bluuebunny/crossref_metadata_2025 huggingface dataset:
Ergonomic Principles as an Adjunct to the Profession of Biokinetics
Authors: Burger M. , Ellapen Terry J. , Paul Y. , Strydom Gert L.
Published: November 2019

Work-related injuries date back to antiquity. Attempts to resolve these work-related challenges have, inter alia, led to the establishment of the professions of Ergonomics, Occupational Therapy, Physiotherapy, Occupational Hygiene, and Biokinetics. The objective of this article is to illustrate the value of Ergonomic principles as an adjunct to the profession of Biokinetics. Insofar as Ergonomics addresses the physical and environmental risks which predispose and precipitate injuries, the profession of Ergonomics is primarily concerned with the practice of eradicating work-related challenges that impede human–machine interfacing, and which adversely influence work productivity and employee health. While Occupational Therapy and Biokinetics, by rehabilitating work-related injuries, assist in improving working conditions, little is known about the exact interface between the professions of Ergonomics and Biokinetics. The Google Scholar database was consulted in order to determine the relationship between Ergonomics and Biokinetics. The key words used were ergonomics and biokinetics and lead to the identification of 545 records, none of which pertained to the aforementioned subject. A subsequent search was conducted using the key words work-related musculoskeletal injuries and biokinetics. This search identified 925 records, the number of which were reduced to 42 (4.76%) after the exclusion of patents ( n = 24), citations ( n = 3), and nonbiokinetic work-related injury research ( n = 856). Given that many work-related injuries are managed through the use of biokinetic rehabilitation, knowledge of the physical ergonomic risk factors at play will afford biokineticists an enhanced understanding of the etiology of work-related injuries, thereby helping to improve the vigor of the rehabilitation.
Cumulative Violence and PTSD Symptom Severity Among Urban Street-Based Female Sex Workers
Authors: Park Ju Nyeong , Decker Michele R. , Bass Judith K. , Galai Noya , Tomko Catherine , Jain Kriti M. , Footer Katherine H.A. , Sherman Susan G.
Published: November 2019

Female sex workers (FSW) are a marginalized and vulnerable population at high risk of gender-based violence within and outside of their occupation. However, FSW remain underrepresented in the trauma and mental health literature. The aims of this study were to (a) characterize exposure to violence among street-based FSW, including violence type, patterns over the life course, and key perpetrator groups, and (b) examine the multivariate associations between posttraumatic stress disorder (PTSD) symptom severity and two constructs (revictimization across life stages and cumulative violence). Data were drawn from the Sex Workers and Police Promoting Health in Risky Environments (SAPPHIRE) study, an observational community-based cohort of street-based FSW recruited through targeted sampling across Baltimore, Maryland (USA) in 2016 to 2017. PTSD symptom severity was measured using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (PCL-5). At baseline, 61% of FSW screened positive for PTSD symptoms. The mean PCL-5 score was 38.6. We documented extensive histories of sexual and physical violence (lifetime: 81.8%; childhood and adult revictimization: 15.0% for sexual and 37.7% for physical). The vast majority of perpetrators were male and included paying clients, police officers, family members, and intimate partners. Exposure to childhood and adult sexual violence were independently associated with higher PTSD severity ( p < .05), with marginal associations observed for physical violence. Data supported a cumulative violence model of PTSD severity ( p < .05). Binge drinking also appeared to be a contributing factor ( p < .05). The levels of PTSD observed among our sample were comparable with that reported among treatment-seeking war veterans. Our findings underscore the urgent need for tailored trauma-informed interventions and policies to address violence among urban street-based FSW, a population experiencing extremely high levels of violence, PTSD, and substance use.
Effectiveness of a Prison-Based Treatment Program for Male Perpetrators of Intimate Partner Violence: A Quasi-Experimental Study of Criminal Recidivism
Authors: McNeeley Susan
Published: November 2019

Despite increasing interest in programming for perpetrators of intimate partner violence (IPV), the literature provides weak support for the effectiveness of these interventions. However, there are few studies that evaluate programs offered to felony IPV offenders who are serving prison sentences. This study uses a quasi-experimental design to evaluate the effectiveness of a prison-based implementation of a popular IPV intervention in reducing general and offense-specific recidivism among 169 men released from state prison in 2017. Because recidivism data were collected through early March 2019, the average follow-up period was approximately 20 months for both the control group and experimental group. Observable selection bias was minimized by using propensity score matching to create a comparison group of 169 nonparticipants released in 2017 who were not significantly different from the program participants. Cox regression models were used to predict general rearrest, reconviction, reincarceration, and supervised release revocation, as well as rearrest and reconviction for any violent offenses and rearrest and reconviction for domestic violence offenses in particular. No significant differences in any type of recidivism were found between the comparison group and those who participated in treatment, regardless of whether the participant completed or failed to complete the program. The findings suggest that the intervention is no more successful when offered within prisons than when offered in the community. The study concludes by making recommendations for increasing the effectiveness of prison-based domestic violence programming.
Improvement of organoclay dispersion into polystyrene-based nanocomposites by incorporation of SBS and maleic anhydride-grafted SBS
Authors: Dike Ali Sinan , Yilmazer Ulku
Published: November 2019

