bluuebunny/crossref_metadata_2025 huggingface dataset:
The Discipline of Happiness: The Foucauldian Use of the “Positive Energy” Discourse in China’s Ideological Works
Authors: Chen Zifeng , Wang Clyde Yicheng
Published: February 2020

One important question about ideological works in China concerns the tension between mobilisation (encouraging public expression) and control (limiting public expression). Recently Xi Jinping’s administration has doubled down on both strategies. To study the rationale of this seemingly self-contradictory move, the authors examine the recently prominent ideological discourse of “positive energy.” Through a combination of online ethnography and discourse analysis using Foucauldian methods, we find that the discourse borrows and evolves from previous ideological works, but most importantly and distinguishably features a more dispersive, rather than centralised power structure. It penetrates popular culture and private lives, and by doing so disciplines people’s subjectivities, rather than only aiming at top-down persuasion or control. The logic of “positive energy” produces self-disciplined docile subjects, and quietly resolves the tension between mobilisation and control by having subjects internalise the interests of the state as their own good.
Mine the Gap: Augmenting Foresight Methodologies with Data Analytics
Authors: Boysen Anne
Published: February 2020

The explosion of Big Data and analytic tools in recent years has brought new opportunities to the field of foresight. Big Data and improved analytics capabilities can expand the knowledge base and act as a corrective to our cognitive biases. Moreover, several data mining and machine learning techniques that increase performance for businesses can be applied in foresight to help researchers discover patterns that may be early signals of change and correct our misperception of patterns where they don’t exist. This article discusses the opportunities and limitations of various data mining and machine learning techniques in foresight.
Depressive Symptoms and Self-Esteem as Moderators of Metaperceptions of Social Rejection Versus Acceptance: A Truth and Bias Analysis
Authors: Moritz Daniel , Roberts John E.
Published: February 2020

Metaperception involves making judgments regarding what others think of us and is important in navigating the social world. We measured the degree of accuracy and bias in metaperceptions of liking and desire for future contact following unstructured social interactions with new acquaintances and tested how depression and self-esteem influence bias and accuracy in these judgments. Results indicated that depression and lower self-esteem are associated with negative directional biases but are also associated with lower reciprocity bias (the tendency to assume that partners return one’s feelings of liking and acceptance). In addition, individuals with lower self-esteem displayed greater meta-insight (accuracy when controlling for bias) compared with those with higher self-esteem. Implications for cognitive and depressive realism theories of depression are discussed.
Morphological Parameters of the Thoracic Pedicle in an Asian Population: A Magnetic Resonance Imaging–Based Study of 3324 Pedicles
Authors: Soh Tamara Lee Ting , Kho Kangshi Cherish , Lim Zhi Kai , Tandon Ankit Anil , Kaliya-Perumal Arun-Kumar , Oh Jacob Yoong-Leong
Published: February 2020

Study Design:

A cross-sectional magnetic resonance imaging (MRI)–based anatomical study.

Objectives:

Instrumentation of the thoracic spine may be challenging due to the unique pedicle morphology and the proximity of vital structures. As prior morphological studies have mostly been done in Caucasians, our study aims to determine the optimal pedicle screw size for transpedicular fixation in an Asian population.

Methods:

A retrospective analysis of 400 patients who had undergone MRI of the thoracic spine was performed. A total of 3324 pedicles were included. Pedicle morphology was graded qualitatively based on the size of its cancellous channel, and quantitatively with the following parameters: pedicle transverse diameter, pedicle screw path length, and pedicle angle. Subgroup analysis based on gender was performed.

Results:

Mean pedicle transverse diameter was the narrowest at the T4 (2.9 ± 1 mm) and T5 (3.1 ± 1.1 mm) level. The mean pedicle screw path length progressively increased from T1 (34 ± 4.6 mm) to T12 (47 ± 4.6 mm). The mean pedicle angle was the largest at T1 (34° ± 7.9°) and decreased caudally, to 9.4° ± 3.8° at the T12 level. Females had significantly lower mean pedicle diameter and screw path length than males at every vertebral level; however, they had a larger pedicle angle at T8 to T10. The most common size of the pedicle cancellous channel was more than 4 mm.

Conclusion:

Morphological differences in the Asian pedicle suggest that caution needs to be taken during thoracic spine instrumentation, particularly in Asian females who have significantly smaller pedicles. In such cases, the use of alternative techniques or intraoperative navigation may be useful.
Path to diagnosis and women’s perspectives on the impact of endometriosis pain
Authors: Lamvu Georgine , Antunez-Flores Oscar , Orady Mona , Schneider Beth
Published: February 2020

Introduction:

Endometriosis is a burdensome chronic disease that can be difficult to diagnose, yet few studies examine experiences along the continuum of disease state. We sought to explore women’s journeys to an endometriosis diagnosis, experience with endometriosis pain, and interactions with healthcare practitioners.

Methods:

An anonymous 23-question online survey was distributed to women (aged >19 years) who self-identified as having a surgical or nonsurgical diagnosis of endometriosis and living in seven English-speaking countries through the social media network MyEndometriosisTeam.com .

