bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening at stationary versus mobile units in BreastScreen Norway
Authors: Holen Åsne , Sebuødegård Sofie , Waade Gunvor G , Aase Hildegunn , Hopland Nina-Merete , Pedersen Kristin , Larsen Marthe , Tsuruda Kaitlyn M , Hofvind Solveig
Published: September 2019

Objective

To compare breast characteristics, compression parameters, and early performance measures (rates of recall, screen-detected and interval breast cancer, and histopathologic tumour characteristics) for mammographic screening at a stationary versus mobile screening unit.

Methods

Results from 92,408 mammographic screening examinations performed as part of BreastScreen Norway during 2008–2017 at either a stationary ( n = 52,620) or mobile ( n = 39,788) unit in Hordaland county were compared using descriptive statistics and generalized estimating equations. A generalized estimating equation for a binary outcome was used to estimate crude and adjusted odds ratios with 95% confidence intervals for the outcomes of interest. Adjusted generalized estimating equation models included age, breast volume, and density grade as covariates.

Results

Screening at the stationary unit was performed on smaller breasts with higher mammographic density, using lower compression force but higher pressure than at the mobile unit. Using the stationary screening unit as reference, for women screened at the mobile unit, the adjusted odds ratio was: for recall 0.94 (95% CI: 0.87--1.01), screen-detected breast cancer 0.92 (95% CI: 0.78--1.10), and interval breast cancer 1.17 (95% CI: 0.83–1.64).

Conclusions

The quality of care did not differ for women screened at the stationary versus the mobile unit, but there were differences between the women who attended the two units. Sociodemographic factors should be included in future analyses to fully understand the risk of breast cancer among women residing in urban versus rural areas.
Attitudes and Other Factors Influencing End-of-Life Discussion by Physicians, Nurses, and Care Staff: A Nationwide Survey in Japan
Authors: Hamano Jun , Hanari Kyoko , Tamiya Nanako
Published: September 2019

Context:

Better understanding about the attitudes of health-care providers toward end-of-life discussion would facilitate the development of systematic strategies for improving end-of-life care.

Objective:

To clarify attitudes toward end-of-life discussion with patients near death and explore the factors influencing these attitudes among physicians, nurses, and care staff.

Methods:

This study was part of a nationwide cross-sectional anonymous survey of the public attitudes toward end-of-life medical care performed in December 2017. The participants were physicians, nurses, and care staff from randomly selected facilities, including hospitals, clinics, home-visit nursing offices, nursing homes, and long-term care facilities throughout Japan. The questionnaire was sent to 4500 physicians, 6000 nurses, and 2000 care staff. We assessed attitudes about end-of-life discussion with patients near death, identification of the proxy decision maker, and sharing documented information on end-of-life discussion with the multidisciplinary team.

Results:

We analyzed responses from 1012 physicians, 1824 nurses, and 749 care staff. The number of responders who considered they had adequate end-of-life discussion with patients near death was 281 (27.8%), 324 (17.8%), and 139 (18.6%), respectively. Participation in a nationwide education program and caring for at least 1 dying patient per month were factors that showed a significant association with adequate end-of-life discussion and identification of the proxy decision maker.

Conclusions:

The percentages of physicians, nurses, and care staff involved in adequate end-of-life discussion with patients near death were not high. Participation in a structured education program might have a positive influence on end-of-life discussion with patients.
Development of de novo psoriasis during nivolumab therapy in a patient with small cell lung cancer
Authors: C Guven Deniz , Kilickap Saadettin , Guner Gurkan , Taban Hakan , Dizdar Omer
Published: September 2019

Introduction

The immune checkpoint inhibitors recently entered to small cell lung cancer (SCLC) stage, firstly in the third and recently in the first lines of therapy. This efficacy comes at the expense of many toxicities including skin toxicity. This toxicity is usually in the form of rash and pruritis; however, rare reactions like psoriasis can also be seen.

Case report

Herein, we report an SCLC case who developed de novo psoriasis while treated with nivolumab as the third-line treatment for SCLC.

Management and outcome

The psoriatic plaques were regressed with the topical highly potent steroid therapy, and immunotherapy was continued without further complications.

Discussion

We think that rare adverse events like de novo psoriasis are important considering the expanding role of these agents; their timely recognition and treatment are important in the management of cancer patients.
Current state of vascular access in Singapore
Authors: Pang Suh Chien , Tan Ru Yu , Kwek Jia Liang , Lee Kian Guan , Foo Marjorie Wai Yin , Choong Lina Hui Lin , Chong Tze Tec , Tan Chieh Suai
Published: September 2019

This article described the current state of vascular access management for patients with end-stage renal disease in Singapore. Over the past 10 years, there has been a change in the demographics of end-stage renal disease patients. Aging population and the increase in prevalence of diabetes mellitus has led to the acceleration of chronic kidney disease and increase in incidence and prevalence of end-stage renal disease. Vascular access care has, therefore, been more complicated, with the physical, psychological, and social challenges that occur with increased frequency in elderly patients and patients with multiple co-morbidities. Arteriovenous fistula and arteriovenous graft are created by vascular surgeons, while maintenance of patency of vascular access through endovascular intervention has been a shared responsibility between surgeons, interventional radiologists, and interventional nephrologists. Pre-emptive access creation among end-stage renal disease patients has been low, with up to 80% of new end-stage renal disease patients being commenced on hemodialysis via a dialysis catheter. Access creation is exclusively performed by a dedicated vascular surgeon with arteriovenous fistula success rate up to 78%. The primary and cumulative patency rates of arteriovenous fistula and arteriovenous graft were consistent with the results from many international centers. Vascular access surveillance is not universally practiced in all dialysis centers due to its controversies, in addition to the cost and the limited availability of equipment for surveillance. Timely permanent access placement, with reduced dependence on dialysis catheters, and improved vascular access surveillance are the main areas for potential intervention to improve vascular access management.
Essential Mineral Intake During Pregnancy and Its Association With Maternal Health and Birth Outcomes in South East Queensland, Australia
Authors: McAlpine Janelle M , McKeating Daniel R , Vincze Lisa , Vanderlelie Jessica J , Perkins Anthony V
Published: September 2019