In this study, organoclay-containing polystyrene (PS)-based nanocomposites were fabricated by extrusion in the presence of thermoplastic elastomer modifiers. Styrene–butadiene–styrene (SBS) rubber was used as the elastomeric compatibilizer and maleic anhydride (MA) was grafted onto SBS rubber at different ratios. Grafting was made via melt blending. Cloisite® 30B was used as the organoclay and it was added to PS and PS/SBS blends using a corotating twin-screw extruder, followed by injection molding. Clay loading was kept constant as 2 wt%, and the elastomer content was varied between 0 and 40 wt% throughout the study. MA grafted SBS enhanced the intercalation/exfoliation of clay layers resulting in higher tensile strength, modulus, elongation at break, and impact strength with respect to neat PS. Composites containing 15 wt% MA grafted SBS displayed the optimum average domain size resulting in the high impact strength without deteriorating the tensile strength and modulus values. Elastomer addition increased the glass transition temperature of the samples due to branching or cross-linking during extrusion. PS and PS/SBS exhibited similar melt flow index values with their organoclay-containing composites. MA acted as a plasticizer and decreased viscosity. Scanning electron microscopy study indicated that dispersion of clay layers was observed at the PS-SBS interphase and also in the elastomer phase. Intercalated and exfoliated structures of organoclay layers were confirmed by X-ray diffraction and transmission electron microscopy analyses.
Does Governance Matter? Evidence from BRICS
Authors: Singh Bhanu Pratap
Published: November 2019

The role of governance is widely debated in the process of economic development. The current study focuses on examining the growth and the governance relationship for BRICS countries utilizing the annual balanced panel data for the period spanning from 1997 to 2015. Per capita real GDP growth is taken as a proxy for economic growth and six World Bank Governance Indicators are used as a measure of governance. Pedroni (2004, Econometric Theory, 20, 597–625) panel cointegration technique and fully modified ordinary least square (FMOLS) are used to look into a long-run equilibrium relationship. Dumitrescu and Hurlin’s (2012, Economic Modelling, 29, 1450–1460) panel causality test is used as a short-run diagnostics test for long-run equilibrium relationship. The major findings of the study show that growth and governance are complementary to each other. In the long run, governance promotes and sustains high-income growth, whereas, in the short run, minimum economic development is required for better functioning of institutions.
Native Americans’ Memorable Conversations About Living Kidney Donation and Transplant
Authors: Anderson Jenn , Britt Rebecca K. , Britt Brian C. , Harming Shana , Fahrenwald Nancy
Published: November 2019

Living kidney donation and transplant (LKDT) offers a path of hope for patients on indefinite dialysis treatment. However, identification of a living donor can be challenging; initiating these conversations is difficult. Our study analyzes memorable conversations about LKDT that occurred in response to an LKDT campaign targeted to Native Americans. Our analysis of n = 28 memorable conversations revealed that the campaign prompted conversations and increased communication efficacy about LKDT. Based on these findings, we suggest that campaign designers utilize narratives within campaigns to model communication self-efficacy and then analyze the content of postcampaign conversations as an indicator of campaign effectiveness.
Characteristics Associated With School Health Services for the Management of Chronic Health Conditions
Authors: Tiu Georgianne F. , Leroy Zanie C. , Lee Sarah M. , Maughan Erin D. , Brener Nancy D.
Published: November 2019

It is unknown how health services staff (school nurse or school physician) or school characteristics are associated with the number of services provided for chronic health conditions in schools. Using data from the 2014 School Health Policies and Practices Study, four services (identification or school-based management, tracking, case management, and referrals) were analyzed using a multivariable ordered logistic regression. Approximately 57.2% of schools provided all four, 17.5% provided three, 10.1% provided two, 5.8% provided one, and 9.4% did not provide any such services. Schools with a school nurse were 51.5% ( p < .001) more likely to provide all four, and schools with access to consult with a school physician were 15.4% ( p < .05) more likely, compared to schools without one. Schools comprised of mostly racial/ethnic minority students (less than or equal to 50% non-Hispanic White) were 14.7% ( p < .05) less likely to provide all four, compared to schools with greater than 50% White students.
Incarcerated for a Sex Offense: In-Prison Experiences and Concerns about Reentry
Authors: Baker Thomas , Zgoba Kristen , Gordon Jill A.
Published: November 2019

Using a sample of 3,041 incarcerated men and women, this study examines the impact of being incarcerated for a sex offense and individuals’ in-prison experiences on their concerns about reentry into society. Bivariate analyses suggest that being incarcerated for a sex offense is related to greater concerns about housing and fewer concerns about recidivism compared with individuals incarcerated for nonsex offenses. A sex offense conviction is also associated with weaker social bonds, greater relational difficulties, and greater fear of victimization while incarcerated. Multiple regression models indicate that, after controlling for in-prison experiences, being incarcerated for a sex offense increases reentry concerns related to employment and housing, though may reduce them for recidivism. In-prison experiences mediate the relationship between being incarcerated for a sex offense and reentry concerns. Policy implications of these findings are discussed.
Efficacy of Omega-3/Omega-6 Fatty Acids in Preschool Children at Risk of ADHD: A Randomized Placebo-Controlled Trial
Authors: Döpfner Manfred , Dose Christina , Breuer Dieter , Heintz Stefan , Schiffhauer Stefanie , Banaschewski Tobias
Published: November 2019