Results:

From January through April 2018, 317 women in the United States and 134 women outside the United States completed the survey. More than 50% of the women waited 6 or more years for a diagnosis of endometriosis. Overall, 54.3% experienced endometriosis-related pain daily. Respondents (US/non-US) reported a significant impairment in quality of life that interfered with their family (45.7%/45.5%) and social life (40.1%/44.0%), education/career (42.9%/46.3%), and sexual function (68.1%/70.1%). Women reported their disease led to other conditions, including fatigue (93.6%), gastrointestinal issues (91.8%), and difficulty sleeping (87.4%). Many women were not satisfied with their practitioner’s ability to listen to concerns and felt that their practitioner’s treatment recommendations lacked consistency with their own goals/needs.

Conclusion:

Women still experience long delays and difficult journeys to an endometriosis diagnosis. Disease-associated pain is pervasive and has direct and indirect impacts on quality of life. Women are frequently not satisfied with disease-management options presented to them by their practitioners. These results suggest a need for improved medical education on disease state for both patients and practitioners.
Shedding light on endometriosis: Patient and provider perspectives on a challenging disease
Authors: Zale Madalene , Lambert Emily , LaNoue Marianna D , Leader Amy E
Published: February 2020

Background:

Endometriosis is a serious yet understudied medical condition impacting millions of women worldwide.

Methods:

This mixed-methods study aimed to understand healthcare provider perceptions and patient experiences with endometriosis in the United States. Providers were surveyed to assess their understanding of disease prevalence. A subset of providers also participated in short, open-ended interviews about treating patients who have or are suspected to have endometriosis. Interviews were also conducted with women diagnosed with endometriosis to understand their experiences with the disease. Means and frequencies were calculated for survey data; interviews were transcribed and separately analyzed by two coders using an iterative coding process until agreement was reached.

Results:

Fifty-three providers completed surveys. Of the 53 providers, 6 (11%) accurately identified the prevalence of endometriosis. Four providers and 12 patients completed interviews. Emergent themes among providers included limited training, difficulty of diagnosis, complexity of the referral process, a challenging patient–provider dynamic, and the importance of multidisciplinary collaboration. Emergent themes from patients included the psychological impact of the disease, difficulties interacting with the healthcare system, self-advocacy, quality of life, and limited treatment options.

Conclusion:

Providers are frequently unfamiliar with the far-reaching scope of endometriosis and cite many challenges caring for patients with the disease. Patients equally find the disease challenging to live with as it encroaches on physical, mental, and emotional well-being.
Menstrual characteristics, bleeding and other non-pelvic-pain symptoms in women presenting with severe endometriotic disease
Authors: Markham Robert , Luscombe Georgina M , Manconi Frank , Fraser Ian S
Published: February 2020

Introduction:

The purpose of this study was to investigate the detailed nature of menstrual characteristics, bleeding and other symptoms in women with and without endometriosis. Pelvic pain symptoms in this cohort have been reported elsewhere.

Method:

This is a self-administered cross-sectional study and was conducted using a structural questionnaire. A total of 737 women completed the study: women with endometriosis (n = 529) and with no current gynaecological complaint, ‘control’ (n = 208).

Results:

Some of the key findings in this study included significant differences between the control and endometriosis subjects in terms of bleeding symptoms, increased length and heaviness of menses, rectal and bladder bleeding, infertility and obstetric complications which were all more common in the endometriosis group. Other symptoms found to have a highly significant positive association with endometriosis included abdominal bloating, low resistance to infection, fatigue, increased urinary frequency, diarrhoea and constipation (p < 0.000). Data were cross-tabulated to examine the association of a number of symptoms to each other. The relationship of symptoms to a range of psychosocial factors was investigated to determine how the effects of endometriosis impacted on the life of subjects. Most women reported that endometriosis sometimes or often interfered with daily aspects of their life.

Conclusion:

The range of non-pain symptoms in women with endometriosis was generally much more diverse and extensive than recognised by most clinicians.
Communicatively Managing Multiple, Intersecting Identities Among Immigrant Women Entrepreneurs
Authors: Haseki Müge , Scott Craig R. , Gailliard Bernadette M.
Published: February 2020

Immigrant women comprise one of the fastest growing groups of business owners in the United States and other urban economies; however, a greater proportion of immigrant women business owners shut down their business within a year compared with their nonimmigrant peers. In an attempt to address this challenge, the study reported here explores the communication strategies adopted by immigrant women entrepreneurs as they manage key identities (gender, ethnicity, religion, and immigrant status) that may influence their success. Drawing on a structurational model of multiple identities and linking that with intersectionality research, this study examines the experiences of 60 immigrant women entrepreneurs from 30 different countries in New York City as they (dis)connect with their various identities. In addition to insights about each separate identity, we identify three tensions at the intersection of multiple identities, business sector, and sociocultural and historical context: visible versus invisible, expressive versus silent, and revealing versus concealing. Furthermore, we show how strategic communication practices are adopted to negotiate these tensions, and hence secure and/or increase business opportunities and business survival.
Comparison of conventional and rapid-acting antidepressants in a rodent probabilistic reversal learning task
Authors: Wilkinson Matthew P. , Grogan John P. , Mellor Jack R. , Robinson Emma S. J.
Published: February 2020

