bluuebunny/crossref_metadata_2025 huggingface dataset:
A-217 Associations among Symptom Validity Tests in Combat Veterans
Authors: R Shura , P Armistead-Jehle , J Rowland , K Taber , D Cooper
Published: August 2020

Objective

The Neurobehavioral Symptom Inventory (NSI) is a 22-item self-report measure of non-specific cognitive and somatic symptoms, which contains an embedded measure of symptom validity (Validity 10 scale [V-10]). The mild brain injury atypical symptom (mBIAS) is a separate 5-item measure of symptom validity designed for use in mild traumatic brain injury evaluation. The current study evaluated the NSI V-10 and mBIAS in relation to the Structured Inventory of Malingered Symptomatology (SIMS) Total score and subtest scores.

Method

Participants were 338 veterans who completed a parent study at a VA Medical Center. All participants deployed to Iraq and/or Afghanistan, did not have a history of moderate or severe traumatic brain injury, and did not have significant neurological or psychiatric conditions. Participants completed the SIMS and the NSI with mBIAS as part of a larger battery. The sample was 86% male and 57% White, with a mean age of 42 years and education of 15 years.

Results

AUC values using a higher SIMS Total cutoff score were .887 for the V-10 and .735 for the mBIAS; diagnostic accuracy data at various cutoff scores are presented. For SIMS subscales, the mBIAS had higher correlations to the Psychosis (r = .48) and Low Intelligence (r = .31) scales, whereas the V-10 had higher correlations to the Neurologic Impairment (r = .73), Amnestic Disorders (r = .66), and Affective Disorders (r = .59) scales.

Conclusion

Current data suggest that the V-10 and mBIAS measure different symptom validity constructs and could therefore be employed in a complimentary manner.
A-225 The Rey Dot Counting Test as a Tool for Detecting Suboptimal Performance in Athlete Baseline Testing
Authors: A Dacosta , A Roccaforte , R Sohoni , A Crane , F Webbe , A Logalbo
Published: August 2020

Objective

The limitations of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)‘s embedded validity measures (EVMs) are well-documented, as estimates suggest up to 35% of invalid baseline performances go undetected (Gaudet & Weyandt, 2017). Few studies have examined standalone performance validity tests (PVT) as a supplement to ImPACT’s EVMs (Gaudet & Weyandt, 2017).

Method

College athletes (n = 1,213) were administered a preseason baseline assessment that included ImPACT and the Rey Dot Counting Test (DCT), a standalone PVT, among other measures.

Results

Sixty-nine athletes (5.69%) met criteria for suboptimal effort on either ImPACT or the DCT. The DCT detected more cases of suboptimal effort (n = 50) than ImPACT (n = 21). A χ2 test of independence detected significant disagreement between the two measures, as only 2 individuals produced suboptimal effort on both (χ2(2) = 1.568, p = .210). Despite this disagreement, there were significant differences between the suboptimal effort DCT group and the adequate effort DCT group across all four ImPACT neurocognitive domains (U = 19225.000, p < .001; U = 17859.000, p < .001; U = 13854.000, p < .001; U = 17850.500, p < .001).

Conclusions

The DCT appears to detect suboptimal effort otherwise undetected by ImPACT’s EVMs.
A-229 Is the Multitude Proficiently Able to Elucidate the Imperative Substance and Subsequently Able to Identify the Applicable Inferential Material to Adequately Utilize Assessments: Can People Read and Understand our Reports?
Authors: G Newsham , Z Imre , M Kibby , H Cormier
Published: August 2020

Objective

Many U.S. adults read at an eighth-grade level (Safeer, R., 2005). Thus, neuropsychological reports’ technical language might present a challenge for average readers. However, there are no professional guidelines on report readability and little formal research on the topic. Hence, the study’s objective was to investigate the average readability of psychological and neuropsychological reports from a local university clinic and to provide suggestions for improving the readability of reports.

Method

73 psychological reports and 34 neuropsychological reports were analyzed using the readability feature in Microsoft Word. This feature provides two outcomes of interest: the Flesch Reading Ease score (a 100-point scale with higher numbers indicating easier readability) and the Flesch–Kincaid Grade Level Score (which provides a U.S. grade-level equivalence). Documents are considered readable with a reading ease score of 60 and a grade level score of 8.0. The average and range of scores for each report type were calculated.

Results

In general, psychological reports were written at a 13.2 (12–14.8) grade level, with a readability score of 34.3 (24.2–41.4). Neuropsychological reports were written at a 12.6 (11.2–14.5) grade level, with a readability score of 36.3 (25.5–42.7).

Conclusion(s)

The reports reviewed are functionally unreadable to many in the general public, which has important implications for clinical practice. This could be addressed by altering the reading level at which reports are written, including “plain-language” inserts, or altering specific parts of reports that have the most relevance to clients (e.g. summary and recommendations) to increase comprehension. Feedback on these ideas will be garnered at the poster.
A-234 Weight for It: Comparing Statistical Methods for Aggregating Cognition Data
Authors: B Ivins , J Arrieux , W Cole
Published: August 2020

Objective

In statistics, larger sample studies are assumed to more accurately reflect the population mean and thus assumed to have less random error. We use an overall test battery mean (OTMB) from the D-KEFS taken from two different studies to evaluate two methods of weighting means when aggregating data: Method 1, assuming that larger studies have less error and thus giving their variances more weight and Method 2, assuming equal error and uncertainty across studies and assigning equal weight to variances from all studies.