Micronutrient supplements are often recommended during pregnancy, yet their role and necessity remain poorly understood in the Australian population. This study aimed to determine the essential mineral intake of a population of pregnant women in South East Queensland and investigate the effects of supplements on their micronutrient status and birth outcomes. Women completing the Oral Glucose Tolerance Test at two South East Queensland hospitals between 180 and 210 days gestation provided fasting blood samples and dietary data using the Maternal Outcomes and Nutrition Tool (n = 127). Birth outcomes were sourced from medical records. Serum elemental profiles were determined by inductively coupled plasma mass spectrometry (ICP-MS) analysis. Intake of 8 essential minerals was compared with Australian dietary recommendations; matched serum mineral levels were compared with the current Queensland pregnancy reference ranges. Data were examined using cross-sectional cohort design and independent sample t-tests. Supplement use had no significant influence on serum values of trace elements or the incidence of hypertensive disorders, gestational diabetes, preterm birth or infant birthweight. Dietary selenium, zinc and iodine were significantly higher in women birthing beyond 41 completed weeks; selenium ( P = .026) and zinc ( P = .034) both made unique contributions to the regression models when controlling for confounders. Women exhibited adequate to excessive serum micronutrient levels compared with pregnancy reference ranges, a finding consistent with dietary intake calculations. Data suggest that excessive essential mineral intake contributed to prolonged pregnancy in this cohort, supporting previous studies in this population. Further research is required to determine individual needs and eliminate the potential for harm before recommending pregnancy supplements.
Tribological analysis of electrostatically developed nanocomposite-coated cutting tool material
Authors: Jadhav Pavandatta Manohar , Narala Suresh Kumar Reddy
Published: September 2019

The nanocomposite coating has immense significance because of its high hardness and excellent oxidation resistance desired for a cutting tool. A systematic approach needs to be designed and developed to achieve high-performance nanocomposite coating to enhance the tribological and mechanical properties. Therefore, the current research attributes a distinct study of nanocomposite coating devised and deposited by the developed electrostatic spray coating technique. The microstructure and mechanical properties of electrostatically deposited YSZ, Al2O3, SiC nanocomposite coatings were assessed to study the wear behaviour. The nanocomposite coating micrographs of microstructure, wear morphology, elemental mapping and energy dispersive X-ray analysis were examined by the field emission scanning electron microscopy. Mechanical tests include the microhardness at room and elevated temperatures to perceive the interaction between coating properties and wear behaviour. The tribological tests, such as scratch and dry sliding wear tests, were performed at room temperature. Scratch test is performed to assess the critical loads of cohesive and adhesive failures of coating. The dry sliding tests were conducted using the pin on disc configuration against an uncoated and YSZ, Al2O3, SiC nanocomposite-coated tungsten carbide (pin), and the counterpart (disc) being titanium alloy (Ti–6Al–4 V). When comparing the uncoated and nanocomposite coating based on friction and wear performance, the nanocomposite coating exhibited exceptional wear resistance. Wear tracks of uncoated and coated pins were observed; the nanocomposite coating indicated minimum values of wear rates due to higher plastic deformation. The electrostatically deposited novel nanocomposite coatings performed better and the outcome is expected to be useful in various industrial applications.
Indocyanine Green Fluorescence Angiography Can Guide Intraoperative Localization During Parathyroid Surgery
Authors: Di Meo G. , Karampinis I. , Gerken A. , Lammert A. , Pellicani S. , Nowak K.
Published: September 2019

Background and Aims:

Intraoperative localization of pathologic parathyroid glands is of major importance for the hyperparathyroidism treatment. Based on the small size and the anatomic variability, the localization can be very challenging. The current practice is to compare preoperative ultrasonography with Technetium-99m sestamibi scintigraphy (MIBI) and plan the resection accordingly. In this study, we implemented indocyanine green angiography for the intraoperative localization of parathyroid glands.

Materials and Methods:

This is a retrospective analysis of 37 patients with primary, secondary, or tertiary hyperparathyroidism who were operated using indocyanine green angiography for the intraoperative localization of pathological parathyroid glands. An indocyanine green solution of 2.5 mg was were intravenously administered for parathyroid gland visualization. Different fluorescence scores were correlated with changes in postoperative parathyroid hormone levels.

Results:

Patients were divided into two groups depending on the presence of uniglandular or multiglandular disease. Sixty-four lesions were resected, and the final histopathologic analysis confirmed the parathyroid origin in 62 of them (96.8%). None of the patients with uniglandular disease developed postoperative hypoparathyroidism, whereas three patients in the multiglandular group developed temporary hypoparathyroidism symptoms. Indocyanine green imaging had higher sensitivity for the intraoperative detection of parathyroid glands compared with ultrasonography and MIBI ( p < 0.001).