Deficits in reward processing are a central feature of major depressive disorder with patients exhibiting decreased reward learning and altered feedback sensitivity in probabilistic reversal learning tasks. Methods to quantify probabilistic learning in both rodents and humans have been developed, providing translational paradigms for depression research. We have utilised a probabilistic reversal learning task to investigate potential differences between conventional and rapid-acting antidepressants on reward learning and feedback sensitivity. We trained 12 rats in a touchscreen probabilistic reversal learning task before investigating the effect of acute administration of citalopram, venlafaxine, reboxetine, ketamine or scopolamine. Data were also analysed using a Q-learning reinforcement learning model to understand the effects of antidepressant treatment on underlying reward processing parameters. Citalopram administration decreased trials taken to learn the first rule and increased win-stay probability. Reboxetine decreased win-stay behaviour while also decreasing the number of rule changes animals performed in a session. Venlafaxine had no effect. Ketamine and scopolamine both decreased win-stay probability, number of rule changes performed and motivation in the task. Insights from the reinforcement learning model suggested that reboxetine led animals to choose a less optimal strategy, while ketamine decreased the model-free learning rate. These results suggest that reward learning and feedback sensitivity are not differentially modulated by conventional and rapid-acting antidepressant treatment in the probabilistic reversal learning task.
Extended preclinical investigation of lactate for neuroprotection after ischemic stroke
Authors: Buscemi Lara , Blochet Camille , Price Melanie , Magistretti Pierre J , Lei Hongxia , Hirt Lorenz
Published: February 2020

Lactate has been shown to have beneficial effect both in experimental ischemia–reperfusion models and in human acute brain injury patients. To further investigate lactate’s neuroprotective action in experimental in vivo ischemic stroke models prior to its use in clinics, we tested (1) the outcome of lactate administration on permanent ischemia and (2) its compatibility with the only currently approved drug for the treatment of acute ischemic stroke, recombinant tissue plasminogen activator (rtPA), after ischemia–reperfusion. We intravenously injected mice with 1 µmol/g sodium l-lactate 1 h or 3 h after permanent middle cerebral artery occlusion (MCAO) and looked at its effect 24 h later. We show a beneficial effect of lactate when administered 1 h after ischemia onset, reducing the lesion size and improving neurological outcome. The weaker effect observed at 3 h could be due to differences in the metabolic profiles related to damage progression. Next, we administered 0.9 mg/kg of intravenous (iv) rtPA, followed by intracerebroventricular injection of 2 µL of 100 mmol/L sodium l-lactate to treat mice subjected to 35-min transient MCAO and compared the outcome (lesion size and behavior) of the combined treatment with that of single treatments. The administration of lactate after rtPA has positive influence on the functional outcome and attenuates the deleterious effects of rtPA, although not as strongly as lactate administered alone. The present work gives a lead for patient selection in future clinical studies of treatment with inexpensive and commonly available lactate in acute ischemic stroke, namely patients not treated with rtPA but mechanical thrombectomy alone or patients without recanalization therapy.
Movement, Gesture, and Singing: A Review of Literature
Authors: Kilpatrick Carlton E.
Published: February 2020

The purpose of this review of literature was to explore intersections between movement and gesture, and to examine their effects on singing. Music educators have long championed the integration of movement into music instruction. The effects of movement have been studied and correlations found between an individual singer’s intonation, internal pulse, and tone quality. The incorporation of movement activities into choral rehearsals has shown a significant level of perceived benefits by singers. The conducting gesture as a form of aesthetic movement has also been examined. One factor consistently reported is a relationship between the intentional use of movement in rehearsal and increased engagement. Additionally, movement has also been found to share a meaningful link with music and emotion. Movement and music both illustrate abstract emotional concepts and can aid in the formation of concrete relationships between them. Recommendations for music educators and suggestions for future research are provided.
Re-description of the sauropod dinosaur Amanzia (“Ornithopsis/Cetiosauriscus”) greppini n. gen. and other vertebrate remains from the Kimmeridgian (Late Jurassic) Reuchenette Formation of Moutier, Switzerland
Authors: Schwarz Daniela , Mannion Philip D. , Wings Oliver , Meyer Christian A.
Published: February 2020

Dinosaur remains were discovered in the 1860’s in the Kimmeridgian (Late Jurassic) Reuchenette Formation of Moutier, northwestern Switzerland. In the 1920’s, these were identified as a new species of sauropod, Ornithopsis greppini, before being reclassified as a species of Cetiosauriscus (C. greppini), otherwise known from the type species (C. stewarti) from the late Middle Jurassic (Callovian) of the UK. The syntype of “C. greppini” consists of skeletal elements from all body regions, and at least four individuals of different sizes can be distinguished. Here we fully re-describe this material, and re-evaluate its taxonomy and systematic placement. The Moutier locality also yielded a theropod tooth, and fragmentary cranial and vertebral remains of a crocodylomorph, also re-described here. “C.” greppini is a small-sized (not more than 10 m long) non-neosauropod eusauropod. Cetiosauriscus stewarti and “C.” greppini differ from each other in: (1) size; (2) the neural spine morphology and diapophyseal laminae of the anterior caudal vertebrae; (3) the length-to-height proportion in the middle caudal vertebrae; (4) the presence or absence of ridges and crests on the middle caudal centra; and (5) the shape and proportions of the coracoid, humerus, and femur. These anatomical differences, combined with their discrepancy in stratigraphic age, make it unlikely that C. stewarti and “C.” greppini belong to the same genus, as also supported through our phylogenetic analysis. “C.” greppini cannot be assigned to any other contemporaneous sauropod taxon from Europe, but is diagnosed by an autapomorphic rugosity on the posteromedial margin of the humerus, as well as a unique combination of features. As such, we erect the new genus name Amanzia for the Swiss taxon “Ornithopsis” greppini, augmenting the growing diversity of Late Jurassic European sauropods. Our phylogenetic analysis places it outside of Neosauropoda, either as the sister taxon to that clade, or as a member of Turiasauria.