Objective: To evaluate the efficacy of an Omega-3/Omega-6 fatty acid supplement in preschool children at risk for ADHD. Method: Forty preschool children with elevated levels of ADHD symptoms were randomly assigned to either a verum or a placebo group. Children in the verum group received a 4-month treatment with Omega-3/Omega-6 fatty acids. Outcome measures comprised parent- and teacher-rated ADHD symptoms, which were the primary outcome variables, internalizing and externalizing problems, and intellectual abilities. Results: Intention-to-treat analyses of covariance, controlling for age and baseline data, revealed effects on parent- and teacher-rated ADHD symptoms (primary outcomes; parent ratings: F = 4.51, df = 1, p = .04, d = 0.63; teacher ratings: F = 4.67, df = 1, p = .04, d = 0.70), parent-rated internalizing symptoms ( F = 8.47, df = 1, p < .01, d = 0.63), and parent- and teacher-rated externalizing symptoms (parent ratings: F = 4.58, df = 1, p = .04, d = 0.54; teacher ratings: F = 5.99, df = 1, p = .02, d = 0.79). Analyses involving only cases with available data yielded significant moderate effects on teacher-rated inattention symptoms ( F = 4.60, df = 1, p = .04, d = 0.79) and parent-rated internalizing problems ( F = 6.04, df = 1, p = .02, d = 0.57). Conclusion: The intention-to-treat analyses provide some evidence for positive effects of Omega-3/Omega-6 fatty acids. However, the results require replication in larger samples to allow for firm conclusions for practice.
Indigenous voices on measuring and valuing health states
Authors: Willing Esther , Paine Sarah-Jane , Wyeth Emma , Te Ao Braden , Vaithianathan Rhema , Reid Papaarangi
Published: November 2019

The philosophical assumptions that underpin the way in which health states are valued within economic measures of health are rarely made explicit and fail to capture the experiences of Indigenous peoples. Within a Kaupapa Māori theoretical paradigm, in-depth interviews were conducted with six Māori key informants who had cared for whānau (family) members through illness to give voice to dimensions of health and illness that Western economic measures of health fail to capture. An Indigenous measure of health needs to consider the individual within the context of the collective and the environment that they are connected to. Economic measures of health are widely used to inform decisions about resource allocation that have significant impacts on Indigenous health outcomes. This article sets out to start a conversation around what an Indigenous measure of health might look like and how it might value key dimensions of health.
Oculomotor behavior in children with autism spectrum disorders
Authors: Caldani Simona , Steg Sarah , Lefebvre Aline , Atzori Paola , Peyre Hugo , Delorme Richard , Bucci Maria Pia
Published: November 2019

To identify quantitative indicators of social communication dysfunctions, we explored the oculomotor performances in subjects with autism spectrum disorders. Discordant findings in the literature have been reported for oculomotor behavior in subjects with autism spectrum disorders. This study aimed to explore reflexive and voluntary saccadic performance in a group of 32 children with autism spectrum disorders (mean age: 12.1 ± 0.5 years) compared to 32 age-, sex-, and IQ-matched typically developing children (control group). We used different types of reflexive and voluntary saccades: gap, step, overlap, and anti-saccades. Eye movements were recorded using an eye tracker (Mobile EBT®) and we measured latency, percentage of anticipatory and express saccades, errors of anti-saccades and gain. Children with autism spectrum disorders reported similar latency values with respect to typically developing children for reflexive and voluntary saccades; in contrast, they made more express and anticipatory saccades overall, as shown in paradigm testing (gap, step, overlap, and anti-saccades). Our findings support previous evidence of the atypicality of the cortical network, which is involved in saccade triggering and attentional processes in children with autism spectrum disorders.
Weight Loss Intervention Before Total Knee Replacement: A 12-Month Randomized Controlled Trial
Authors: Liljensøe A. , Laursen J. O. , Bliddal H. , Søballe K. , Mechlenburg I.
Published: November 2019

Background and Aims:

Obesity is an increasing problem in patients after total knee replacement. The aim of this study was to investigate whether a weight loss intervention before primary total knee replacement would improve quality of life, knee function, mobility, and body composition 1 year after surgery.

Material and Methods:

Patients scheduled for total knee replacement due to osteoarthritis of the knee and obesity were randomized to a control group receiving standard care or to an intervention group receiving 8-week low-energy diet before total knee replacement. Patient-reported quality of life, 6-Min Walk Test, and body composition by dual-energy X-ray absorptiometry were assessed before intervention for the diet group, and within 1 week preoperatively for both groups, and the changes in outcome from baseline to 1 year after total knee replacement were compared between groups. The number of participants was lower than planned, which might introduce a type-2 error and underestimate the trend for a better outcome after weight loss.

Results:

The analyses are based on a total of 76 patients, 38 in each group. This study showed major improvement in both study groups in quality of life and knee function, though no statistically significant differences between the groups were observed 1 year after total knee replacement. The average weight loss after 8-week preoperative intervention was 10.7 kg and consisted of a 6.7 kg reduction in fat mass. One year after total knee replacement, the participants in the diet group managed to maintain the weight reduction, whereas there was no change in the control group.