Methods

The OTBM from seven D-KEFS achievement scores was calculated from a D-KEFS normative sample (n = 854), and aggregated with the same D-KEFS OTBM from a healthy military sample (n = 246). Weighted averages were calculated for selected points from the distributions of scores (e.g., mean, median, etc.). Variances, standard errors, and 95% confidence intervals for the weighted means were calculated using Method 1 and Method 2, as described above.

Results

The weighted mean OTBM from both samples was 51.48. The variance, standard error, and confidence interval using Method 1 were 11.63, 2.41, and 46.76–56.21, respectively, and using Method 2 were 16.74, 4.09, and 43.6–59.50, respectively.

Conclusion

Method 1 results in weighted means with less variability, though may result in larger studies disproportionately reducing measurement error. Method 2 results in greater variances, standard errors, and wider confidence intervals and somewhat mutes the impact of larger studies. Researchers should consider the implications for their results when choosing a method for assessing the precision of their weighted means.
A-236 Concurrent Validity of the Paper-Match in a Diverse Population
Authors: C Veloz , E Weiss , E Ayers , K Possin , J Verghese
Published: August 2020

Introduction

Symbol and digit substitution tasks are key instruments in the evaluation of attention, speed of processing, executive functioning, and cognitive dysfunction. The Match is an electronic (app-based) substitution task developed as part of the University of California San Francisco Brain Health Assessment that has been used to demonstrate cognitive impairment. We describe the paper-based oral symbol/number substitution task (Paper-Match), which was developed as part of the 5-Cog battery to assess for cognitive impairment including dementia and demonstrate it’s use in an urban, multi-ethnic, socioeconomically disadvantaged primary care population in Bronx NY.

Method

109 participants, mean age 72.61 SD 6.42 and education 11.70 SD 3.82 years, 81% female, 48.6% Hispanic/Latino and 47.7% African American seen as part of 5-Cog. Participants (36.7% tested in Spanish) completed the Paper-Match (scored based on the number of correct matches in 90 seconds) and a comprehensive neuropsychological battery. Descriptive and correlational analysis were conducted.

Results

Mean Paper-Match score was 38.24 SD 11.83 items correct (range 4–51). Paper-Match performance was highly correlated with performance on the Symbol Digit Modalities Test (r = .819, p < .001) and moderately correlated with performance on the Montreal Cognitive Assessment (MOCA; r = .604, p < .001). Years of education and primary language impacted performances.

Conclusion

The results of this study provide the initial description and validation of the Paper-Match an oral symbol digit substitution task and its use in a diverse population of older primary care patients. Further research on the psychometric properties and construct validity of the Paper-Match are needed.
A-239 Cost of Neuropsychological Evaluation Comparable to Neuroimaging in the Eastern USA
Authors: N Kurniadi , J Davis , K Kitchen-Andren , C Mullen , S Rolin
Published: August 2020

Objective

Anecdotal evidence indicates a belief among physicians that neuropsychological evaluation is more expensive than brain imaging procedures. Another concern is that neuropsychological evaluations are a limited resource to be utilized sparingly, likely due to insurance limits on the annual allowable units of neuropsychological evaluation. This study aimed to contextualize the cost of neuropsychological evaluation relative to common neuroimaging studies used in conditions seen by neuropsychologists.

Data Selection

Publically available fee schedules from 27 hospitals in the eastern U.S. were reviewed to identify standard costs of head CT, brain MRI, and 5- and 8-hour neuropsychological evaluations conducted with technicians.

Data Synthesis

Head CT averaged $2963 (range $282–$6007) and brain MRI averaged $4857 (range $834–$11,524). Five-hour evaluations using technicians averaged $2080 (range $698–$4165). Eight-hour evaluations using technicians averaged $3289 (range $1104–$6657).

Conclusions

Contrary to anecdotal concerns, neuropsychological evaluations do not appear more expensive than brain neuroimaging procedures in several eastern U.S. hospitals. Focused neuropsychological evaluations comparable to or less than head CT procedure cost. Comprehensive neuropsychological evaluations are comparable to or less than MRI brain procedure cost. These preliminary findings may dispel the notion that neuropsychological evaluations are more costly than brain imaging. Additional research is needed in all regions of the U.S.
A-254 A Pediatric Case Study of Mild Intellectual Disability in the Context of Complex Chiari Malformation, Hydrocephalus, Cleft Palette, and Complex Psychosocial Environment
Authors: C Haak , E Chin
Published: August 2020

Objective

Chiari malformation is a congenital condition involving structural skull defects, causing brain tissue herniation and likely resulting in hydrocephalus. People with these medical conditions are at risk for varied cognitive impairments. Recently, emerging evidence has suggested the co-occurrence of Chiari malformation and cleft palette contributing to increased cognitive challenges, highlighting the importance of introducing interventions in a timely manner.

Method

This case study presents on the neuropsychological profile of an 11-year-old girl with a medical history of complex Chiari malformation with accompanying hydrocephalus and syringomyelia, and lymphangioma born with cleft palette. Relevant social history includes recent parent separation and unstable home life. Presenting concerns included intermittent hand weakness and headaches status post 5 surgeries related to Chiari malformation and hydrocephalus, inattention/impulsivity, learning difficulties, and increased emotional and behavioral dysregulation.