ZooBank LSID: urn:lsid:zoobank.org:pub:37860D8F-E49C-4F6B-9F51-705153499C1A.
Multistability in the epithelial-mesenchymal transition network
Authors: Xin Ying , Cummins Bree , Gedeon Tomáš
Published: February 2020

Background

The transitions between epithelial (E) and mesenchymal (M) cell phenotypes are essential in many biological processes like tissue development and cancer metastasis. Previous studies, both modeling and experimental, suggested that in addition to E and M states, the network responsible for these phenotypes exhibits intermediate phenotypes between E and M states. The number and importance of such states is subject to intense discussion in the epithelial-mesenchymal transition (EMT) community.

Results

Previous modeling efforts used traditional bifurcation analysis to explore the number of the steady states that correspond to E, M and intermediate states by varying one or two parameters at a time. Since the system has dozens of parameters that are largely unknown, it remains a challenging problem to fully describe the potential set of states and their relationship across all parameters. We use the computational tool DSGRN (Dynamic Signatures Generated by Regulatory Networks) to explore the intermediate states of an EMT model network by computing summaries of the dynamics across all of parameter space. We find that the only attractors in the system are equilibria, that E and M states dominate across parameter space, but that bistability and multistability are common. Even at extreme levels of some of the known inducers of the transition, there is a certain proportion of the parameter space at which an E or an M state co-exists with other stable steady states.

Conclusions

Our results suggest that the multistability is broadly present in the EMT network across parameters and thus response of cells to signals may strongly depend on the particular cell line and genetic background.
Successful control of an extended-spectrum beta-lactamase-producing Klebsiella pneumoniae ST307 outbreak in a neonatal intensive care unit
Authors: Baek Eun-Hwa , Kim Se-Eun , Kim Sunjoo , Lee Seungjun , Cho Oh-Hyun , In Hong Sun , Shin Jeong Hwan , Hwang Inyeong
Published: February 2020

Background

In this study, we evaluated the genetic relatedness of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-KPN) isolates from an outbreak in a neonatal intensive care unit (NICU) in August 2017, We implemented an active countermeasure to control this outbreak successfully.

Methods

The incidence of healthcare-associated ESBL-KPN bacteremia was evaluated before and after initiating enhanced infection control (IC) practices in January 2018. Surveillance cultures were set up and monitored for neonates, medical personnel, and NICU environments. Molecular analyses, including pulse-field gel electrophoresis (PFGE), sequence typing, and ESBL genotyping, were performed for the isolated KPN strains.

Results

After implementing the enhanced IC procedures, the healthcare-associated bacteremia rate decreased from 6.0 to 0.0 per 1000 patient-days. Samples from neonates (n = 11/15, 73.3%), medical personnel (n = 1/41, 2.4%), and medical devices and the environments (6/181, 3.3%) tested positive for ESBL-KPN in the surveillance cultures in December 2017. Active surveillance cultures revealed that 23 of 72 neonates who were screened (31.9%) were colonized with ESBL-KPN between January and March 2018. All the isolates demonstrated closely related PFGE patterns and were identified as ST307 strain carrying the CTX-M-15 gene.

Conclusions

Contaminated NICU environments and medical devices, as well as transmission by medical personnel, appeared to be the source of the outbreak of ESBL-KPN infection. We employed an enhanced IC strategy during January–March 2018 and successfully controlled the clonal outbreak of CTX-M-15-positive KPN. ST307 has emerged as an important bacteremia-causing pathogen in the NICU and should be carefully monitored.
A case of Tinea Faciei caused by Trichophyton benhamiae: first report in China
Authors: Tan Jingwen , Liu Xiaoping , Gao Zhiqin , Yang Hong , Yang Lianjuan , Wen Hai
Published: February 2020

Background

Trichophyton benhamiae is a zoophilic dermatophyte that can cause tinea in humans and animals. Lesions caused by T. benhamiae tend to be highly inflammatory, and patients are often infected by animals or other patients infected with T. benhamiae. In this paper, we report the first case of tinea faciei caused by T. benhamiae in a Chinese girl who might be transmitted from a fox.

Case presentation

A 4-year-old girl from HaiNing city developed an itchy, erythematous, and annular plaque on her right face for the past 2 months. Before the lesion appeared, she was in close contact with the fur of a fox for almost 1 week. Septate hyaline hyphae were detected by direct mycological examination of the scales. Cultures grew on Sabouraud’s dextrose agar (SDA) at 26 °C for 2 weeks revealed the presence of T. mentagrophytes. A molecular sequencing test confirmed that the isolate was consistent with reference strains to T. benhamiae. Then, the diagnosis of tinea faciei due to T. benhamiae was made. Treatment with terbinafine (oral 125 mg/d) and sertaconazole nitrate cream (topical, twice daily) for 4 weeks was initiated and achieved significant improvement of the skin lesions.