Conclusion:

The results suggest that it is feasible and safe to implement an intensive weight loss program shortly before total knee replacement. The preoperative intervention resulted in a 10% body weight loss, improved body composition, lower cardiovascular risk factors, and sustained s-leptin.
From Arcadia to Wonderland: Reflections on a Decade of Continuing Education in Scotland
Authors: Thomson Raymond A
Published: November 2019

This paper traces developments in post-compulsory education over the last twenty years form the personal perspective of a practitioner working across the sectors of Further Education and University Continuing Education. The dominance of accreditation in recent years has deflected universities into creating financially protective frameworks for UCE with the consequent loss of its previous raison d'etre of intrinsic worth. Even recent positive responses to the emphasis on widening participation is seen as financially driven rather than being truly a concern for greater social inclusion.
Educating for Devolution: The Scottish Office Voter Education Campaign, 1999
Authors: Cloonan Martin , Lynch Peter
Published: November 2019

This article examines the origins and impact of a political education campaign of a type, which had not hitherto been witnessed in the UK. It examines how the Scottish Office sought to educate Scotland's adult population about a new electoral system which combined the traditional first past the post (FPTP) system used in elections to the Westminster Parliament with the additional member system (AMS). We set out events leading up to the voter-education campaign by outlining the development of the voting system and the political sensitivities which surrounded it We then review a similar voter-education campaign in New Zealand, before examining the Scottish campaign and responses to it. We conclude by drawing together common elements from the two campaigns and analysing the lessons which can be drawn from them.
Annona atemoyaleaf extract ameliorates cognitive impairment in amyloid-β injected Alzheimer’s disease-like mouse model
Authors: Lim Hye-Sun , Kim Yu Jin , Sohn Eunjin , Yoon Jiyeon , Kim Bu-Yeo , Jeong Soo-Jin
Published: November 2019

Annona atemoya is a hybrid of Annona squamosa and Annona cherimola that grow in several subtropical or tropical areas such as Florida in the US, Philippines, Cuba, Jamaica, Taiwan, and Jeju in South Korea. We report that the A. atemoya leaves (AAL) have inhibitory effects on the pathogenesis and regulatory mechanisms of Alzheimer’s disease (AD). Ethanol extract of AAL prevented amyloid-β (Aβ) aggregation and increased free radical scavenging activity. In addition, AAL extract exerted protective effects against neuronal cell death in HT22 hippocampal cells. Moreover, oral administration of AAL extract significantly improved memory loss in the passive avoidance task and Y-maze test, as well as downregulated the expression of neuronal markers neuronal nuclei and brain-derived neurotrophic factor in Aβ-injected AD mice. To verify the molecular mechanisms responsible for anti-AD actions of AAL, we conducted the antibody microarray analysis and found that epidermal growth factor receptor/G protein-coupled receptor kinase 2 signaling was activated in neuronal cells and AD-like mouse models. Additionally, quantitative analyses of the six standard compounds using high-performance liquid chromatography revealed that rutin is the most abundant compound of AAL. Furthermore, efficacy analyses of six standard compounds showed that rutin and isoquercitrin had significant inhibitory activity on Aβ aggregation. Taken together with biological activity and the content of compounds, rutin maybe a bioactive compound of AAL in the AD pathogenesis. Overall, our findings provide the first scientific support for the therapeutic effects of AAL in AD and AD-related disorders.

Impact statement

Our study was aimed to find a novel candidate drug for Alzheimer’s disease (AD) using natural products. We assessed the effects of Annona atemoya extracts on crucial events in the pathogenesis of AD. A. atemoya leaf (AAL) extract significantly inhibited amyloid-β aggregation, oxidative stress, neuronal cell death, and memory impairment through the epidermal growth factor receptor/G protein-coupled receptor kinase 2 pathway. Simultaneous analysis using HPLC determined six standard compounds of AAL extract, and rutin was identified as a bioactive compound. Of note, the anti-AD activity of AAL extract was more significant compared to other extracts from medicinal plants of which efficacy was previously reported. The potential of AAL extract as an anti-AD agent may provide insight into the new drug development for AD treatment.
Looking Forward: Research to Respond to a Rapidly Aging Population
Authors: Lakin K. Charlie , Burke Meghan M.
Published: November 2019

People aging with severe disabilities face many age- and disability-related challenges that are shared with a range of family members and other caregivers. Although these challenges are often exacerbated by substantial physical, cognitive, communication, health, and other impairments associated with severe disabilities, thematically, they are often similar to the challenges faced by other older persons as they navigate the aging process. These themes include (a) planning for a desired post–working years lifestyle, (b) identifying and securing services and supports that accommodate disability, (c) sustaining the support of family and friends, (d) maintaining optimal health, (e) dealing with grief and end-of-life issues, and (f) avoiding loneliness and isolation. Using these themes, this final article reviews the findings of the articles in this special issue as well as other related studies to suggest potentially fruitful directions in future research to contribute to the well-being of the rapidly growing population of persons aging with severe disabilities.
VaSe-MRP: Velocity-aware and stability-estimation–based multi-path routing protocol in flying ad hoc network
Authors: Ma Zhongyu , Guo Qun , Ma Ji , Zhang Zhe , Ma Hongfeng , Peng Linru , Li Ying
Published: November 2019

