responding foresters suggested that restrictive quotas reduced landowner revenue on pay-as-cut timber sales. Consulting firms reporting that sawtimber quotas were never a problem in their area reported at least two more sawtimber outlets than those concerned about restrictive mill quotas.
Older Adults’ Recalled Memorable Messages about Aging and Their Associations with Successful Aging
Authors: Bernhold Quinten S , Giles Howard
Published: October 2019

Using the Communicative Ecology Model of Successful Aging (CEMSA), this study examined how one’s own age-related communication and memorable message characteristics indirectly predict successful aging, via aging efficacy. Older adults with higher dispositional hope recalled memorable messages as (a) higher in positivity, (b) higher in efficacy, and (c) more likely to contain a theme of aging not being important or being a subjective state that can be overcome with the right mindset. Older adults were classified as engaged, bantering, or disengaged agers, based on their own age-related communication. Uniquely for CEMSA’s development and the blended role of hope theory within it, memorable message efficacy indirectly predicted greater successful aging, via heightened aging efficacy.
Point-actuated feedback control of multidimensional interfaces
Authors: Tomlin Ruben J , Gomes Susana N
Published: October 2019

We consider the application of feedback control strategies with point actuators to multidimensional evolving interfaces in order to stabilize desired states. We take a Kuramoto–Sivashinsky equation as a test case; this equation arises in the study of thin liquid films, exhibiting a wide range of dynamics in different parameter regimes, including unbounded growth and full spatiotemporal chaos. The controls correspond physically to mass-flux actuators located in the substrate on which the liquid film lies. In the case of partial state observability, we utilize a proportional control strategy where forcing at a point depends only on the local observation. We find that point-actuated controls may inhibit unbounded growth of a solution, if the actuators are sufficient in number and in strength, and can exponentially stabilize the desired state. We investigate actuator arrangements, and find that the equidistant case is the most favourable for control performance, with a large drop in effectiveness for poorly arranged actuators. Proportional controls are also used to synchronize two chaotic solutions. When the interface is fully observable, we construct model-based controls using the linearization of the governing equation. These improve on proportional controls and are applied to stabilize non-trivial steady and travelling wave solutions.
Measuring and decomposing the effort regarding the equity of inpatient benefits based on the adjustment of the new cooperative medical scheme in western rural China
Authors: Xie Yongxin , Li Qin , Qiao Hui , Zhao Ting , Chen Ya’nan , Yang Biao
Published: October 2019

Background

The ultimate objective of rural health reform and development is to establish a mature healthcare service system that adapts to the socialist market economy and the developmental level of the Chinese economy and meets the health demands of the people. Reform of the payment system is one of the key elements. This article explores the effect of the system and the causes of benefit inequity, provides an objective evaluation of policy implementation and offers data support for policy adjustment.

Methods

A two-stage stratified random sampling data collection method comprising a survey in 2009 (the sample size was 3832 families) and a follow-up survey in 2015 (the sample size was 3992 families) was used. Qualitative data are presented as rates or ratios and the χ2 test was used for descriptive statistics. Quantitative data were analysed using a t test. A generalized linear model (GLM) with gamma distribution of the log connection function was adopted to analyse the factors of the compensation benefit inequity. The degree of the compensation benefit inequity contribution was analysed using the concentration index (CI) decomposition method and the Oaxaca decomposition method.

Results

Reimbursement refers to the reimbursement expense received by inpatients from the New Cooperative Medical System (NCMS). In the GLM, there were some positive factors for reimbursement in the NCMS, including economic level, level of health facility and deductibles. The CI decomposition analysis results show that the main factors that increased the compensation benefit inequity were economic levels and deductibles over the past 2 y. However, inpatient days (2009) and the actual reimbursement ratio (2015) decreased the inequity. The Oaxaca decomposition analysis results suggest that changes in compensation benefit inequity between 2009 and 2015 were more attributable to changes in economic status and variables related to policy compensation than to demographic variables.

Conclusions: This study showed that inequity decreased from 2009 to 2015, which could be the result of adjustment of the compensation policy. However, we should remain vigilant lest the gap between the rich and the poor leads to an increase in inequity.
Prevalence and determinants of poor glycaemic control: a cross-sectional study among Moroccan type 2 diabetes patients
Authors: Chetoui Ahmed , Kaoutar Kamal , Elmoussaoui Soufiane , Boutahar Kaltoum , El Kardoudi Abdesslam , Chigr Fatiha , Najimi Mohamed
Published: October 2019

Background

Diabetes remains poorly controlled in a high proportion of diabetes patients. This study examines the prevalence of poor glycaemic control and associated factors in type 2 diabetes patients in the Beni-Mellal Khenifra region in Morocco.