Conclusions

This rare dermatophytosis case highlights the importance of ITS sequencing in helping to recognize rare pathogenic fungi that can be easily misdiagnosed with a conventional morphological diagnosis.
The impact of 18F-FDOPA-PET/MRI image fusion in detecting liver metastasis in patients with neuroendocrine tumors of the gastrointestinal tract
Authors: Barachini O. , Bernt R. , Mirzaei S. , Pirich C. , Hergan K. , Zandieh S.
Published: February 2020

Background

This study assesses the value of image fusion using 18F-fluoro-L-DOPA (18F-DOPA) positron emission tomography (PET) and magnetic resonance imaging (MRI) for examining patients with neuroendocrine tumors (NETs) and a suspicion of metastasis of the liver.

Methods

Eleven patients (five women and six men aged between 20 and 81, with a mean age of 54.6 years) were included in the study. All patients underwent whole-body 18F-DOPA PET examinations and contrast-enhanced MRI with diffusion-weighted sequences (DWS). Image fusion was performed using a semiautomatic voxel-based algorithm. Images obtained using PET and MRI were assessed separately. Side-by-side evaluations of fused PET/MRI images were also performed.

Results

In total, 55 liver lesions (52 liver metastases and 3 benign lesions) were detected in the 11 patients. Sensitivity detection for liver lesions was higher when using PET/CT than when using contrast-enhanced MRI without DWSs and lower than using MRI with DWSs. The sensitivity of PET/MRI image fusion in the detection of liver metastasis was significantly higher than that of MRI with DWSs (P < 0.05).

Conclusion

Images of the liver obtained using PET and MRI in patients with NETs exhibited characteristic features. These findings suggest that an appropriate combination of available imaging modalities can optimize patient evaluations.
Stereotactic radiotherapy on brain metastases with recent hemorrhagic signal: STEREO-HBM, a two-step phase 2 trial
Authors: Lesueur Paul , Kao William , Leconte Alexandra , Geffrelot Julien , Lequesne Justine , Lacroix Joëlle , Brachet Pierre-Emmanuel , Hrab Ioana , Royer Philippe , Clarisse Bénédicte , Stefan Dinu
Published: February 2020

Background

Brain metastases often occur in cancer evolution. They are not only responsible for death but also for disorders affecting the quality of life and the cognitive functions.

Management of brain metastases usually consists in multi-modality treatments, including neurosurgery, whole brain radiotherapy (WBRT), and more recently radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT), systemic treatment (chemotherapy or targeted therapy), combined or not with corticosteroids. Almost 20% of brain metastases can present recent (within 15 days) bleeding signs on neuro-imagery. In these conditions, WBRT is the usual treatment. Yet, patients may benefit from a more aggressive strategy with SRT or FSRT. However, these options were suspected to possibly major the risk of brain haemorrhage, although no scientifically proven. Radiation oncologists therefore usually remain reluctant to deliver SRS/FSRT for bleeding brain metastases.

It is therefore challenging to establish a standard of care for the treatment of bleeding brain metastases.

We propose a phase II trial to simultaneously assess safety and efficacy of FSRT to manage brain metastases with hemorrhagic signal.

Methods

The STEREO-HBM study is a multicenter two-step non-randomised phase II trial addressing patients with at least one bleeding brain metastasis out of a maximum of 3 brain metastases. Each brain metastasis will be treated with 30 Gy in 3 fractions for 1 week.

The main endpoint is based on both safety and efficacy endpoints as proposed by Bryant and Day’s design. Safety endpoint is defined as the rate of bleeding complications 4 months post-FSRT while efficacy endpoint is defined as the 6-month local control rate. Multi-modal MRI will be used to assess intra-tumoral hemorrhagic events before and after treatment. Patients’ quality of life will also be assessed.

Discussion

Management of bleeding brain metastases is still debated and poorly explored in clinical trials. There is sparse and weak data on the signification of pretreatment intra-tumour haemorrhagic signs or on the risk of brain bleeding complications after FSRT.

We expect this first prospective phase 2 trial in this particular setting will allow to clarify the place of FSRT to optimally manage bleeding brain metastases.

Trial registration

NCT 03696680, registered October, 4, 2018.

Protocol version

Version 2.1 dated from 2018/11/09.
Reduced doses of dabrafenib and trametinib combination therapy for BRAF V600E-mutant non-small cell lung cancer prevent rhabdomyolysis and maintain tumor shrinkage: a case report
Authors: Adachi Yuta , Yanagimura Naohiro , Suzuki Chiaki , Ootani Sakiko , Tanimoto Azusa , Nishiyama Akihiro , Yamashita Kaname , Ohtsubo Koushiro , Takeuchi Shinji , Yano Seiji
Published: February 2020

Background

A BRAF V600E mutation is found as driver oncogene in patients with non-small cell lung cancer. Although combined treatment with dabrafenib and trametinib is highly effective, the efficacy of reduced doses of the drugs in combination therapy has not yet been reported.