Flying ad hoc network is widely used in many military and civilian scenarios. Compared with mobile ad hoc network and vehicular ad hoc network, flying ad hoc network holds some special characteristics such as high mobility, long-distance communication, and sparse node-deployment, which cause an important challenge in the design of routing protocols. In this article, a velocity-aware and stability-estimation–based multi-path routing protocol is proposed for flying ad hoc network. The protocol is mainly composed of two important parts, which are the routing discovery mechanism and routing maintenance mechanism. In routing discovery process, the routing discovery request packet only can be forwarded by the reliable node, which is decided by the calculation of co-direction degree, then the routing overhead is reduced at some extent. Noticeably, the correlation of the survival duration between adjacent links is fully considered, which is very important to the path stability criteria. In routing maintenance progress, a path similarity and path remaining survival duration–based multi-path selection mechanism is proposed. The performance superiority of velocity-aware and stability-estimation–based multi-path routing protocol is also demonstrated by extensive simulations. The results show that velocity-aware and stability-estimation–based multi-path routing protocol is much better than other existing protocols in terms of network throughput, average delay of data transmission, routing overhead, and the convergence time of the routing discovery.
Critical Reappraisal of the Time-in-Range: Alternative or Useful Addition to Glycated Hemoglobin?
Authors: Heinemann Lutz , Freckmann Guido , Müller-Wieland Dirk , Kellerer Monika
Published: November 2019

The HbA1c value is a well-established parameter used to characterize glucose control. Continuous glucose monitoring (CGM)-derived parameters calculated using daily glucose profiles such as Time-in-Range (TiR) have increasingly been gaining interest for assessing a patient’s current therapy. The question has arisen as to whether TiR could replace HbA1c? Because TiR focuses on the current quality of glucose control during a minimum of 10 to 14 days of CGM use and reflects the variability of glucose concentrations. Time-in-Range could be considered an attractive option for improving diabetes control in patients with diabetes. Due to the lack of established standards for glucose measurements with CGM systems, results from different CGM systems can deviate from each other. Time-in-Range should not be viewed as a replacement for HbA1c, but should be used to deliver valuable additional information.
Glucose and insulin levels are associated with arterial stiffness and concentric remodeling of the heart
Authors: Markus Marcello Ricardo Paulista , Rospleszcz Susanne , Ittermann Till , Baumeister Sebastian Edgar , Schipf Sabine , Siewert-Markus Ulrike , Lorbeer Roberto , Storz Corinna , Ptushkina Violetta , Peters Annette , Meisinger Christa , Bamberg Fabian , Nauck Matthias , Bahls Martin , Völzke Henry , Felix Stephan Burkhard , Bülow Robin , Rathmann Wolfgang , Dörr Marcus
Published: November 2019

Background

Mortality attributable to heart failure remains high. The prevalence of heart failure in patients with diabetes mellitus ranges from 19 to 26%. It is estimated that up to 21.1 million adults in the United States have diagnosed diabetes mellitus and around 80.8 million have impaired fasting glucose. We investigated the associations of fasting glucose (FG) and fasting insulin (FI), the homeostasis model assessment-insulin resistance index (HOMA-IR) and 2-h postload glucose (2HG) and insulin (2HI) with parameters of left ventricular geometry and function and arterial stiffness determined by magnetic resonance imaging in individuals without diagnosed type 2 diabetes.

Methods

Cross-sectional analyses of 1001 individuals (453 women, 45.3%), aged 21 to 80 years, from two independent population-based studies, the Study of Health in Pomerania (SHIP-TREND-0) and KORA FF4 Study. FG, FI, HOMA-IR, 2HG and 2HI, as well as glucose tolerance categories, were analyzed for associations with heart and arterial parameters using multivariable-adjusted linear regression models.

Results

In total, 390 individuals (39%) had prediabetes (isolated impaired fasting glucose, isolated glucose tolerance or both), and 49 (4.9%) were found to have unknown type 2 diabetes. In the multivariable-adjusted analysis, positive linear associations of FG, FI, HOMA-IR, 2HG and 2HI with arterial stiffness index and left ventricular wall-thickness and concentricity and inverse linear associations with left ventricular end-diastolic volume were observed. A 1 mmol/l higher FG was associated with a 1.18 ml/m2.7 (1.80 to 0.57; p < 0.001) lower left ventricular end-diastolic volume index, a 0.042 mm/m2.7 (0.014 to 0.070) higher left ventricular wall-thickness index, a 0.12 mmHg m2.7/ml (0.06 to 0.17; p < 0.001) greater arterial stiffness index and a 0.037 g/ml (0.018 to 0.056; p < 0.001) higher left ventricular concentricity.

Conclusions

Our findings suggest that higher glucose levels in the prediabetic range and insulin resistance might lead to higher arterial stiffness and concentric remodeling of the heart.
Iodine status of 8 to 10 years old children within 20 years following compulsory salt iodization policy in Shanghai, China
Authors: Wang Zhengyuan , Zang Jiajie , Shi Zhehuan , Zhu Zhenni , Song Jun , Zou Shurong , Jin Wei , Jia Xiaodong , Guo Changyi , Liu Shoujun
Published: November 2019

Background

In 1996, Shanghai implemented universal salt iodization and has became the last provincial unit in China to carry out this intervention. In this study, we summarized achievements in past 20 years, to provide suggestions and evidence for the next stage of iodine supplementation.