Results

Neuropsychological testing revealed impairments in intellectual functioning (WISC-V FSIQ = 64), adaptive skills, attention/executive functioning, language, visuomotor skills, memory, and academic skills. Significant emotional and behavior adjustment problems were indicated, secondary to medical treatment, resulting physical limitations, and psychosocial stressors. Finally, staring spells episodes were observed that were concerning for possible seizure activity.

Conclusions

Recommendations were given to aid in treatment planning for her referring neurosurgeon alongside clinical interventions (e.g., psychotherapy, social work, speech/language, and occupational therapy). Recommendations related to continued intensive special education services were also provided. This case study demonstrates the need for further understanding cognitive impairment in the context of Chiari malformation with co-occurring hydrocephalus and cleft palette. Multidisciplinary collaboration is essential to facilitate the prompt introduction of appropriate clinical interventions.
The costs of ignoring species detectability on functional diversity estimation
Authors: Palacio Facundo Xavier , Maragliano René E , Montalti Diego
Published: August 2020

Functional diversity (FD) approaches have been increasingly used to understand ecosystem functioning in bird communities. These approaches typically rely on the assumption that species are perfectly detected in the field, despite the fact that imperfect detection represents a ubiquitous source of bias in biodiversity studies. This may be notably important in FD studies, because detection may depend on the functional traits used to compute FD metrics. However, little effort has been devoted to account for imperfect detection in FD studies, and therefore the degree to which species traits and detectability affects FD remains poorly understood. We predict that observed FD metrics may either underestimate or overestimate detection-corrected FD, because FD has multiple independent dimensions with different data properties. We assessed whether detection was related to bird traits (body mass, diet, and foraging stratum), accounting for habitat type, season, and phylogeny. We then used a multi-species occupancy model to obtain detection-corrected FD metrics (functional richness [FRic], functional evenness [FEve], and functional divergence [FDiv]), and compared observed and detection-corrected FD estimates in bird communities from east-central Argentina. Some functional types of birds (raptors and insectivores) were more easily overlooked, whereas others (seed and leaf eaters) were more easily detected. Some observed FD metrics underestimated detection-corrected FD (FRic and FDiv), whereas some others (FEve) overestimated detection-corrected FD. Both observed and detection-corrected FRic revealed differences between seasons, but not between habitat types. However, detection-corrected FEve and FDiv showed differences between seasons, contrary to observed estimates. Our results indicate that failure to account for unequal ease of detecting species can lead to erroneous estimates of FD because some functional types of birds are more easily overlooked. We outline some guidelines to help ornithologists identifying under which circumstances detection may be a concern and warn against the indiscriminate use of FD metrics without accounting for species detection.
Seminal plasma AnnexinA2 protein is a relevant biomarker for stallions which require removal of seminal plasma for sperm survival upon refrigeration†
Authors: Gaitskell-Phillips Gemma , Martín-Cano Francisco E , Ortiz-Rodríguez José M , Silva-Rodríguez Antonio , Rodríguez-Martínez Heriberto , Gil Maria C , Ortega-Ferrusola Cristina , Peña Fernando J
Published: August 2020

Some stallions yield ejaculates that do not tolerate conservation by refrigeration prior to artificial insemination (AI), showing improvement after removal of most of the seminal plasma (SP) by centrifugation. In this study, the SP-proteome of 10 different stallions was defined through high-performance liquid chromatography with tandem mass spectrometry and bioinformatic analysis in relation to the ability of the ejaculates to maintain semen quality when cooled and stored at 5°C. Stallions were classified into three groups, depending on this ability: those maintaining good quality after direct extension in a commercial extender (good), stallions requiring removal of seminal plasma (RSP) to maintain seminal quality (good-RSP), and stallions, unable to maintain good semen quality even after RSP (poor). Pathway enrichment analysis of the proteins identified in whole equine SP using human orthologs was performed using g: profiler showing enriched Reactome and the Kyoto Encyclopedia of Genes and Genomes pathways related to hexose metabolism, vesicle mediated transport, post translational modification of proteins and immune response. Specific proteins overrepresented in stallions tolerating conservation by refrigeration included a peroxiredoxin-6 like protein, and transcobalamin-2, a primary vitamin B12-binding, and transport protein. Also, the protein involved in protein glycosylation, ST3 beta-galactoside alpha-2,3-sialyltransferase 1 was present in good stallions. These proteins were nearly absent in poor stallions. Particularly, annexinA2 appeared as to be the most powerful discriminant variable for identification of stallions needing RSP prior to refrigeration, with a P = 0.002 and a q value = 0.005. Overall this is the first detailed study of the equine SP-proteome, showing the potential value of specific proteins as discriminant bio-markers for clinical classification of stallions for AI.
Does reproductive mode affect sexually-selected coloration? Evaluating UV–blue spots in parthenogenetic and bisexual lizards of the genusDarevskia
Authors: Abramjan Andran , Arakelyan Marine , Frynta Daniel
Published: August 2020