Case presentation

A Japanese man in his mid-sixties was diagnosed with unresectable lung adenocarcinoma and was unresponsive to cytotoxic chemotherapy and immune checkpoint inhibitors. The BRAF V600E mutation was detected by next generation sequencing, and the patient was subjected to treatment with dabrafenib and trametinib in combination. Although the treatment reduced the tumor size, he experienced myalgia and muscle weakness with elevated serum creatine kinase and was diagnosed with rhabdomyolysis induced by dabrafenib and trametinib. After the patient recovered from rhabdomyolysis, the treatment doses of dabrafenib and trametinib were reduced, which prevented further rhabdomyolysis and maintained tumor shrinkage.

Conclusion

The reduction of the doses of dabrafenib and trametinib was effective in the treatment of BRAF V600E-mutant NSCLC, and also prevented the incidence of rhabdomyolysis.
Correlation of skin rash and overall survival in patients with pancreatic cancer treated with gemcitabine and erlotinib – results from a non-interventional multi-center study
Authors: Westphalen C. Benedikt , Kukiolka Tobias , Garlipp Benjamin , Hahn Lars , Fuchs Martin , Malfertheiner Peter , Reiser Marcel , Kütting Fabian , Heinemann Volker , Beringer Andreas , Waldschmidt Dirk T.
Published: February 2020

Background

Gemcitabine/erlotinib treatment offers limited benefit in unselected patients with pancreatic ductal adenocarcinoma (PDAC). Development of skin rash has been associated with favorable outcomes in patients treated with gemcitabine/erlotinib. This study aimed to extend knowledge on the effectiveness of gemcitabine/erlotinib in metastatic PDAC in the context of clinical practice and with focus on skin rash.

Methods

This multicenter, non-interventional study enrolled 376 patients with metastatic PDAC receiving gemcitabine/erlotinib. The primary endpoint was overall survival (OS) in patients with skin rash versus no skin rash. Secondary endpoints included progression-free survival (PFS), treatment satisfaction and safety. All data were analyzed using descriptive statistics. Survival time and time to disease progression were estimated using the Kaplan-Meier method. Effectiveness endpoints were analyzed for subgroups by skin rash grade (no rash, rash grade 1, rash grade ≥ 2), duration of erlotinib treatment (≤8 weeks, > 8 weeks), Eastern Cooperative Oncology Group (ECOG) performance status at baseline (0–1, 2) and age (≤65 years, > 65 years).

Results

Within the full analysis set (FAS; N = 270), 48 patients (17.8%) developed grade 1 rash, 51 patients (18.9%) grade ≥ 2 rash, while 171 patients (63.3%) did not develop a rash. Median OS of all patients was 9.11 months with an OS of 9.93 months in rash-positive and 8.68 months in rash-negative patients. Median PFS was 5.06 months for rash-positive and 4.11 months for rash-negative patients. PFS was longer in patients with rash grade ≥ 2 and in older patients (> 65 years). Examination using a multivariate Cox proportional model revealed that an age > 65 years was associated with longer OS (hazard ratio 0.640; p = 0.0327) and PFS (hazard ratio 0.642; p = 0.0026). Out of the 338 patients in the SAF, 310 patients (91.7%) experienced at least one AE, and 176 patients (52.1%) experienced skin-related side effects, all of which were CTC grade 1 to 3.

Conclusions

Comparing rash-positive with rash-negative patients showed no significant difference in survival. While patients with rash grade ≥ 2 and older patients (independent of skin reactions) showed longer PFS, this did not translate into prolonged OS. The study did not reveal new safety signals.

Trial registration

ClinicalTrials.gov Identifier: NCT01782690, retrospectively registered on 4 February 2013.
Child characteristics and early intervention referral and receipt of services: a retrospective cohort study
Authors: McManus Beth M. , Richardson Zachary , Schenkman Margaret , Murphy Natalie J. , Everhart Rachel M. , Hambidge Simon , Morrato Elaine
Published: February 2020

Background

Early Intervention (EI) is a federally mandated, state-administered system of care for children with developmental delays and disabilities under the age of three. Gaps exist in the process of accessing EI through pediatric primary care, and low rates of EI access are well documented and disproportionately affect poor and minority children. The aims of this paper are to examine child characteristics associated with gaps in EI (1) referral, (2) access and (3) service use. To our knowledge, this is the first study to leverage linked safety net health system pediatric primary care and EI records data to follow EI-referred children longitudinally to understand EI service use gaps from EI referral to EI service utilization.

Methods

In a retrospective cohort design (14,710 children with developmental disability or delay), we linked pediatric primary care records between a large, integrated safety net health system in metro Denver and its corresponding EI program (2014–2016). Using adjusted marginal effects [ME, (95% CI)], we estimated gaps in EI referral, access, and service type (i.e., physical [PT], occupational [OT], speech therapy [ST] and developmental intervention [DI]). Analyses accounted for child characteristics including socio-demographics, diagnosis, condition severity, and baseline function.

Results

Only 18.7% of EI-eligible children (N = 2726) received a referral; 26% of those (N = 722) received services for a net enrollment rate of 5% among EI-eligible children. Having the most severe developmental condition was positively associated with EI referral [ME = 0.334 [0.249, 0.420]) and Individualized Family Services Plan (IFSP) receipt [ME = 0.156 [0.088, 0.223]). Children less likely to be EI-referred were Black, non-Hispanic (BNH) [ME = -0.029 (− 0.054, − 0.004)] and had a diagnosed condition ([ME = − 0.046 (− 0.087, − 0.005)]. Children with a diagnosis and those with higher income were more likely to receive PT or OT. Higher baseline cognitive and adaptive skills were associated with lower likelihood of PT [ME = -0.029 (− 0.054, − 0.004)], OT [ME = -0.029 (− 0.054, − 0.004)], and ST [ME = -0.029 (− 0.054, − 0.004)].