Methods

This study summarized and analyzed monitoring data of children from 1997, 1999, 2005, 2011, 2014, and 2017 in Shanghai. In each monitoring year, 30 streets or towns were selected using the probability-proportional-to-size sampling technique. One primary school was selected from each street or town by a simple random sampling technique. From each school, 40 children aged 8 to 10 years were randomly selected. The number of children was divided equally by sex and age.

Results

In 1997, 1999, 2005, 2011, 2014, and 2017, median urinary iodine (MUI) was 227.5 μg/L, 214.3 μg/L, 198.1 μg/L, 181.6 μg/L, 171.4 μg/L, and 183.0 μg/L, goiter rate was 3.07, 0.40, 0.08, 0.08, 0.86, and 1.90%, and median thyroid volume (MTvol) was 2.9 mL, 1.2 mL, 2.4 mL, 1.0 mL, 1.8 mL, and 2.8 mL, respectively. There was a linear correlation between goiter rate and median thyroid volume (MTvol) (r = 0.95, P = 0.014). Household salt iodine concentration (SIC) was dropping every monitoring (P < 0.05). There was a significant difference among different household SIC groups in MUI in 1999 and 2017, and in MTvol in 1999 (P < 0.05). No significant differences were detected in the other years.

Conclusions

In Shanghai, the iodine status of 8 to 10 years old children is adequate. Household SIC have little effect on iodine status of children. Future studies should analyze the dietary sources of iodine, especially from pre-packaged and prepared-away-from-home foods or meals. The regular monitoring of iodine status is important to human health.
STING: a master regulator in the cancer-immunity cycle
Authors: Zhu Yuanyuan , An Xiang , Zhang Xiao , Qiao Yu , Zheng Tongsen , Li Xiaobo
Published: November 2019

The aberrant appearance of DNA in the cytoplasm triggers the activation of cGAS-cGAMP-STING signaling and induces the production of type I interferons, which play critical roles in activating both innate and adaptive immune responses. Recently, numerous studies have shown that the activation of STING and the stimulation of type I IFN production are critical for the anticancer immune response. However, emerging evidence suggests that STING also regulates anticancer immunity in a type I IFN-independent manner. For instance, STING has been shown to induce cell death and facilitate the release of cancer cell antigens. Moreover, STING activation has been demonstrated to enhance cancer antigen presentation, contribute to the priming and activation of T cells, facilitate the trafficking and infiltration of T cells into tumors and promote the recognition and killing of cancer cells by T cells. In this review, we focus on STING and the cancer immune response, with particular attention to the roles of STING activation in the cancer-immunity cycle. Additionally, the negative effects of STING activation on the cancer immune response and non-immune roles of STING in cancer have also been discussed.
Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision
Authors: Houvenaeghel Gilles , Bannier Marie , Rua Sandrine , Barrou Julien , Heinemann Mellie , Lambaudie Eric , Cohen Monique
Published: November 2019

Background

Robotic latissimus dorsi-flap reconstruction (RLDFR) after skin-sparing mastectomy (SSM) for breast cancer (BC) has been performed through a single nipple incision. We report results of SSM with RLDFR, mainly with analysis of feasibility, morbidity, indications, and technique standardization.

Methods

We determined characteristics of patients, previous treatment of BC, and type of reconstruction. Surgical technique, duration of surgery, and complication rate were reported according to three successive periods: P1–3.

Results

Forty RLDFR, with breast implant for 16 patients, with previous breast radiotherapy in 30% had been performed. In logistic regression, factors significantly associated with duration of surgery ≥ 300 min were P2 (OR 0.024, p = 0.004) and P3 (OR 0.012, p = 0.004) versus P1. The median mastectomy weight was 330 g and 460 g for BMI < and ≥ 23.5 (p = 0.025). Length of hospitalization was 4 days. Total complication rate was 20% (8/40): seven breast complications (four re-operations) and one RLDF complication with re-operation. Periods were significantly predictive of complications (p = 0.045).

Conclusion

SSM with RLDFR is feasible, safe, and reproducible. We reported a decrease of duration of surgery, length of post-operative hospitalization, and complication rate.
Risk and early predictive factors of anastomotic leakage in laparoscopic low anterior resection for rectal cancer
Authors: Fukada Masahiro , Matsuhashi Nobuhisa , Takahashi Takao , Imai Hisashi , Tanaka Yoshihiro , Yamaguchi Kazuya , Yoshida Kazuhiro
Published: November 2019

Background

In recent years, laparoscopic surgery has been widely used for rectal cancer. In laparoscopic rectal surgery, a double-stapling technique (DST) anastomosis using a stapling device is considered a relatively difficult procedure. Postoperative anastomotic leakage (AL) is a major complication related to patients’ quality of life and prognosis.

Methods

This study was a retrospective, single-institution study of 101 rectal cancer patients who underwent laparoscopic low anterior resection (LAR) with DST anastomosis (excluding simultaneous resection of other organs and construction of protective diverting stoma) between February 2008 and November 2017 at the Gifu University Graduate School of Medicine. This study aimed to identify risk and early predictive factors of AL.

Results

Among 101 patients, symptomatic AL occurred in 13 patients (12.9%), of whom 10 were male and 3 were female. Their median BMI was 22.7 kg/m2 (range, 17.9–26.4 kg/m2).