Methods

A cross-sectional survey was conducted in 2017 among 1456 diabetes patients attending primary health centres. Demographic and clinical data were collected through face-to-face interviews using structured and pre-tested questionnaires. Anthropometric measurements, including body weight, height and waist circumference were taken using standardized techniques and calibrated equipment. Glycaemic control was assessed in terms of the glycated haemoglobin (HbA1c) level and poor glycaemic control was defined as HbA1c ≥7% and a level <7% reflects good glycaemic control.

Results

Of the total participants, 66.3% had poor glycaemic control. Bivariate analysis showed that sex (p=0.010), education level (p=0.013), body mass index (p=0.048), duration of diabetes (p<0.0001) and type of therapeutic regimen (p<0.0001) were significantly associated with HbA1c level. However, multiple logistic regression analyses revealed that only a longer duration of diabetes (OR 1.525 [95% confidence interval {CI} 1.183–1.967], p=0.001) and receiving insulin therapy alone (OR 1.589 [95% CI 1.157–2.183], p=0.004) or a combination of oral antidiabetics with insulin (OR 2.554 [95% CI 1.786–3.653], p<0.001) were significantly associated with inadequate glycaemic control.

Conclusions

Despite the particularities of the region, the findings about glycaemic control and its cross-sectionally associated factors are in line with findings from other regions of Morocco. In this subgroup, the longer duration of diabetes and insulin treatment could constitute a cause leading to poor glycaemic control. However, inverse causality cannot be excluded.
Health inequality in the tropics and its costs: a Sustainable Development Goals alert
Authors: Callander Emily J , Topp Stephanie M
Published: October 2019

Background

It is known that health impacts economic performance. This article aims to assess the current state of health inequality in the tropics, defined as the countries located between the Tropic of Cancer and the Tropic of Capricorn, and estimate the impact of this inequality on gross domestic product (GDP).

Methods

We constructed a series of concentration indices showing between-country inequalities in disability-adjusted life years (DALYs), taken from the Global Burden of Disease Study. We then utilized a non-linear least squares model to estimate the influence of health on GDP and counterfactual analysis to assess the GDP for each country had there been no between-country inequality.

Results

The poorest 25% of the tropical population had 68% of the all-cause DALYs burden in 2015; 82% of the communicable, maternal, neonatal and nutritional DALYs burden; 55% of the non-communicable disease DALYs burden and 61% of the injury DALYs burden. An increase in the all-cause DALYs rate of 1/1000 resulted in a 0.05% decrease in GDP. If there were no inequality between countries in all-cause DALY rates, most high-income countries would see a modest increase in GDP, with low- and middle-income countries estimated to see larger increases.

Conclusions

There are large and growing inequalities in health in the tropics and this has significant economic cost for lower-income countries.
Medical injection and access to sterile injection equipment in low- and middle-income countries: a meta-analysis of Demographic and Health Surveys (2010–2017)
Authors: Adewuyi Emmanuel O , Auta Asa
Published: October 2019

Background

Unsafe injection practices contribute to increased risks of blood-borne infections, including human immunodeficiency virus, hepatitis B and hepatitis C viruses. The aim of this study was to estimate the prevalence of medical injections as well as assess the level of access to sterile injection equipment by demographic factors in low- and middle-income countries (LMICs).

Methods

We carried out a meta-analysis of nationally representative Demographic and Health Surveys (DHSs) conducted between 2010 and 2017 in 39 LMICs. Random effects meta-analysis was used in estimating pooled and disaggregated prevalence. All analyses were conducted using Stata version 14 and Microsoft Excel 2016.

Results

The pooled 12-month prevalence estimate of medical injection was 32.4% (95% confidence interval 29.3–35.6). Pakistan, Rwanda and Myanmar had the highest prevalence of medical injection: 59.1%, 56.4% and 53.0%, respectively. Regionally, the prevalence of medical injection ranged from 13.5% in west Asia to 42.7% in south and southeast Asia. The pooled prevalence of access to sterile injection equipment was 96.5%, with Pakistan, Comoros and Afghanistan having comparatively less prevalence: 86.0%, 90.3% and 90.9%, respectively.