Conclusions

We identified and characterized gaps in EI referral, access, and service use in an urban safety-net population of children with high rates of developmental delay. Interventions are needed to improve integrated systems of care affecting primary care and EI processes and coordination.
The use of long-acting Aripiprazole in a multi-center, prospective, uncontrolled, open-label, cohort study in Germany: a report on global assessment of functioning and the WHO wellbeing index
Authors: Schöttle Daniel , Janetzky Wolfgang , Luedecke Daniel , Beck Elmar , Correll Christoph U. , Wiedemann Klaus
Published: February 2020

Background

In this non-interventional study, the functionality and well-being of patients with schizophrenia with aripiprazole once-monthly (AOM) was evaluated under real-life conditions in a naturalistic population.

Methods

This non-interventional, prospective, multicenter 6-month study included 242 predominantly symptomatically stable patients (mean age 43.1 ± 15.1 years, 55% male) who switched their treatment to AOM after 9.7 (± 22.3) months of oral treatment. Outcome parameters included functionality (Global Assessment of Functioning, GAF), patient’s wellbeing (WHO-5 Well-Being Index, WHO-5), and both patient’s and clinician’s assessment of efficacy and tolerability of AOM. Treatment emergent adverse events (TRAE) were also recorded.

Results

At baseline, the mean GAF score was 47.0 (±13.9), indicating that patients experienced serious impairment in functioning. A continuous increase to 60.2 (±17.0) during treatment was found, with a robust and significant increase already after 4 weeks. At study start, patients reported diminished wellbeing, with a mean score of 10.6 (±5.6) on the WHO-5 scale. During treatment, patient wellbeing increased continuously with strong and significant improvements even after 4 weeks and an overall improvement of 4.8 (±6.9) over the course of 6 months with an endpoint of 15.4 (±5.5). Stratification of these results showed that more pronounced effects were achieved in younger patients ≤35 years (p<0.05 for GAF). The effectiveness and tolerability of AOM was rated good/very good by most patients (89.2 and 93.7%) and physicians (91.4 and 96.8%). Only few TRAEs occurred.

Conclusions

Our results show a significant positive effect after initiation of AOM treatment in predominantly stable patients with schizophrenia on their functioning and wellbeing, which was even more pronounced in patients aged ≤35 years, thereby supporting previous randomized controlled findings under routine conditions in clinical practice.
Prevalence and risk factors of post-traumatic stress disorder among elderly survivors six months after the 2008 Wenchuan earthquake in China
Authors: Li Lan , Reinhardt Jan D. , Van Dyke Craig , Wang Heng , Liu Maoqiong , Yamamoto Aiko , Chen Qian , Hu Xiuying
Published: February 2020

Background

Several studies indicate that older age is a risk factor for probable post-traumatic stress disorder (PTSD). However, evidence on the prevalence and risk factors for elderly disaster survivors is limited.

Methods

Multi-stage stratified sampling was applied in this cross-sectional study. The Revised Version of the Impact of Event Scale (IES-R) was used to evaluate symptoms of PTSD. Chi-squared test was used for univariable analysis of prevalence of probable PTSD by possible determinants. Multivariable logistic regression analysis was utilized to further explore risk factors for PTSD.

Results

427 elderly survivors age 60 or older participated. The prevalence of probable PTSD was 40.5, 36.3, and 21.5% according to a cut off score of the IES-R of 33, 35, and 2 points on average across items, respectively. In multivariable logistic regression, elderly survivors with a higher number of diagnosed chronic illnesses were more likely to be screened positive for PTSD and those with a greater number of family members living in the same home were less likely to be classified as having probable PTSD for all cut off scores. Elderly survivors with improved economic status and those with primary school or lower education were more often estimated to have probable PTSD with a cut off score of 35 and 2 points on average.

Conclusions

Elderly survivors in a high impact area following a major earthquake are at high risk for developing PTSD. Those who live alone and report pre-existing chronic illness are particularly vulnerable.
Impact of mother’s education on full immunization of children aged 12–23 months in Eritrea: population and health survey 2010 data analysis
Authors: Kibreab Fitsum , Lewycka Sonia , Tewelde Andebrhan
Published: February 2020

Background

Although vaccination coverage in Eritrea has improved in recent years, some children are still missing out, and it’s important to identify risk factors for lower coverage in order to target campaigns and interventions. The objective of this study was to assess: (1) the impact of maternal education on full immunization of children aged 12–23 months, and (2) whether the association was confounded or modified by other factors.

Methods

This study was a secondary data analysis of the Eritrean Population and Health Survey 2010 (EPHS 2010). In this analysis 1323 mothers of children aged 12–23 months were included. The outcome of the study was full immunization, defined as receiving all the WHO recommended basic vaccines: one dose of Bacillus Calmette-Gué rin (BCG), three doses of diphtheria-pertussis-tetanus(DPT), three doses of polio, and one dose of measles vaccine. The primary exposure was maternal education. Data on immunization coverage came from vaccination cards and from mothers’ or caretakers’ verbal reports. Bivariate and multivariable logistic regression analyses were performed.