Conclusion:

Indocyanine green angiography indicated high sensitivity for the intraoperative identification of pathologic parathyroid glands leading to a resection rate of 95.16%. The modality was useful, especially in cases of revisional surgery or ectopic parathyroid glands. Randomized trials have already proven the value of indocyanine green imaging in predicting postoperative hypocalcemia. Our results support the regular use of this method during parathyroid surgery.
‘It’s the organization that is wrong’: Exploring disengagement from organizations through leadership development
Authors: Larsson Magnus , Holmberg Robert , Kempster Steve
Published: September 2019

This research explores the relationship between participation in leadership development programmes and disengagement from the employing organization. Based on repeated interviews with 10 managers participating in an open leadership development programme, our analysis shows that half of the participants reflected a sense of distancing themselves from how their organizations practiced leadership, and for some, an emotional disengagement with their home organization which we see as analogous to changes in social identity. We problematize the role of management and leadership development programmes with regard to the relationship between organizations and employees. A series of paradoxes are reflected in our critique of this relationship. The most prominent in terms of implications is that a successful management and leadership development programme – recognized by employees and employers – can generate dissatisfaction with the home organization as a consequence of the purpose of the programme: to increase confidence and enhanced agency. This paradox has significant implication to the leadership development industry and we explore these implications.
Health-promotion intervention in a group home: Perspectives of residents, staff and rehabilitation professionals
Authors: Umb Carlsson Õie
Published: September 2019

Promoting healthier lifestyles in people with intellectual disabilities is important in order to improve health and reduce health inequalities. Few studies have explored how health-promotion interventions for people with intellectual disabilities in community-based settings are experienced. The aim of this study was to explore residents’, staff members’ and rehabilitation professionals’ experiences of how a health-promotion intervention affected the habits of people living in a group home regarding eating habits and physical activities and staffs’ ways of working. Semi-structured group interviews were conducted with five residents, six staff members and five rehabilitation professionals. The group discussions were analysed with content analysis separately for each group. Four different categories described residents’, staff members’ and rehabilitation professionals’ views respectively. It is suggested that including people with intellectual disabilities as active parties throughout the process would facilitate implementation of a health-promotion profile in community residences.
Functional rare variants influence the clinical response to anti-TNF therapy in Crohn’s disease
Authors: Chaparro María , Aterido Adrià , Guerra Iván , Iborra Marisa , Cabriada Jose Luis , Bujanda Luis , Taxonera Carlos , García-Sánchez Valle , Marín-Jiménez Ignacio , Barreiro-de Acosta Manuel , Vera Isabel , Martín-Arranz Maria Dolores , Hernández-Breijo Borja , Mesonero Francisco , Sempere Laura , Gomollón Fernando , Hinojosa Joaquín , Bermejo Fernando , Beltrán Belén , Rodríguez-Pescador Ainhoa , Banales Jesús María , Olivares David , Aguilar-Melero Patricia , Menchén Luis , Ferreiro-Iglesias Rocío , Blazquez Gómez Isabel , Benitez García Beatriz , Guijarro Luis G , Marin Alicia C , Bernardo David , Marsal Sara , Julia Antonio , Gisbert Javier P
Published: September 2019

Background:

The effect of low-frequency functional variation on anti-tumor necrosis factor alpha (TNF) response in Crohn’s disease (CD) patients remains unexplored. The objective of this study was to investigate the impact of functional rare variants in clinical response to anti-TNF therapy in CD.

Methods:

CD anti-TNF naïve patients starting anti-TNF treatment due to active disease [Crohn’s Disease Activity Index (CDAI > 150)] were included. The whole genome was sequenced using the Illumina Hiseq4000 platform. Clinical response was defined as a CDAI score <150 at week 14 of anti-TNF treatment. Low-frequency variants were annotated and classified according to their damaging potential. The whole genome of CD patients was screened to identify homozygous loss-of-function (LoF) variants. The TNF signaling pathway was tested for overabundance of damaging variants using the SKAT-O method. Functional implication of the associated rare variation was evaluated using cell-type epigenetic enrichment analyses.

Results:

A total of 41 consecutive CD patients were included; 3250 functional rare variants were identified (2682 damaging and 568 LoF variants). Two homozygous LoF mutations were found in HLA-B and HLA-DRB1 genes associated with lack of response and remission, respectively. Genome-wide LoF variants were enriched in epigenetic marks specific for the gastrointestinal tissue (colon, p = 4.11e–4; duodenum, p = 0.011). The burden of damaging variation in the TNF signaling pathway was associated with response to anti-TNF therapy ( p = 0.016); damaging variants were enriched in epigenetic marks from CD8+ ( p = 6.01e–4) and CD4+ ( p = 0.032) T cells.