Sexual selection often leads to evolution of conspicuous signals, raising the chances of attracting not only potential mates, but also predators. In lacertid lizards, ultraviolet (UV)–blue spots on flanks and shoulders represent such a trait. Some level of correlation between male and female ornamentation is also known to exist. Therefore, the phenotype of females may change in the absence of sexual selection. We tested this hypothesis on a complex of parthenogenetic and bisexual lizards of the genus Darevskia. We evaluated area, counts, and chromatic properties (UV opponency, saturation) of UV–blue spots and compared the values between the clones and their bisexual progenitor species. We found a fair heterogeneity between the parthenogenetic species, but no general tendency toward higher crypsis or conspicuousness. Values of the parthenogens were not significantly different from the values of sexual females. A possible explanation is that the changes in selective forces associated with parthenogenetic reproduction are too small to affect the resulting pattern of selective pressures on the studied traits, or that the phenotypes of the parthenogens result from the unique combination of parental genomes and are conserved by clonal reproduction.
Antemortem diagnosis of nonbacterial thrombotic endocarditis in a patient with previously resected pancreatic adenocarcinoma: a case report
Authors: Muhammadzai Hamza Zahid Ullah , Shavadia Jay , Okpalauwaekwe Udoka , Haddad Haissam
Published: August 2020

Background

Nonbacterial thrombotic endocarditis (NBTE) is a rare manifestation of a number of systemic diseases, which include advanced malignancy and hypercoagulable states.

Case summary

We present a 67-year-old woman who had presented with chest pain and heart failure. Eight years ago, she had a successful Whipple resection for pancreatic adenocarcinoma. Echocardiography revealed mitral valve vegetations with negative blood cultures. She had multiple infarcts in the kidney, spleen, and brain. She was found to have a mass in the left 8th rib, consistent with metastatic pancreatic adenocarcinoma on biopsy. Ultimately, a diagnosis of NBTE was made after excluding other causes for her presentation. Because of her general poor condition, she expressed the wish for palliative care and later died 28 days after presentation.

Discussion

This case illustrates the possibility of NBTE in patients successfully treated for pancreatic adenocarcinoma and highlights the consideration of this relatively rare differential in patients with a previously treated malignancy presenting with heart failure.
Case report: spontaneous coronary artery dissection and suspicion of takotsubo cardiomyopathy in a patient presenting with T-wave inversions, severe QTc prolongation, elevated cardiac biomarkers, and apical akinesia
Authors: Frederiksen Kåre Peter , Søholm Helle , Havndrup Ole , Procida Kristina
Published: August 2020

Background

In patients suspected of acute coronary syndrome, but where the coronary angiography (CAG) has shown unobstructed coronary arteries differential diagnoses include spontaneous coronary artery dissection and takotsubo cardiomyopathy. This case report presents a patient with spontaneous coronary artery dissection but diagnostic signs suspicious of takotsubo cardiomyopathy. Which leads to a consideration of the co-existence of the diseases.

Case summary

A 57-year-old woman was acutely admitted to the emergency ward with sudden development of chest discomfort, palpitations, and dyspnoea. At hospitalization, the electrocardiography showed T-wave inversions in I, aVL, and V2, and Troponin I was elevated. Initial echocardiography revealed apical akinesia consistent with takotsubo cardiomyopathy. Initially, a diagnosis of acute coronary syndrome or takotsubo cardiomyopathy was suspected. The patient was further diagnostically assessed with CAG including optical coherence tomography which showed spontaneous coronary artery dissection in the left anterior descending artery. At follow-up 3 months later, CAG showed a fully healed coronary artery, and repeated echocardiography showed normalization of the left ventricular function.

Discussion

In this case report, initially, acute coronary syndrome was suspected due to electrocardiography with T-wave inversions and elevated cardiac biomarkers. Takotsubo cardiomyopathy was suspected when echocardiography showed apical ballooning, but CAG with optical coherence tomography revealed a spontaneous coronary artery dissection. Interestingly no severe obstructions of coronary arteries were seen, and follow-up echocardiography showed fully regained myocardial function. This leads to the debate as to whether this might be a case of co-existing spontaneous coronary artery dissection and takotsubo cardiomyopathy.
Novel oral anticoagulants in intracardiac thrombosis resolution: a case series
Authors: Al-Sadawi Mohammed , Francois Jonathan , Rodriguez Ortega Romy , Capric Violeta , Budzikowski Adam S
Published: August 2020

Background

Vitamin K antagonists (VKAs) have been regarded as the therapy of choice for intracardiac thrombosis for decades based mostly on observational data. The advent of direct oral anticoagulants (DOACs) has displaced VKAs as the first-line therapy for multiple thrombotic disorders but not for intracardiac thrombosis. Although limited, there is growing evidence that DOACs are effective for intracardiac thrombosis and some data suggest that thrombus resolution might be superior to that with warfarin.

Case summary

Here, we present a series of six patients with left atrial appendage thrombi were treated with a venous thromboembolic dose of DOACs with resolution within 2–6 months with no reported complications.

Discussion

This case series adds to the accumulating evidence supporting the efficacy of DOACs in the treatment of intracardiac thrombi.
Austerity
Authors: Dellas Harris , Niepelt Dirk
Published: August 2020

We study the optimal debt and investment decisions of a sovereign with private information. The separating equilibrium is characterised by a cap on the current account. A sovereign repays debt amount due that exceeds default costs in order to signal creditworthiness and smooth consumption. Accepting funding conditional on investment/reforms relaxes borrowing constraints, even when investment does not create collateral, but it depresses current consumption. The model contains the signalling elements emphasised by creditors in the Greek austerity programmes and is consistent with the reduction in the loans issued by Greece and their interest rate following the 2015 election.
May Measurement Month 2018: an analysis of blood pressure screening results from Republic of the Congo
Authors: Ellenga Mbolla Bertrand F , Kouala Landa Christian M , Bakekolo Paterne R , Makani Bassakouahou Jospin K , Bouithy Sabrina N , Eyeni-Sinomono Tony , Bianza Jean-R , Ossou-Nguiet Paul-M , Bani Aloise M , Kimpamboudi Aubierge , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Xia Xin , Kimbally Kaky Suzy-G
Published: August 2020