Among the pre- and intraoperative factors, AL was significantly associated with tumor location (lower rectum), distance from the anal verge (< 6 cm), intraoperative blood loss (≥ 50 ml), and the number of linear staples (≥ 2) in univariate analysis. In multivariate analysis, only intraoperative blood loss (≥ 50 ml, odds ratio [OR] 4.59; 95% confidence interval [CI] 1.04–19.52; p = 0.045) was identified as an independent risk factor for AL.

Among the postoperative factors, AL was significantly associated with tachycardia-POD1 (≥ 100 bpm), CRP-POD3 (≥ 15 mg/dl), fever on postoperative day (fever-POD) 3 (≥ 38 °C), and first defecation day after surgery (< POD3) in univariate analysis. In multivariate analysis, fever-POD3 (≥ 38 °C, OR 30.97; 95% CI 4.68–311.22; p = 0.0003) and first defecation day after surgery (< POD3, OR 5.82; 95% CI 1.34–31.30; p = 0.019) were identified as early predictive factors for AL.

Conclusion

In this study, intraoperative blood loss was an indicator of difficulty in a transection and anastomosing procedure, and fever-POD3 and early first defecation day after surgery were independent early predictive factors for AL. Careful surgery using an appropriate technique and standardized procedures with minimal bleeding and careful postoperative management paying attention to fever and defecation may prevent the onset and severity of AL.
Prognostic role of the advanced lung cancer inflammation index in cancer patients: a meta-analysis
Authors: Hua Xin , Chen Jing , Wu Ying , Sha Jun , Han Shuhua , Zhu Xiaoli
Published: November 2019

Background

Inflammation plays a critical role in the development and progression of cancers. The advanced lung cancer inflammation index (ALI) is thought to be able to reflect systemic inflammation better than current biomarkers. However, the prognostic significance of the ALI in various types of cancer remains unclear. Our meta-analysis aimed to comprehensively investigate the relationship between the ALI and oncologic outcomes to help physicians better assess the prognosis of cancer patients.

Methods

The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched for relevant studies. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated and pooled from the included studies. Furthermore, a sensitivity analysis was performed to evaluate the reliability of the articles. Finally, Begg’s test, Egger’s test, and the funnel plot were applied to assess the significance of publication bias.

Results

In total, 1736 patients from nine studies were included in our meta-analysis. The median cutoff value for the ALI was 23.2 (range, 15.5–37.66) in the analyzed studies. The meta-analysis showed that there was a statistically significant relationship between a low ALI and worse overall survival (OS) in various types of cancer (HR = 1.70, 95% CI = 1.41–1.99, P < 0.001). Moreover, results from subgroup meta-analysis showed that the ALI had a significant prognostic value in non-small cell lung cancer, small cell lung cancer, colorectal cancer, head and neck squamous cell carcinoma, and diffuse large B cell lymphoma (P < 0.05 for all).

Conclusions

These results showed that a low ALI was associated with poor OS in various types of cancer, and the ALI could act as an effective prognostic biomarker in cancer patients.
Job satisfaction of public and private primary care physicians in Malaysia: analysis of findings from QUALICO-PC
Authors: Ab Rahman N. , Husin M. , Dahian K. , Mohamad Noh K. , Atun R. , Sivasampu S.
Published: November 2019

Background

Job satisfaction of doctors is an important factor determining quality and performance of a health system. The aim of this study was to assess job satisfaction among doctors of the public and private primary care clinics in Malaysia and evaluate factors that could influence the job satisfaction rating.

Methods

This study was part of the Quality and Costs of Primary Care (QUALICOPC) Malaysia, a cross-sectional survey conducted between August 2015 and June 2016 in Malaysia. Data was collected from doctors recruited from public and private primary care clinics using a standardised questionnaire. Comparisons were made between doctors working in public and private clinics, and logistic regression analysis was used to determine factors influencing the likelihood of job satisfaction outcomes.

Results

A total of 221 doctors from the public and 239 doctors from the private sector completed the questionnaire. Compared to private doctors, a higher proportion of public doctors felt they were being overloaded with the administrative task (59.7% vs 36.0%) and part of the work does not make sense (33.9% vs 18.4%). Only 62.9% of public doctors felt that there was a good balance between effort and reward while a significantly higher proportion (85.8%) of private doctors reported the same. Over 80% of doctors in both sectors indicated continued interest in their job and agreed that being a doctor is a well-respected job. Logistic regression analysis showed public-private sector and practice location (urban-rural) to be significantly associated with work satisfaction outcomes.

Conclusion

A higher proportion of public doctors experienced pressure from administrative tasks and felt that part of their work does not make sense than their colleague in the private sector. At the same time, the majority of private doctors reported positive outcome on effort-and-reward balance compared to only one third of public doctors. The finding suggests that decreasing administrative workload and enhancing work-based supports might be the most effective ways to improve job satisfaction of primary care doctors because these are some of the main aspects of the job that doctors, especially in public clinics, are most unhappy with.
The tumor inflammation signature (TIS) is associated with anti-PD-1 treatment benefit in the CERTIM pan-cancer cohort
Authors: Damotte Diane , Warren Sarah , Arrondeau Jennifer , Boudou-Rouquette Pascaline , Mansuet-Lupo Audrey , Biton Jérôme , Ouakrim Hanane , Alifano Marco , Gervais Claire , Bellesoeur Audrey , Kramkimel Nora , Tlemsani Camille , Burroni Barbara , Duche Angéline , Letourneur Franck , Si Han , Halpin Rebecca , Creasy Todd , Herbst Ronald , Ren Xing , Morel Pascale , Cesano Alessandra , Goldwasser François , Leroy Karen
Published: November 2019

Background

The 18-gene tumor inflammation signature (TIS) is a clinical research assay that enriches for clinical benefit to immune checkpoint blockade. We evaluated its ability to predict clinical benefit of immunotherapy in cancer patients treated with PD-1 checkpoint inhibitors in routine clinical care.