Conclusions

Overuse of medical injection and potentially unsafe injection practices remain a considerable challenge in LMICs. To stem the tides of these challenges, national governments of LMICs need to initiate appropriate interventions, including education of stakeholders, and equity in access to quality healthcare services.
Do the Unemployed Pay Lower Prices? A Reassessment of the Value of Unemployment Insurance
Authors: Campos Rodolfo G , Reggio Iliana
Published: October 2019

It is well known that transitions from employment to unemployment reduce consumption expenditure, but is this fall mainly driven by quantities or by prices? Using panel data on expenditure and quantities from the Spanish consumption survey we find that the unemployed pay prices that are, on average, 1.5% lower, and that this difference in prices accounts for roughly one sixth of the gap in consumption expenditure between the employed and the unemployed. The reduction in prices estimated with panel data is considerably lower than the existing estimates for the United States, which rely on cross-sectional comparisons. Based on our estimates, and using economic theory, we reassess the value of providing unemployment insurance and show how the social value of providing unemployment insurance can be decomposed into a consumption-smoothing component and a component that depends on prices.
Optimal Contracting with Endogenous Project Mission
Authors: Cassar Lea , Armouti-Hansen Jesper
Published: October 2019

Empirical evidence suggests that workers care about the mission of their job, in addition to their wage. This paper studies how organizations can choose a mission to attract, incentivize, and screen their workers. We analyze a model in which a principal offers a contract to an agent for the development of a project and can influence the agent’s marginal return of effort through the choice of project mission. The principal’s and the agents’ mission preferences are misaligned and the agents vary in the intensity of their mission drive. Our main results highlight that how far the organization chooses to move from its preferred mission depends on the contractual environment in which it operates. Missions will be more agent-preferred in environments in which effort is noncontractible. In environments in which agents’ drive is unknown, missions will be less agent-preferred and the organization will find it optimal to offer contract menus that may be implemented via scoring auctions when there are competing agents. Our analysis applies to the design and allocation of aid contracts, research funding, and creative jobs.
Is the ischiofemoral space value of Japanese hip joints equal to that of Western populations?
Authors: Mimura Tomohiro , Mori Kanji , Okumura Noriaki , Kumagai Kosuke , Maeda Tsutomu , Yayama Takafumi , Imai Shinji
Published: October 2019

Ischiofemoral space (IFS) is a radiological parameter employed for diagnosing ischiofemoral impingement (IFI). The mean IFS value measured with the leg in natural resting position has been reported as 23.0 mm in males and 18.6 mm in females in a patients-based Western population. The normal value of IFS for an Asian population is unknown. This study therefore aimed to investigate whether the IFS value in Japanese hip joints equals that of the Western population. We retrospectively examined 89 consecutive Japanese individuals (178 hips) (46 male subjects with 92 hips, 43 female subjects with 86 hips; mean age 58.7 ± 15.7 years, range 17–84 years) who had undergone computed tomography (CT) for conditions unrelated to hip disorders and ordered by other departments at our institution. All CT scans were performed in a standardized fashion: patient in a flat spine position, hips and knees in extension, and the leg in its natural resting position. IFS was evaluated on axial images as the shortest distance between the ischium and the lesser trochanter. The mean IFSs of this Japanese patient-based population were 20.5 ± 7.3 mm [95% confidence interval (CI) 19.0–22.0] in the male cohort and 13.9 ± 6.5 mm (95% CI 12.6–15.3) in the female cohort. The IFS value was significantly smaller in female subjects than in male subjects. Taking the lower limit of 95% CI into consideration, the IFSs measured in natural leg-resting position in the Japanese male and female groups were significantly smaller than those of the Western populations.
Compressive cryotherapy is superior to cryotherapy alone in reducing pain after hip arthroscopy
Authors: Klaber Ianiv , Greeff Eugene , O’Donnell John
Published: October 2019

The early post-operative period after hip arthroscopy for femoroacetabular impingement is characterized by pain and swelling. Minimization of pain is of critical importance to the patient, but pain might also reduce patients’ compliance to early physiotherapy, delay rehabilitation and hospital discharge. Avoiding early mobilization represents a risk factor for developing capsulolabral adhesions. Compressive cryotherapy (CC) has been shown to reduce pain after knee and hip replacement surgery. The aim of this study was to assess the effect of the inclusion of CC in the pain management and early discharge after hip arthroscopy. A prospective cohort of 20 patients who received CC and 20 retrospectively matched controls who received standard cryotherapy (SC) were compared. The CC was added to the standard post-operative analgesia and rehabilitation protocol. Using non-parametric tests, the percentage of patients discharged in post-operative day one, pain VAS scores and analgesia requirement were compared. The CC group reported significantly lower pain scores compared to SC; VAS 1 (0–3) and 2 (0–5) (P = 0.0028), respectively. A non-significant reduction in analgesic requirement 1.75 versus 2.8 doses per patient was found and 20/20 patients were discharged on post-operative day one versus 17/20 in the SC group (P = 0.23). Patients treated with CC after hip arthroscopy reported lower levels of pain during the early post-operative phase and were able to be discharged home sooner when compared with a matched control group receiving ice therapy alone. A trend towards lower opioid analgesia requirement was observed.
Return to Pilates following hip arthroscopy for treatment of femoroacetabular impingement syndrome
Authors: Keating Timothy C , Chahla Jorge , Beck Edward C , Riff Andrew J , Clapp Ian M , Jan Kyleen , Nho Shane J
Published: October 2019