To determine the proportion with hypertension among opportunistic screenees in the Republic of the Congo. This cross-sectional study was conducted in Republic of the Congo in May 2018. This screening was done in urban and rural areas that included Brazzaville, Pointe-Noire, District of Ngoyo, and District of Nkayi. The study protocol was provided by the International Society of Hypertension, and local ethical clearance was obtained. The data were processed by the May Measurement Month global project team. In total, 6169 people were screened, 2418 of which were female (39.2%). Most of the people screened were from 18 to 29 years old (n = 4184, 67.8%). The proportion of hypertension found was 22.2% (n = 1371). Among the hypertensive patients, 40.2% were aware of their hypertension, but only 493 (36.0%) were on antihypertensive treatment, and only 16.0% were controlled. The frequency of diabetes was 2.2% (n = 135), 2.3% (n = 139) had a previous stroke, and overweight and obesity were present in 15.4% (n = 952) and 7.3% (n = 449), respectively. Hypertension is frequent in the Republic of the Congo, and levels of awareness, treatment and control are low. Actions are needed to increase access of all to a correct diagnosis and treatment of hypertension to achieve universal health coverage.
Analysis of blood pressure and selected cardiovascular risk factors in the Democratic Republic of the Congo: the May Measurement Month 2018 results
Authors: Buila Nathan B , Ngoyi Georges N , Bayauli Pascal M , Katamba Fortunat K , Lubenga Yves N , Kazadi Serge M , Kiadi Glodie D , Lepira François B , Kabanda Gilbert K , Kika Mireille L , Beaney Thomas , Ster Anca Chis , Poulter Neil R , M’Buyamba-Kabangu Jean-René ,   MMM18/DRC investigators, Balazire Flory , Bazayidio Jonas , Bokengola Lumba , Bulungwe Paulin , Engua Fortune , Ilunga Fortune , Gingulula Joséphine , Kalema Alida , Kamba Rabbi , Kanyinda Emmanuel , Kinzomba Benedicte , Kitambala Dodo , Kumbi Lassi , Lugemba Chloé , Lundoloka Chadrack , Mande Dessy , Mayengele Yannick , Mbowa Donatien , Mbuyi Patience , Mpia Jules , Mubili Christelle , Mushiya Françoise , Ndombe Pamu , Nsatebe Sarah , N’Sembe Eunice , Olenga Samuel , Otchia Patric , Saka Lysette , Tamouk Israël , Tankama Didier , Taty Fidélité , Wende Augustin
Published: August 2020

Hypertension (HT) is the largest contributor to cardiovascular disease mortality and is characterized by high prevalence and low awareness, treatment, and control rates in sub-Saharan Africa. May Measurement Month (MMM) is an international campaign intended to increase awareness of high blood pressure (BP) among the population and advocate for its importance to the health authorities. This study aimed to increase awareness of raised BP in a country where its nationwide prevalence is yet unestablished. Investigators trained and tested how to use the campaign materials, collected participants’ demographic data, lifestyle habits, and obtained from each one three BP measurements. Hypertension was defined as a BP ≥140/90 mmHg, or use of antihypertensive medication. Of the 18 719 screened (mean age 41 years; 61.4% men), 26.1% were found to be hypertensive of whom 46.3% were aware of their condition and 29.6% were taking antihypertensive medication. The control rate of HT was 43.0% in those on medication and 12.7% among all hypertensive respondents. Comorbidities found were—diabetes (3.3%), overweight/obesity (35.5%); and a previous stroke and a previous myocardial infarction were reported by 1.2% and 2.0%, respectively. Imputed age- and sex-standardized BP was higher in treated hypertensive individuals (135/85 mmHg) than those not treated (124/78 mmHg). Based on linear regression models adjusted for age and sex (and an interaction) and antihypertensive medication, stroke survivors, those who drank once or more per week (vs. never/rarely), and overweight/obese participants were associated with higher BP. MMM18 results in the Democratic Republic of the Congo corroborated the high prevalence of HT in Kinshasa screenees with low rates of treatment and control. Extension of the MMM campaign to other parts of the country is advisable.
May Measurement Month 2018: an analysis of blood pressure screening results from Nepal
Authors: Adhikari Tara Ballav , Bhattarai Harikrishna , Ranabhat Kamal , Khanal Pratik , Mishra Shiva Raj , Koirala Sweta , Pandey Sadhna , Devkota Surya , Gairhe Milan , Dhamala Bimala , Soti Pabitra Babu , Paudel Sandip , Lohani Gunaraj , Koirala Bhagawan , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Neupane Dinesh
Published: August 2020