Methods

The CERTIM cohort is a prospective cohort which includes patients receiving immune checkpoint inhibitors in Cochin University hospital. RNA extracted from 58 archival formalin fixed paraffin embedded tumor blocks (including 38 lung cancers, 5 melanomas, 10 renal carcinomas, 4 urothelial carcinomas and 1 colon carcinoma) was hybridized to a beta version of the NanoString® PanCancer IO360™ CodeSet using nCounter® technology. Gene expression signatures were correlated with tumor responses (by RECIST criteria) and overall survival. PD-L1 immunostaining on tumor cells was assessed in 37 non-small cell lung cancer (NSCLC) samples and tumor mutational burden (TMB) measured by whole exome sequencing in 19 of these.

Results

TIS scores were significantly associated with complete or partial response to anti-PD-1 treatment in the whole cohort (odds ratio = 2.64, 95% CI [1.4; 6.0], p = 0.008), as well as in the NSCLC population (odds ratio = 3.27, 95% CI [1.2; 11.6], p = 0.03). Patients whose tumor had a high TIS score (upper tertile) showed prolonged overall survival compared to patients whose tumor had lower TIS scores, both in the whole cohort (hazard ratio = 0.37, 95% CI [0.18, 0.76], p = 0.005) and in the NSCLC population (hazard ratio = 0.36, 95% CI [0.14, 0.90], p = 0.02). In the latter, the TIS score was independent from either PD-L1 staining on tumor cells (spearman coefficient 0.2) and TMB (spearman coefficient − 0.2).

Conclusions

These results indicate that validated gene expression assay measuring the level of tumor microenvironment inflammation such as TIS, are accurate and independent predictive biomarkers and can be easily implemented in the clinical practice.
Prime-pull vaccination with a plant-derived virus-like particle influenza vaccine elicits a broad immune response and protects aged mice from death and frailty after challenge
Authors: Hodgins Breanna , Pillet Stephane , Landry Nathalie , Ward Brian J.
Published: November 2019

Background

Administered intramuscularly (IM), plant-derived, virus-like-particle (VLP) vaccines based on the influenza hemagglutinin (HA) protein elicit both humoral and cellular responses that can protect aged mice from lethal challenge. Unlike split virus vaccines, VLPs can be administered by different routes including intranasally (IN). We evaluated novel vaccine strategies such as prime-pull (IM boosted by IN) and multi-modality vaccination (IM and IN given simultaneously). We wished to determine if these approaches would provide better quality protection in old mice after less severe (borderline-lethal) challenge (ie: immunogenicity, frailty and survival).

Results

Survival rates were similar in all vaccinated groups. Antibody responses were modest in all groups but tended to be higher in VLP groups compared to inactivated influenza vaccine (IIV) recipients. All VLP groups had higher splenocyte T cell responses than the split virus group. Lung homogenate chemokine/cytokine levels and virus loads were lower in the VLP groups compared to IIV recipients 3 days after challenge (p < 0.05 for viral load vs all VLP groups combined). The VLP-vaccinated groups also had less weight loss and recovered more rapidly than the IIV recipients. There was limited evidence of an immunologic or survival advantage with IN delivery of the VLP vaccine.

Conclusion

Compared to IIV, the plant-derived VLP vaccine induced a broader immune response in aged mice (cellular and humoral) using either traditional (IM/IM) or novel schedules (multi-modality, prime-pull).
Making way for a clinical feedback system in the narrow space between sessions: navigating competing demands in complex healthcare settings
Authors: Hovland Runar Tengel , Moltu Christian
Published: November 2019

Background

Although substantial empirical research supports the clinical value of routine outcome measures/clinical feedback systems (ROM/CFS), translation into routine practice poses several challenges. The present case study investigated how stakeholders, clinicians, patients and clinical managers related to the implementation of the Norse Feedback (NF) in ordinary practice.

Methods

We did an in-depth qualitative case study of the implementation of NF in a public mental-health institution. The settings were two outpatient clinics and two in-patient clinics organized under the same health trust. Data were drawn from three sources: archival sources (n = 16), field notes (n = 23), and 43 in-depth interviews with clinicians (n = 19), clinical managers (n = 5) and patients (n = 12). Ten of the participants were interviewed twice. The data were coded inductively and analyzed using a stringent qualitative methodology.

Results

We present our findings under three inter-related domains. First, we describe what followed the clinical feedback implementation. Second, we present the context experienced as being complex and high on work-pressure. Third, we describe the situated rules about the priority between competing tasks.

Conclusions

The preliminary results complement and contextualize understandings of known barriers to implementing ROM/CFS in clinical settings. We apply a socio-material perspective to discuss clinicians’ responses to complexity, implementation, and why some incentivized tasks prevailed over others regardless of therapists’ perceived benefits.