Conclusions:

Functional rare variants are involved in the response to anti-TNF therapy in CD. Cell-type enrichment analysis suggests that the gut mucosa and CD8+ T cells are the main mediators of this response.
Inhibitory Effects of Ceramide From the Seeds of Brassica napus L. on the Atopic Function via the Regulation of Human Kallikrein 5 and 7 Protease
Authors: Kim Yu M. , Seo Youngeun , Bae Kyung S.
Published: September 2019

The stratum corneum tryptic enzyme kallikrein 5 (KLK5) is a serine protease that is involved in the cell renewal and maintenance of the skin barrier functions. The excessive activation of KLK5 causes an exacerbation of dermatoses, such as rosacea and atopic dermatitis. Brassica napus play a well-known role in the treatment of canola oil through their anti-oxidative and DNA protective properties. We aimed to investigate whether the bioactive ceramide modulate the KLK5 protease. The ceramides were evaluated using an enzymatic assay to measure the anti-KLK5 activity. Our study revealed that the ceramides modulate the KLK5 and 7 protease activity. Ceramides may affect the skin barrier and atopic function via the regulation of proteases.
Weekday Versus Weekend Presentation in the Acute Management of Ischemic Stroke Through Telemedicine
Authors: Asaithambi Ganesh , Castle Amy L. , Tipps Megan E. , Ho Bridget M. , Marino Emily H. , Hanson Sandra K.
Published: September 2019

A “weekend effect” resulting in higher mortality rates for patients with stroke admitted on weekends has been reported. We examine this phenomenon for patients with acute ischemic stroke (AIS) presenting to telestroke (TS) sites to determine its effect on stroke alert process times and outcomes. From October 2015 to June 2017, we reviewed patients with AIS receiving intravenous alteplase within our TS network. We compared patients presenting to TS sites on weekdays (Monday 07:00 to Friday 18:59) to those presenting on weekends (Friday 19:00 to Monday 06:59). We analyzed door-to-alert activation, alert activation-to-TS evaluation, door-to-imaging, and door-to-needle times. Rates of favorable outcome (modified Rankin Scale score ≤2) and death at 90 days were compared. We identified 89 (54 weekday and 35 weekend) patients (mean age: 71.8 ± 13.3 years, 47.2% women) during the study period. Median door-to-alert activation ( P = .01) and door-to-needle ( P = .004) times were significantly longer for patients presenting on weekends compared to weekdays. There were no significant differences in median door-to-imaging ( P = .1) and alert activation-to-TS evaluation ( P = .07) times. Rates of favorable outcome ( P = .19) and death ( P = .56) at 90 days did not differ. While there were no significant differences in outcomes, patients presenting on weekends had longer door-to-alert activation and door-to-needle times. Efforts to improve methods in efficiency of care on weekends should be considered.
Predicting lymph node metastases with endoscopic resection in cT2N0M0 oesophageal cancer: A systematic review and meta‐analysis
Authors: Al‐Kaabi Ali , van der Post Rachel S , Huising Jonathan , Rosman Camiel , Nagtegaal Iris D , Siersema Peter D
Published: September 2019

Background

Despite modern imaging modalities, staging of clinically staged T2N0M0 (cT2N0M0) oesophageal cancer is suboptimal, often leading to overtreatment. Endoscopic resection – the first‐line therapy for early localised tumours – could be used to improve staging and to attain predictors of nodal upstaging enabling more stage‐guided treatment decisions.

Objective

A systematic literature review and a meta‐analysis were conducted to assess the prevalence and the pathological risk factors of lymph node metastases in cT2N0M0 oesophageal cancer.

Methods

Databases of PUBMED, EMBASE and Cochrane were searched for literature. The primary outcome was lymph node metastases determined after primary surgical resection.

Results

Nine studies with a total of 1650 cT2N0M0 patients were included. The prevalence of lymph node metastases was 43% (95% confidence interval: 35–50%) with heterogeneity being high across studies (I 2  = 0.86, p  < 0.001). Factors potentially attainable by endoscopic resection and having a significant association with lymph node metastases were invasion depth, differentiation grade, tumour size, depth of invasion in the muscularis propria and lymphovascular invasion.

Conclusions

Clinical lymph node staging is inaccurate in almost half of cT2N0M0 oesophageal cancer. Endoscopic resection is a promising diagnostic modality that might even be a valid alternative to surgery in selected patients without high‐risk features, but further evidence is warranted.
Life Beyond Clickbait Journalism: A Transnational Study of the Independent Football Magazine Market
Authors: Ramon Xavier , Tulloch Christopher D.
Published: September 2019

In a cluttered and increasingly complex environment characterized by the multiplication of platforms, a constellation of quality football print magazines has emerged as an alternative destination in sports journalism. To trace the expansion of the independent football magazine market, in-depth interviews were conducted with the editors of eight prestigious projects from seven countries: Howler (United States), Panenka and Líbero (Spain), Mundial (United Kingdom), So Foot (France), 11 Freunde (Germany), Offside (Sweden), and Ballesterer (Austria). Independent football magazines position themselves as part of a journalistic counteroffensive to the metric-driven, routinized, and complacent approach that currently shapes mainstream sports media output. In contrast to the primary orientation of sports journalism towards economic capital, their editorial philosophy is built on three core axes aimed at developing cultural capital: (1) a diverse and multifaceted football agenda that embraces unheard voices and far-reaching issues of a sociocultural, geopolitical, and economic nature; (2) the importance of dedicating time and resources to create a visually distinctive output; and (3) a deliberate emphasis on nostalgia and resistance to the seemingly endless commodification of football. As part of their creative approach, gathering and nourishing a community of readers has been fundamental to the growth and sustainability of those projects.
Estrogen Receptor, Progesterone Receptor, and HER-2 Expression in Recurrent Pleomorphic Adenoma
Authors: de Souza Ana Amélia , Altemani Albina , de Araujo Ney Soares , Texeira Lucas Novaes , de Araújo Vera Cavalcanti , Soares Andresa Borges
Published: September 2019