Raised blood pressure (BP) is a leading risk factor for mortality globally and in Nepal. May Measurement Month (MMM) is a global initiative aimed at screening for hypertension and raising awareness on high BP worldwide. This study provides the results of the 2018 MMM (MMM18) in Nepal. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018 nationwide. The standard MMM protocol was followed for BP measurement, the definition of hypertension, and statistical analysis. The campaign was publicized through various social media for recruiting volunteers and inviting participation. A total of 15 561 (58.7% male) from 35 districts of Nepal were screened in MMM18, of which 4 321 (27.8%) had hypertension. A total of 2 633 (19.0%) of 13 873 individuals who were not on antihypertensive treatment were found to be hypertensive. Of those on medication, 799 (47.4%) had uncontrolled BP. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher in people on antihypertensive treatment, smokers, and alcohol drinkers compared with those who were not on antihypertensive treatment, smokers, and alcohol drinkers, respectively. Likewise, SBP and DBP steadily increased across increasing body mass index categories. MMM18 was the largest BP screening campaign undertaken in Nepal. MMM has highlighted the importance of a periodic public health program at the national level to increase awareness on hypertension detection and control rate, and thus, the prevention of cardiovascular diseases.
May Measurement Month 2018: an analysis of blood pressure screening in the Philippines
Authors: Castillo Rafael R , Mercado-Asis Leilani B , Atilano Alberto A , David-Ona Deborah Ignacia , Diaz Alejandro F , Granada Carmela N , Bonzon Dolores D , Vilela Gilbert C , Chua Carlos L , Gomez Lynn A , Oliva Raymond V , Morales Dante D , Beaney Thomas , Ster Anca Chis , Poulter Neil R ,   on behalf of the Philippine MMM18 Investigators
Published: August 2020

Building on the gains of May Measurement Month 2017 (MMM17), the Philippine Society of Hypertension once again took part in MMM18 to raise awareness of high blood pressure (BP) in the country and to harness opportunistic BP screening in detecting unaware hypertensive individuals and referring them for treatment. We followed the standard MMM18 protocol designed by the International Society of Hypertension, utilizing convenience sampling with volunteer investigators, taking three sitting BP measurements of volunteer adults (≥18 years). Basic data on demographic, lifestyle, and environmental factors were also taken. We analysed 177 176 screened individuals from the Philippines. Of these, 29.1% (51 527) had also participated in MMM17, whereas 68.8% (121 893) were new screenees; and 14.2% (25 232) had their BP taken for the first time ever. After multiple imputation, 39.0% (69 126) were hypertensive. Of these, 50.3% (34 795) were aware they were hypertensive. 49.9% (34 491) were on antihypertensive medication, 58.0% (20 010) of whom had controlled BP <140/90 mmHg. Only 28.9% of all participants with hypertension had controlled BP. Systolic BPs and diastolic BPs were significantly higher in the overweight and obese, in those receiving antihypertensive medications, in patients with diabetes, and significantly lower in pregnant women. MMM18 has again shown that opportunistic BP screening, harnessing volunteers, is a pragmatic public health measure to improve awareness and treatment rates of raised BP.
May Measurement Month 2018: an analysis of blood pressure screening campaign results from Poland
Authors: Jankowski Piotr , Banach Maciej , Małyszko Jolanta , Mastej Mirosław , Tykarski Andrzej , Narkiewicz Krzysztof , Hoffman Piotr , Nowicki Michał P , Tomasik Tomasz , Windak Adam , Olszanecka Agnieszka , Tomaszewskil Maciej , Motyl Agnieszka , Nowak Dariusz , Skowron Łukasz , Beaney Thomas , Ster Anca Chis , Xin Xia , Poulter Neil R , Jóźwiak Jacek
Published: August 2020

Hypertension remains the most important cardiovascular risk factor in Poland. May Measurement Month is a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for blood pressure (BP) screening and demonstrating the potential of the opportunistic BP measurements. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in 146 sites in May 2018. Blood pressure was measured in 6450 subjects (mean age: 41 ± 15 years; 59% females). After multiple imputation, the age and sex standardized systolic and diastolic BP was 126.7/78.4 mmHg in the whole analysed group, 132.8/81.3 mmHg in subjects taking antihypertensive drugs, and 125.7/78.0 mmHg in those not taking any antihypertensive drugs. After multiple imputation, the proportions of subjects with high BP (systolic ≥140 mmHg or diastolic ≥90 mmHg or on treatment for raised BP) were 22.2% in the whole analysed group, 39.2% in subjects taking antihypertensive drugs, and 18.6% those not taking any antihypertensive drugs. Overall, hypertension was present in 32.8% of participants, among them 38.7% were not aware of the disease, 53.1% were taking antihypertensive drugs, and 32.3% had BP controlled to target (<140/90 mmHg). Blood pressure was increasing with increasing body mass index and alcohol intake. Smokers and project participants with diabetes had increased average BP. In conclusion, this project provides additional evidence for a considerable potential for further reduction of cardiovascular risk through improvement in detection and treatment of hypertension in Poland.
Results of May Measurement Month 2018 campaign in Venezuela
Authors: Hernández-Hernández Rafael , Duín Amanda , Octavio-Seijas José Andrés , López-Rivera Jesús , Morr Igor , Silva Egle , Gúzman-Franolic Mónica L , Costantini-Olmos Antonieta P , Marval José , Ruíz-Lugo José Félix , Vásquez Dámaso , Méndez-Amaya Nedina Coromoto , Armas-Hernández Maria J , Beaney Thomas , Ster Anca Chis , Poulter Neil R
Published: August 2020