Result

Full vaccination coverage among children aged 12–23 months was 83%. Most children received BCG (95%), DPT1 (97%), DPT2 (96%), DPT3 (93%), polio1 (97%), polio2 (97%), polio3 (91%) and measles (92%). In unadjusted analyses, children of mothers with primary (OR = 2.75, 95% CI 1.74–4.37), and middle or above (OR = 3.16, 95% CI 2.09–4.78) education were more likely to be fully immunised. However, after adjusting for wealth, region, ANC visit, and vaccination card ownership, only the effect for primary education remained significant (OR = 2.34, 95% CI 1.30–4.21).

Conclusion

The result of this study suggested that children of mothers who attained primary level were more likely to be fully vaccinated than children of mothers with no education. The association was influenced by wealth index of household, mothers ANC visit, region, and possession of vaccination card. The Expanded Program on Immunization of the Ministry of Health should target strategies to enhance full immunization among children of mothers with no education.
Assessment of health inequality between urban-to-urban and rural-to-urban migrant older adults in China: a cross-sectional study
Authors: Ma Sha , Li Qiuju , Zhou Xudong , Cao Weiming , Jiang Minmin , Li Lu
Published: February 2020

Background

Many studies focused on health inequality between migrant older adults and local older adults, while few study concerned the health inequalities between urban-to-urban and rural-to-urban migrant older adults. This study aimed to compare physical health and mental health between these two groups in Hangzhou, Zhejiang Province, China, and to explore the relationship between cognitive social capital, social integration and health among migrant older adults.

Methods

A two-stage stratified sampling method was employed to recruit participants from May to August 2013 in Hangzhou. Measurement data were compared with student’s t-tests and multivariate analysis of variance (MANOVA). Multiple linear regression was adopted in this study.

Results

A total of 1000 of participants who met the inclusion criteria were analyzed, consisting of 527 (52.7%) urban-to-urban and 473 (47.3%) rural-to-urban migrant older adults. There were no statistically significant difference in physical health and mental health between urban-to-urban and rural-to-urban groups on the whole. However, urban-to-urban migrant older adults had a higher reciprocity and social integration than did in rural-to-urban group (13.36 vs. 12.50, p < 0.01; 40.07 vs. 38.50, p < 0.01). And both of cognitive social capital and social integration were positively related to physical health (social reciprocity: t = 6.69, p < 0.01; social trust: t = 3.27, p < 0.01; social integration: t = 5.66, p < 0.01) and mental health (social reciprocity: t = 4.49, p < 0.01; social trust: t = 5.15, p < 0.01; social integration: t = 10.02, p < 0.01). Overall, the female, widowed, and the oldest among migrant older adults had a worse health.

Conclusions

Social capital and social integration were played important roles in health of migrant older adults. The female rural-to-urban migrant older adults, those aged over 70 years, and older adults who were not in marriage should be especially concerned in health policy making.
Comparison of knowledge, attitude, and practices of animal and human brucellosis between nomadic pastoralists and non-pastoralists in Kenya
Authors: Njenga M. Kariuki , Ogolla Eric , Thumbi Samuel Mwangi , Ngere Isaac , Omulo Sylvia , Muturi Mathew , Marwanga Doris , Bitek Austine , Bett Bernard , Widdowson Marc-Alain , Munyua Peninah , Osoro Eric Mogaka
Published: February 2020

Background

The seroprevalence of brucellosis among nomadic pastoralists and their livestock in arid lands is reported to be over10-fold higher than non-pastoralists farmers and their livestock in Kenya. Here, we compared the seroprevalence of nomadic pastoralists and mixed farming with their knowledge of the disease and high-risk practices associated with brucellosis infection.

Methods

Across-sectional study was conducted in two counties - Kiambu County where farmers primarily practice smallholder livestock production and crop farming, and Marsabit County where farmers practice nomadic pastoral livestock production. Stratified random sampling was applied, in which sublocations were initially selected based on predominant livestock production system, before selecting households using randomly generated geographical coordinates. In each household, up to three persons aged 5 years and above were randomly selected, consented, and tested for Brucella spp IgG antibodies. A structured questionnaire was administered to the household head and selected individuals on disease knowledge and risky practices among the pastoralists and mixed farmers compared. Multivariable mixed effects logistic regression model was used to assess independent practices associated with human Brucella spp. IgG seropositivity.

Results

While the majority (74%) of pastoralist households had little to no formal education when compared to mixed (8%), over 70% of all households (pastoralists and mixed farmers) had heard of brucellosis and mentioned its clinical presentation in humans. However, fewer than 30% of all participants (pastoralists and mixed farmers) knew how brucellosis is transmitted between animals and humans or how its transmission can be prevented. Despite their comparable knowledge, significantly more seropositive pastoralists compared to mixed farmers engaged in risky practices including consuming unboiled milk (79.5% vs 1.7%, p < 0.001) and raw blood (28.3% vs 0.4%, p < 0.001), assisting in animal birth (43.0% vs 9.3%, p < 0.001), and handling raw hides (30.6% vs 5.5%, p < 0.001).,

Conclusion

Nomadic pastoralists are more likely to engage in risky practices that promote Brucella Infection, probably because of their occupation and culture, despite having significant knowledge of the disease.