Pleomorphic adenoma (PA) is the most common salivary gland neoplasm and, although mostly benign, recurrences, being called recurrent pleomorphic adenoma (RPA) and malignant transformation to carcinoma ex pleomorphic adenoma (CXPA), do occur. Recently, attention has been focused on molecular targeted cancer therapy in various tumors, including salivary gland tumors. The aim of this study was to investigate the role of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) in PA, RPA, and CXPA. In total, 20 cases of PA, 18 of RPA, and 7 cases of CXPA were immunohistochemically studied for ER, PR, and HER-2. For evaluation of ER and PR, only nuclear expression and greater than 10% positive cells were regarded as cutoff criteria. HER-2 was evaluated semiquantitatively and graded from 0 to 3+. HER-2 amplification was assessed by chromogenic in situ hybridization (CISH). Tumors were negative for ER, PR, and HER-2 in all cases of PA and RPA. A case of CXPA showed moderate and complete membranous staining, and 6 cases were negative. HER-2 amplification was not observed in any case. In conclusion, the lack of ER, PR, and HER-2 expression in PA, RPA, and CXPA suggests that these proteins are not involved in progression, recurrence, or malignant transformation of PA.
Combined Tumors in Hematolymphoid Neoplasms: Case Series of Histiocytic and Langerhans Cell Sarcomas Arising From Low-Grade B-Cell Lymphoma
Authors: Skala Stephanie L , Ye Jing C , Stumph Jennifer , Macon William R , Quinones Frances R , Khachaturov Vadim , Ketterling Rhett P , Dewar Rajan
Published: September 2019

We report an index case of histiocytic sarcoma arising in a 70-year-old patient with long-standing chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The patient presented in 2017 with painful, enlarging swelling of the left neck. He had remote history of cutaneous squamous cell carcinoma with no sign of recurrence, and his CLL/SLL was thought to be in remission. Computed tomography showed mild splenomegaly and multifocal lymphadenopathy including a 3-cm left neck mass. Biopsy of the left neck mass showed CLL/SLL with associated histiocytic sarcoma. Flow cytometry demonstrated a B cell neoplasm with CLL/SLL phenotype. Despite radiation therapy, he expired 3 months after presentation. Two similar cases (CLL/SLL and histiocytic sarcoma, follicular lymphoma and Langerhans cell sarcoma) from another institution are also illustrated. The pathological features of combined tumors in lymphoid neoplasms, a general framework to the work-up to determine interrelatedness of tumor components, and the clinical relevance are discussed.
Prognostic implications of 5-hydroxymethylcytosines from circulating cell-free DNA in diffuse large B-cell lymphoma
Authors: Chiu Brian C.-H. , Zhang Zhou , You Qiancheng , Zeng Chang , Stepniak Elizabeth , Bracci Paige M. , Yu Kangkang , Venkataraman Girish , Smith Sonali M. , He Chuan , Zhang Wei
Published: September 2019

Key Points

Genome-wide 5hmC loci can be profiled in 1 to 2 ng of cfDNA from blood plasma and correlate with clinical features of DLBCL. 5hmC in cfDNA collected at the time of DLBCL diagnosis is associated with EFS and OS, independent of established prognostic factors.
Consensus recommendations for management of patients with type 2 diabetes mellitus and cardiovascular diseases
Authors: Bashier Alaaeldin , Bin Hussain Azza , Abdelgadir Elamin , Alawadi Fatheya , Sabbour Hani , Chilton Robert
Published: September 2019

The recent American Diabetes Association and the European Association for the Study of Diabetes guideline mentioned glycaemia management in type 2 diabetes mellitus (T2DM) patients with cardiovascular diseases (CVDs); however, it did not cover the treatment approaches for patients with T2DM having a high risk of CVD, and treatment and screening approaches for CVDs in patients with concomitant T2DM. This consensus guideline undertakes the data obtained from all the cardiovascular outcome trials (CVOTs) to propose approaches for the T2DM management in presence of CV comorbidities. For patients at high risk of CVD, metformin is the drug of choice to manage the T2DM to achieve a patient specific HbA1c target. In case of established CVD, a combination of glucagon-like peptide-1 receptor agonist with proven CV benefits is recommended along with metformin, while for chronic kidney disease or heart failure, a sodium–glucose transporter proteins-2 inhibitor with proven benefit is advised. This document also summarises various screening and investigational approaches for the major CV events with their accuracy and specificity along with the treatment guidance to assist the healthcare professionals in selecting the best management strategies for every individual. Since lifestyle modification and management plays an important role in maintaining the effectiveness of the pharmacological therapies, authors of this consensus recommendation have also briefed on the patient-centric non-pharmacological management of T2DM and CVD.
Testing cellular phone-enhanced GPS tracking technology for urban carnivores
Authors: Ishii Hiroaki , Yamazaki Koji , Noonan Michael J. , Buesching Christina D. , Newman Chris , Kaneko Yayoi
Published: September 2019

Background

We present a cellular phone-enhanced GPS tracking system (GPS mobile with CTG-001G receiver triangulation) suitable for urban carnivores, in tandem with appropriate home range analysis, as an additional tracking technology option in metropolitan settings. We conduct this proof-of-concept study working with the management of introduced invasive raccoons in Japan (and conditions implicit to this control program).