Cardiovascular diseases, mainly coronary heart disease and stroke, are the main cause of death in Venezuela; hypertension is the primary risk factor. The May Measurement Month (MMM) study is a global initiative aimed at raising awareness of elevated blood pressure (BP). The previous MMM 2017 campaign showed 48.9% of participants had hypertension, higher than previous Venezuelan epidemiological studies. The MMM 2018 campaign included 28 649 participants screened [mean age: 54.2 (SD 15.13) years; female 62.8%] carried out mainly in pharmacies in 61 sites. Physical measurements included height, weight, and BP, taken in sitting position three times. After multiple imputations, 48.4% had hypertension, of which 87.7% were aware of their diagnosis. Of the individuals not receiving antihypertensive medication, 14.0% had hypertension and 33.7% of those receiving treatment had uncontrolled hypertension. Overall, the percentage of hypertensives with controlled hypertension was 54.8%. Body mass index was calculated for the total population, and it was on average 25.2 (SD: 4.65) kg/m2. Of all, 14.2% was classified as obese and 32.6% as overweight; meanwhile 4.8% as underweight. Diabetes was reported by 9.5%. These results suggest that repeated screening like the MMM campaign can routinely identify hypertension and consequently implement programmes of treatment in Venezuela, also other common risk factors, like obesity or diabetes.
May Measurement Month 2018: an analysis of blood pressure screening results from Taiwan
Authors: Lin Hung-Ju , Pan Heng-Yu , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Chen Wen-Jone , Wang Tzung-Dau
Published: August 2020

To raise awareness of hypertension in the general population, we have held an annual community-based nationwide campaign for blood pressure (BP) screening. The 2018 May Measurement Month (MMM) campaign in Taiwan followed a similar protocol as the 2017 MMM campaign. We recruited adults aged 20 years and older at about 800 community pharmacies across Taiwan. After a 10-min seated rest, volunteers—consisting of community pharmacists—took three BP readings using automated BP devices. The means of the 2nd and 3rd BP readings were used as the screening BP estimates. Hypertension was defined as current use of antihypertensive medications, or the screening BP of ≥140/90 mmHg. Of the 15 365 enrolled participants with a mean age of 56.8 ± 16.4 years, 53.3% were women. After imputation, we found 48.1% of the individuals had hypertension. Among participants with hypertension, 83.7% were aware, 55.0% had controlled BP, and 81.3% were medically treated, of whom 67.7% had controlled BP (<140/90 mmHg). In contrast to the global results, our results showed that the participants with diabetes mellitus, prior myocardial infarction, or stroke had higher BP than those without these comorbidities. The annual campaign experience enables us to establish a feasible approach to raising awareness and to assessing the management of hypertension in the general population. Whether the regular annual BP screening campaign makes a lasting effect on hypertension-related disease burden awaits verification.
TRIM21 Is Decreased in Colitis-associated Cancer and Negatively Regulates Epithelial Carcinogenesis
Authors: Zhou Guangxi , Wu Huili , Lin Jian , Lin Ritian , Feng Baisui , Liu Zhanju
Published: August 2020

Background

Tripartite motif-containing (TRIM)21 is reported to be associated with the regulation of immune response in gut mucosa. Here we studied the underlying mechanisms of TRIM21 in the pathogenesis of colitis-associated cancer (CAC).

Methods

We analyzed TRIM21 expression in tumor tissues from patients with colorectal cancer (CRC) and ulcerative colitis (UC)-associated cancer by immunohistochemistry and real-time polymerase chain reaction and established a CAC model in TRIM21−∕− and wild type mice by azoxymethane (AOM) and dextran sodium sulfate (DSS). Associated gene expression of tumor cell proliferation, adhesion, tissue remodeling and angiogenesis, and inflammatory cytokines were examined in normal colon and CAC by immunohistochemistry and real-time polymerase chain reaction.

Results

Expression of TRIM21 was found to be decreased in tumor tissues from patients with CRC and UC-associated cancer than that in controls, and TRIM21−∕− deficiency promoted AOM/DSS-induced CAC, characterized by more weight loss and multiple, large colon tumors in TRIM21−∕− mice. Moreover, associated gene expression of tumor cell proliferation (eg, Ki67), tissue remodeling and angiogenesis (eg, MMP10, HIF1-α, COX2, Ang4), and pro-inflammatory cytokines (eg, IL-6, TNF-α, IL-1β) markedly upregulated, whereas associated gene expression of tumor cell adhesion (E-cadherin) and inflammatory cytokines (eg, IL-10, TGF-β, Foxp3, IFN-γ) downregulated in tumor tissues from TRIM21–/– mice compared with controls.

Conclusions

TRIM21 is decreased in colitis-associated cancer and negatively regulates intestinal epithelial carcinogenesis by modulating epithelial cell proliferation, adhesion, tissue remodeling and angiogenesis, and pro-inflammatory responses. Therefore, TRIM21 may serve as a novel therapeutic target for CAC therapy.
Who Publishes Where? Exploring the Geographic Diversity of Global IR Journals
Authors: Lohaus Mathis , Wemheuer-Vogelaar Wiebke
Published: August 2020