The Pilates Method is a common exercise program which focuses on strength, flexibility and control of the body. While the effects of Pilates have been shown to benefit, limited research has investigated its effect on patients with symptomatic femoroacetabular impingement syndrome (FAIS). As such, the purpose of this study was to examine the rate of return to Pilates following hip arthroscopy after undergoing hip arthroscopy for FAIS. The study evaluated consecutive patients who identified themselves as participating in Pilates and had undergone hip arthroscopy for the treatment of FAIS by a single fellowship-trained surgeon between 2012 and 2015 were reviewed. Demographic data, baseline physical examination, imaging, pre- and postoperative patient-reported outcome scores at a minimum of 2-years following surgery as well as a Pilates-specific questionnaire were assessed for all patients. A total of 25 patients (all female) with mean age 38 ± 11 years were identified. Preoperatively, 12 patients had discontinued Pilates due to activity-related hip complaints, 11 patients had scaled back involvement, and 2 patients maintained their baseline routine. Postoperatively, 23 of 25 patients (92%) returned to Pilates at an average of 7.7 ± 4.2 months following surgery (range, 3–14 months). Postoperatively, 96% returned to Pilates at the same level or better than preinjury. Preinjury and postoperative involvement in Pilates were comparable (2.2 h v. 1.8 h per week, P = 0.8). Loss of interest and fear of reinjury were the most common reasons for reduced Pilates involvement. All patients had significant improvements in HOS-ADL (pre 56.52 ± 21.6; post 86.1 ± 18.8; P < 0.001), HOS-SS (30.1 ± 20.0, 63.8 ± 34.8; P < 0.001), mHHS scores (57.6 ± 12.8; 79.2 ± 19.6; P < 0.001), and VAS pain (68.8 ± 15.4; 21.4 ± 26.5; P < 0.001). In conclusion, arthroscopic treatment of FAIS in Pilates participants resulted in significant improvements in hip function and predictably high rates of satisfaction.
WTO Dispute Settlement Post 2019: What to Expect?
Authors: Pauwelyn Joost
Published: October 2019

What does the imminent demise of the WTO Appellate Body (AB) mean for the settlement of ongoing and future trade disputes? This editorial discusses two ‘unlikely solutions’, at least in the short term: the US lifts its veto on AB appointments; a WTO organ unlocks the impasse. Appeals pending on 10 December 2019 will most likely be carried-over pursuant to (contested) Rule 15 of the AB Working Procedures. For panel reports released after that date, four main scenarios emerge: (i) appeals ‘into the void’ blocking the panel report, (ii) no appeal ex post, or ex ante no appeal pacts, (iii) Article 25 appeal arbitration, (iv) ‘floating’ panel reports (interim or final), neither adopted, nor appealed/blocked. The transformation from GATT to WTO took half a century. Regular veto rights in the settlement of trade disputes may be back in a matter of months. It is one thing to lose the AB, quite another to return to pre-WTO dispute settlement where panel outcomes are not automatically binding and power relations play a considerably greater role. At the same time, it would be wrong to equate a (temporary?) return to GATT-style dispute settlement with the collapse of a rules-based WTO system.
Otter diet changes in a reservoir during a severe autumn drought
Authors: Martínez-Abraín Alejandro , Santidrián Tomillo Pilar , Veiga Juan
Published: October 2019

Eurasian otters (Lutra lutra) are known to make extensive use of reservoirs in the Iberian Peninsula, where they forage preferentially on small-size fish (10–20 cm). We hypothesized that the usual consumption of small-size fish by otters in reservoirs is not due to prey size preference, but rather to a higher level of difficulty in capturing larger prey. We studied otter diet in a reservoir that experienced an abrupt drop in stored water caused by an unusually severe drought. We compared relative prey size, hunting success, and diving times between the year of the drought (2017) and two standard rainfall years (2015 and 2016). Otters ate a similar proportion of small and large fish during the drought instead of predominantly eating small fish. Mean diving time during the drought was similar to that of the standard climatic years, indicating a similar physiological cost of capture between small and large fish. Otters had higher hunting success in the drought year (89%) than in the standard years (63%) regardless of prey size. This suggests a higher level of catchability of both fish size classes during the drought as the water level was lower. Results suggest that the usual consumption of small-sized fish by otters in reservoirs could not be related to preference or relative abundance but rather to the difficulty of capturing large-size fish when water levels are high.