Results

Each tracking period averaged 17 days, and a tracking accuracy of < 50 m error was achieved in over 30% of the fixes. Variogram analysis demonstrates that these data were of sufficient quality to support home range analysis. Home range areas estimated from these data revealed that raccoons in urban Japan likely range over a much greater area than has previously been reported.

Conclusions

As a proof of concept, these prototype collars were successful in tracking raccoons in the difficult suburban environment, where this system (CTG) made fixes against FOMA antennae-augmented GPS and yielded data that could support home range analysis. We advocate further research and development to refine this system, with broad application as a tool to diversify wildlife tracking technology options in urbanized environments, where synanthropic and/or invasive species can cause a nuisance warranting effective management.
Neoadjuvant Modified FOLFOX6 With or Without Radiation Versus Fluorouracil Plus Radiation for Locally Advanced Rectal Cancer: Final Results of the Chinese FOWARC Trial
Authors: Deng Yanhong , Chi Pan , Lan Ping , Wang Lei , Chen Weiqing , Cui Long , Chen Daoda , Cao Jie , Wei Hongbo , Peng Xiang , Huang Zonghai , Cai Guanfu , Zhao Ren , Huang Zhongcheng , Xu Lin , Zhou Hongfeng , Wei Yisheng , Zhang Hao , Zheng Jian , Huang Yan , Zhou Zhiyang , Cai Yue , Kang Liang , Huang Meijin , Wu Xiaojian , Peng Junsheng , Ren Donglin , Wang Jianping
Published: September 2019

PURPOSE

In the multicenter, open-label, phase III FOWARC trial, modified infusional fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) plus radiotherapy resulted in a higher pathologic complete response rate than fluorouracil plus radiotherapy in Chinese patients with locally advanced rectal cancer. Here, we report the final results.

METHODS

Adults ages 18 to 75 years with stage II/III rectal cancer were randomly assigned (1:1:1) to five cycles of infusional fluorouracil (leucovorin 400 mg/m2, fluorouracil 400 mg/m2, and fluorouracil 2.4 g/m2 over 48 hours) plus radiotherapy (46.0 to 50.4 Gy delivered in 23 to 25 fractions during cycles 2 to 4) followed by surgery and seven cycles of infusional fluorouracil, the same treatment plus intravenous oxaliplatin 85 mg/m2 on day 1 of each cycle (mFOLFOX6), or four to six cycles of mFOLFOX6 followed by surgery and six to eight cycles of mFOLFOX6. The primary end point was 3-year disease-free survival (DFS).

RESULTS

In total, 495 patients were randomly assigned to treatment. After a median follow-up of 45.2 months, DFS events were reported in 46, 39, and 46 patients in the fluorouracil plus radiotherapy, mFOLFOX6 plus radiotherapy, and mFOLFOX6 arms. In each arm, the probability of 3-year DFS was 72.9%, 77.2%, and 73.5% ( P = .709 by the log-rank test), the 3-year probability of local recurrence after R0/1 resection was 8.0%, 7.0%, and 8.3% ( P = .873 by the log-rank test), and the 3-year overall survival rate was 91.3%, 89.1%, and 90.7% ( P = .971 by log-rank test), respectively.

CONCLUSION

mFOLFOX6, with or without radiation, did not significantly improve 3-year DFS versus fluorouracil with radiation in patients with locally advanced rectal cancer. No significant difference in outcomes was found between mFOLFOX6 without radiotherapy and fluorouracil with radiotherapy, which requires additional investigation of the role of radiotherapy in these regimens.
Prospective Comparison of Preoperative Predictive Performance Between 3 Leading Frailty Instruments
Authors: McIsaac Daniel I. , Harris Emma P. , Hladkowicz Emily , Moloo Husein , Lalu Manoj M. , Bryson Gregory L. , Huang Allen , Joanisse John , Hamilton Gavin M. , Forster Alan J. , van Walraven Carl
Published: September 2019

BACKGROUND:

Guidelines recommend routine preoperative frailty assessment for older people. However, the degree to which frailty instruments improve predictive accuracy when added to traditional risk factors is poorly described. Our objective was to measure the accuracy gained in predicting outcomes important to older patients when adding the Clinical Frailty Scale (CFS), Fried Phenotype (FP), or Frailty Index (FI) to traditional risk factors.

METHODS:

This was an analysis of a multicenter prospective cohort of elective noncardiac surgery patients ≥65 years of age. Each frailty instrument was prospectively collected. The added predictive performance of each frailty instrument beyond the baseline model (age, sex, American Society of Anesthesiologists’ score, procedural risk) was estimated using likelihood ratio test, discrimination, calibration, explained variance, and reclassification. Outcomes analyzed included death or new disability, prolonged length of stay (LoS, >75th percentile), and adverse discharge (death or non-home discharge).

RESULTS:

We included 645 participants (mean age, 74 [standard deviation, 6]); 72 (11.2%) participants died or experienced a new disability, 164 (25.4%) had prolonged LoS, and 60 (9.2%) had adverse discharge. Compared to the baseline model predicting death or new disability (area under the curve [AUC], 0.67; R
2, 0.08, good calibration), prolonged LoS (AUC, 0.73; R
2, 0.18, good calibration), and adverse discharge (AUC, 0.78; R
2, 0.16, poor calibration), the CFS improved fit per the likelihood ratio test (P < .02 for death or new disability, <.001 for LoS, <.001 for discharge), discrimination (AUC = 0.71 for death or new disability, 0.76 for LoS, 0.82 for discharge), calibration (good for death or new disability, LoS, and discharge), explained variance (R
2 = 0.11 for death or new disability, 0.22 for LoS, 0.25 for discharge), and reclassification (appropriate directional reclassification) for all outcomes. The FP improved discrimination and R
2 for all outcomes, but to a lesser degree than the CFS. The FI improved discrimination for death or new disability and R
2 for all outcomes, but to a lesser degree than the CFS and the FP. These results were consistent in internal validation.