To what extent is International Relations (IR) a globalized discipline? We investigate the geographic diversity of authorship in seventeen IR journals from Africa, East Asia, Europe, Latin America, North America, and the United Kingdom. Biographical records were collected for the authors of 2,362 articles published between 2011 and 2015. To interpret the data, we discuss how publishing patterns are driven by author incentives (supply) in tandem with editorial preferences and strategies (demand). Our main findings are twofold. First, global IR is fragmented and provincial. All journals frequently publish works by authors located in their own region—but the size of these local clusters varies. Geographic diversity is highest in what we identify as the “goldilocks zone” of international publishing: English-language journals that are globally visible but not so competitive that North American authors crowd out other contributions. Second, IR is being globalized through researcher mobility. Many scholars have moved to pursue their doctoral education and then publish as expats, returnees, or part of the diaspora. They are joined by academic tourists publishing in regions to which they have no obvious ties. IR journals thus feature more diverse backgrounds than it may seem at first sight, but many of these authors were educated in North America, the United Kingdom, and Europe.
Organizing Global Supply Chains: Input-Output Linkages and Vertical Integration
Authors: Berlingieri Giuseppe , Pisch Frank , Steinwender Claudia
Published: August 2020

We study how the technological importance of inputs—measured by cost shares—is related to the decision to “make” or “buy” that input. Using detailed French international trade data and an instrumental variable approach based on self-constructed input–output tables, we show that multinationals vertically integrate technologically important inputs. A stylized incomplete contracting model with both ex-ante and ex-post inefficiencies explains why: Technologically more important inputs are “made” when transaction cost economics type forces overpower property rights type forces. However, additional results show that both types of forces are needed to explain the full patterns in the data.
Transcript Assembly and Quantification by RNA-Seq Reveals Significant Differences in Gene Expression and Genetic Variants in Mosquitoes of the Culex pipiens (Diptera: Culicidae) Complex
Authors: Kang David S , Kim Sungshil , Cotten Michael A , Sim Cheolho
Published: August 2020

The taxonomy of Culex pipiens complex of mosquitoes is still debated, but in North America it is generally regarded to include Culex pipiens pipiens, Culex pipiens molestus, and Culex quinquefasciatus (or Culex pipiens quinquefasciatus). Although these mosquitoes have very similar morphometry, they each have unique life strategies specifically adapted to their ecological niche. Differences include the capability for overwintering diapause, bloodmeal preference, mating behaviors, and reliance on blood meals to produce eggs. Here, we used RNA-seq transcriptome analysis to investigate the differential gene expression and nucleotide polymorphisms that may link to the divergent traits specifically between Cx. pipiens pipiens and Cx. pipiens molestus.
Factors Affecting the Composition and Succession of Beetles in Exposed Pig Carcasses in Southern Brazil
Authors: Ries Ana Carolina R , Costa-Silva Vinícius , dos Santos Charles F , Blochtein Betina , Thyssen Patrícia J
Published: August 2020

Coleoptera is one of the largest taxon among animals and exhibits diverse eating habits. When associated with decaying corpses, beetles can be of great value in estimating the postmortem interval. In order to consolidate a useful database for the forensic field, it is necessary to study the entomological fauna associated with the carcasses in different geographical regions since the diversity of insects varies according to the biogeoclimate zone. Thus, this study aimed to assess the influence of environmental and ecological factors on the composition and succession of beetles associated with pig carcasses exposed in southern Brazil. Collections were carried out during the hot/dry and cold/wet seasons. A total of 415 specimens belonging to 18 Coleoptera families were sampled. The highest total abundance (n = 329) and diversity (n = 44 taxa) were recorded in the cold/wet season, corresponding to approximately 80% of the total sampled from the two seasons. Dermestidae (26.7%) was the family most abundantly sampled. Regarding eating habits, in an increasing order of importance were necrophagous (43.3%), predator (31.6%), and omnivorous (0.05%). In the hot/dry season, there was no faunal succession. In the cold/wet season, the succession was more associated with differences in abundance than to the presence or absence of a specific taxon by decomposition stage. Considering all the factors analyzed in the current study, three species of beetles, Dermestes maculatus DeGeer (Dermestidae), Euspilotus azureus (Sahlberg, 1823) (Histeridae), and Oxelytrum discicolle Brullé, 1840 (Silphidae), could be identified as being of the greatest forensic relevance in this biogeoclimatic zone.
Optimization of deep learning methods for visualization of tumor heterogeneity and brain tumor grading through digital pathology
Authors: Truong An Hoai , Sharmanska Viktoriia , Limbӓck-Stanic Clara , Grech-Sollars Matthew
Published: August 2020

Background

Variations in prognosis and treatment options for gliomas are dependent on tumor grading. When tissue is available for analysis, grade is established based on histological criteria. However, histopathological diagnosis is not always reliable or straight-forward due to tumor heterogeneity, sampling error, and subjectivity, and hence there is great interobserver variability in readings.

Methods

We trained convolutional neural network models to classify digital whole-slide histopathology images from The Cancer Genome Atlas. We tested a number of optimization parameters.

Results

Data augmentation did not improve model training, while a smaller batch size helped to prevent overfitting and led to improved model performance. There was no significant difference in performance between a modular 2-class model and a single 3-class model system. The best models trained achieved a mean accuracy of 73% in classifying glioblastoma from other grades and 53% between WHO grade II and III gliomas. A visualization method was developed to convey the model output in a clinically relevant manner by overlaying color-coded predictions over the original whole-slide image.

Conclusions

Our developed visualization method reflects the clinical decision-making process by highlighting the intratumor heterogeneity and may be used in a clinical setting to aid diagnosis. Explainable artificial intelligence techniques may allow further evaluation of the model and underline areas for improvements such as biases. Due to intratumor heterogeneity, data annotation for training was imprecise, and hence performance was lower than expected. The models may be further improved by employing advanced data augmentation strategies and using more precise semiautomatic or manually labeled training data.