CONCLUSIONS:

Frailty instruments provide meaningful increases in accuracy when predicting postoperative outcomes for older people. Compared to the FP and FI, the CFS appears to improve all measures of predictive performance to the greatest extent and across outcomes. Combined with previous research demonstrating that the CFS is easy to use and requires less time than the FP, clinicians should consider its use in preoperative practice.
C-type allatostatin and its putative receptor from the mud crab serve an inhibitory role in ovarian development
Authors: Liu An , Liu Fang , Shi Wenyuan , Huang Huiyang , Wang Guizhong , Ye Haihui
Published: September 2019

C-type allatostatins are a family of peptides that characterized by a conserved unblocked-PISCF in C-terminal. In insects, it is well known that C-type allatostatin has a potent inhibitory effect on juvenile hormone biosynthesis by the corpora allata. Recently, C-type allatostatin has been widely identified from crustacean species but little is known about its roles. Therefore, this study described the tissue distribution patterns of C-type allatostatin and its putative receptor in the mud crab Scylla paramamosain, and further explored its potential effect on vitellogenesis. Firstly, the cDNAs encoding C-type allatostatin (Sp-AST-C) precursor and its putative receptor (Sp-AST-CR) were isolated, respectively. Subsequently, RT-PCR results suggested that, Sp-AST-C was mainly expressed in the nervous tissue, middle gut and the heart while Sp-AST-CR had an extensive expression in the detected tissues except the eyestalk ganglion and hepatopancreas. Furthermore, the Sp-AST-C expressing cells in the cerebral ganglion were detected through in situ hybridization, it showed that Sp-AST-C was localized in cluster 6, 8 of protocerebrum, cluster 9, 10, 11 of deutocerebrum, and cluster 14, 15 of tritocerebrum. The whole-mount immunofluorescence gave a similar distribution pattern. An in vitro experiment showed that, the synthetic Sp-AST-C had no effect on the abundance of Sp-Vg in the hepatopancreas and ovary but significantly reduced the expression of Sp-VgR in the ovary in a dose-dependent manner. Furthermore, it was demonstrated that the Sp-VgR expression, Vn content, and oocyte diameter in ovary were reduced after 16-days injection of Sp-AST-C. Finally, the transcripts of Sp-AST-CR were specifically localized in the oocytes of ovary by in situ hybridization, which further revealed that the oocytes were target cells for Sp-AST-C. In conclusion, our results suggested that Sp-AST-C signaling system was involved in the regulation of ovarian development, in which Sp-AST-C might inhibit the uptake of yolk by oocytes directly and obstruct oocyte growth.
Convergent evolution of super black plumage near bright color in 15 bird families
Authors: McCoy Dakota E. , Prum Richard O.
Published: September 2019

We examined extremely low-reflectance, velvety black plumage patches in 32 bird species from 15 families and five orders and compared them with 22 closely related control species with normal black plumage. We used scanning electron microscopy to investigate microscopic feather anatomy, and applied spectrophotometry and hyperspectral imaging to measure plumage reflectance. Super black plumages are significantly darker and have more broadband low reflectance than normal black plumages, and they have evolved convergently in 15 avian families. Super black feather barbules quantitatively differ in microstructure from normal black feathers. Microstructural variation is significantly correlated with reflectance: tightly packed, strap-shaped barbules have lower reflectance. We assigned these super black feathers to five heuristic classes of microstructure, each of which has evolved multiple times independently. All classes have minimal exposed horizontal surface area and 3D micrometer-scale cavities greater in width and depth than wavelengths of light. In many species, barbule morphology varied between the super black exposed tip of a feather and its (i) concealed base or (ii) iridescently colored spot. We propose that super black plumages reduce reflectance, and flatten reflectance spectra, through multiple light scattering between the vertically oriented surfaces of microscale cavities, contributing to near-complete absorption of light by melanin. All super black plumage patches identified occur adjacent to brilliant colored patches. Super black plumage lacks all white specular reflections (reference points used to calibrate color perception), thus exaggerating the perceived brightness of nearby colors. We hypothesize that this sensory bias is an unavoidable by-product of color correction in variable light environments.
Is Inflation Default? The Role of Information in Debt Crises
Authors: Bassetto Marco , Galli Carlo
Published: September 2019

We study the information sensitivity of government debt denominated in domestic versus foreign currency: the former is subject to inflation risk and the latter to default. Default only affects sophisticated bond traders, whereas inflation concerns a larger and less informed group. Within a two-period Bayesian trading game, differential information manifests itself in the secondary market, and we display conditions under which debt prices are more resilient to bad news even in the primary market, where only sophisticated players operate. Our results can explain debt prices across countries following the 2008 financial crisis, and also provide a theory of “original sin.” (JEL D84, F34, H63)
Análise do atendimento nos serviços de saúde entre pessoas vivendo com HIV/AIDS
Authors: Gomes Hévila Nascimento , Macena Raimunda Hermelinda Maia , Arruda Gisele Maria Melo Soares , Gomes Ana Karine Castelo Branco de Paula
Published: September 2019

Objetivo: analisar o atendimento dos serviços de saúde prestados às pessoas que vivem com HIV/AIDS, buscando identificar atitudes de discriminação e preconceito vivenciadas na perspectiva dos usuários no município de Fortaleza/CE. Método: estudo seccional e exploratório, com abordagem quantitativa, realizada no período de março a junho/2018, com 65 indivíduos que frequentam a unidade da Rede Nacional de pessoas que vivem com HIV/AIDS (RNP) na cidade de Fortaleza-CE. As atitudes de discriminação foram mensuradas por meio da escala de Allport. Os dados foram digitados pelo software Excel for Windows® 2010 e, a seguir, exportados e analisados pelo programa STATA/SE® 11.2. Resultados: 20% dos indivíduos afirmaram sofrer algum tipo de discriminação em locais de saúde por viverem com HIV/AIDS. Entretanto, 67,7% informaram já terem sido vitimas de algum tipo de preconceito por causa da doença, desses 50% foram vítimas de piadas e apenas 6% de ataques físicos. Conclusão: ainda há muito a melhorar para uma efetiva garantia do acesso e humanização do atendimento às pessoas vivendo com HIV/AIDS.
Ο «Εις κοιμηθέντας» λόγος του Θεοφίλου Κορυδαλλέως και η αριστοτελική περί ψυχής θεματική του
Authors: Τσιότρας Βασίλειος Ι.
Published: September 2019

Among the various writings of Theophilos Corydalleus, focusing on the Aristotelian interpretation and teaching practice at the major Academies of the Hellenic world under Ottoman rule, we find a unique work, a Funeral Oration. It was performed by Corydalleus himself in Constantinople in the decade of 1630-40 in honor of Poulcheria, a young woman who passed away in her youth. The departed came from an aristocratic family of the Phanariotic society, since her father, Michael Vlastos was a high-ranking officer of the Ecumenical Patriarchate. This discourse is preserved by five manuscripts and it is written in an elaborate demotic Greek language, enriched with a lot of ancient Greek wording and stylistic elements. The main goal of this paper is to study the manuscript tradition, the content and the sources (mainly Aristotelian and secondly patristic or biblical) and to produce a critical edition of the text. In this Oration, Corydalleus managed to simplify in a vivid and fluent language major Aristotelian doctrines concerning death, such as the separation of the soul from the body, the immortality of the soul, the meaning of fear, and the perception of time etc.VASILEIOS I. TSIOTRAS
Η «βυζαντινή φατρία των χυδαϊστών». Επισκοπώντας τα αντικοραϊκά δημοσιεύματα του 1811
Authors: Φραγκίσκος Εμμ. Ν.
Published: September 2019

A «CLIQUE BYZANTINE DES ADEPTES DU DÉMOTICISME». Une revue des publications anticoraïques de l'an 1811 En 1811 ont vu le jour deux publications opposées à la théorie de Coray qui concernait la correction de la langue néogrecque : le Rêve, publié sans signature dans l’édition des Lyriques d’Athanase Christopoulos à Vienne et une seconde signée par l’initial N. et inserée dans les pages de Loghios Hermès en forme de lettre-réponse à l’article d’Alexandre Vassileiou, publié aussi dans ce magazine littéraire, par lequel le négociant savant de Vienne défendait les idées linguistiques de son ami Coray. Les auteurs des deux textes, écrits sous l’influence de la tradition populaire de la langue des D. Catartzi et D. Philippides, employaient d’arguments théoriques identiques, en faveur de la langue vulgaire, et de l’autre côté ils habitaient dans le même lieu, à savoir à Constantinople. Quand ces publications furent parvenues aux mains de Coray, le Grec savant commentera dans sa correspondance seulement la seconde, en considérant que D. Philippides fût son auteur. Mais l’anonyme de Loghios Hermès, comme le professeur Walter Puchner a indiqué autrefois, était Iacovakis Rizos Neroulos, l’auteur des Korakistika, et cette identification est confirmée dans l’article présent par beaucoup d’autres documents. Le fait que, d’après les informations d’Ath. Christopoulos à Ath. Psalidas, cette satire, qui serait publiée l’année 1813, circulait déjà en 1811 en forme manuscrite dans les cercles des savants de Constantinople et les amusait fort, nous fait réfléchir que cet événement était la source de la réaction de Coray quand le mois de décembre de la même année il parlait dans ses lettres des clabaudages des législateurs byzantins de la langue ou de la clique byzantine des adeptes du démoticisme. Évidemment, il aurait reçu lui-même d’informations semblables par son ami Al. Vassileiou transmises de la part de ses frères, aussi négociants savants, qui demeuraient à Constantinople. Donc, puisque tous les trois textes anticoraϊques, le Rêve, texte en forme théâtrale, où on rencontre pour la première fois le terme «korakistika», la lettre anonyme du Loghios Hermès, et la comédie Korakistika, sonts liés de plusieurs points entre eux, on ne peut pas écarter la probabilité qu’ils provenaient du même auteur, à savoir de I. R. Neroulos. En tout cas, face aux atteintes qu’il recevait par ses adversaires, Coray refusait le rôle du législateur de la langue (les seuls législateurs n’étaient que les écrivains et les poètes classiques, pas l’usage commun), il était saisi de doutes sur l’application générale de sa doctrine linguistique en désapprouvant en même temps les confrontations sur ce sujet.Emm. N. Franghiskos