bluuebunny/crossref_metadata_2025_split huggingface dataset:
PAIN EXPERIENCES IN OLDER ADULTS WITH HEART FAILURE IN THE HOME HEALTHCARE SETTING AFTER HOSPITAL DISCHARGE
Authors: Kang Youjeong , Reid Cary 
Published: November 2019

Abstract
Pain symptoms are underreported in older adults (i.e., those ages ≥65), because many consider it a part of aging. Pain is highly prevalent in patients with heart failure (HF). HF is increasing in incidence with the aging population. Pain is also an important risk factor for rehospitalization among home healthcare patients with HF. However, little is known about the pain experiences of older adults with HF after hospital discharge. Accordingly, this study sought to describe pain and other symptoms among older adults with HF in the home healthcare setting using a mixed-methods approach. We conducted semi-structured interviews. We used the Edmonton Symptom Assessment Scale and Brief Pain Instrument on older adults (N=17) with HF in the home healthcare setting within 10 days of hospital discharge. The mean age was 76±9.25 years, nearly 50% were female, and most (90%) were White. The majority of participants managed pain with medications. Loss of appetite had the highest mean severity score (3.88±2.50) of symptoms measured. The mean score for pain at its worst was 4.94±3.07. Pain interfering with sleep had the highest mean score (4.24±3.36). Using content analysis we identified 4 distinct themes regarding the pain experience: (1) differences in the pain experiences before and after being diagnosed of HF, (2) symptoms accompanied with pain, (3) health care providers’ pain assessment, and (4) knowledge about pain management. These findings will contribute to the development and evaluation of a pain assessment and management protocol targeting older adults with HF in the home healthcare setting.
COGNITION, SELF-RATED COGNITIVE HEALTH, AND CONCERNS ABOUT ALZHEIMER’S DISEASE IN OLDER KOREAN AMERICANS
Authors: Jang Yuri , Park Nan Sook , Chiriboga David , Yoon Hyunwoo , Rhee Min-Kyoung 
Published: November 2019

Abstract
Responding to the dearth of research on cognitive health in older ethnic minorities, the present study explored the associations among cognitive performance, self-rated cognitive health, and concerns about Alzheimer’s Disease (AD) in older Korean Americans. We hypothesized that (1) cognitive performance and self-rated cognitive health would be moderately associated; (2) both cognitive performance and self-rated cognitive health would be associated with concerns about AD; and (3) the effect of cognitive performance on concerns about AD would be mediated by self-rated cognitive health. Analyses of the survey data of 2,150 older Korean Americans (mean age = 73.2) residing in five states provided support for the hypotheses. Cognitive performance, measured with a Korean version of the Mini-Mental State Exam (MMSE), and a single item asking respondents to rate their overall cognitive status on a 5-point scale (excellent/very good/good/fair/poor) were moderately associated. Both poor performance in the MMSE and negative ratings of cognitive health status were associated with increased concerns about AD. Mediation analyses using the macro PROCESS showed that the indirect effect of cognitive performance on the concerns about AD through self-rated cognitive health (−.01 [.002]) was significant (bias corrected 95% confidence interval for the indirect effect = −.02, −.01). That is, the effect of cognitive performance on the concerns about AD was mediated by individuals’ subjective evaluations of their cognitive health. Findings not only help better understand the psychological mechanisms that underlie cognitive health and AD concerns but also suggest avenues for interventions.
A Hostile Environment for Children? The Rights and Best Interests of the Refugee Child in the United Kingdom’s Asylum Law
Authors: Brittle Ruth 
Published: November 2019

Abstract
Children experiencing persecution, torture, ill-treatment, exploitation and violence are compelled to flee across international borders to seek protection in another state. When a child seeks international protection, the framework of rights under the Convention on the Rights of the Child and the Convention Relating to the Status of Refugees should guide a state to determine the child’s status and protection needs. However, a child’s best interests and right to protection may clash with a state’s interest in immigration control. Increasingly, states are implementing strict laws to discourage irregular migration and to encourage those without leave to remain to return to their countries of origin. Such laws or policies have an impact on people seeking international protection, including children. The UK government’s ‘hostile environment’ policy is an example of this and applies to all adults and children who enter the UK irregularly and have no right to remain. I argue that the UK’s approach violates its international obligations under the Convention on the Rights of the Child. This article analyses how the children’s rights framework, in particular the ‘best interests’ principle, is able to challenge the UK’s ‘hostile environment’ policy.
Toward efficient energy consumption in middle income housing buildings in Egypt
Authors: Hegazy Ibrahim Rizk 
Published: November 2019

Abstract
Current research pays special attention to the application of approaches that promote sustainable design in a built environment and ensure energy efficiency. In this context, the form of housing buildings is an important parameter that has a meaningful impact on the use of energy in housing buildings. Hence, this research attempts to study the impact of the form of housing buildings on energy efficiency taking into account the mid-hot weather conditions in one of the middle-income housing buildings in new communities in Egypt. To achieve the research aim, a comparative analysis is carried out using parametric numerical analysis—DesignBuilder energy analysis—to compare the various hypothetical proposals for different building configurations. The study determines that the efficiency of energy use in buildings depends to a large extent on their forms that will help urban designers and planners to propose the best energy performance in the form of housing buildings in the stage of conceptual design suitable for other environmental, social and economic urban planning issues. These results should be incorporated into the building codes adopted in Egypt’s new cities in order to reach more energy-efficient housing buildings in Egypt.
Human Immunodeficiency Virus Infection Is Associated With Preterm Delivery Independent of Vaginal Microbiota in Pregnant African Women
Authors: Gudza-Mugabe Muchaneta , Havyarimana Enock , Jaumdally Shameem , Garson Kirsty Lee , Lennard Katie , Tarupiwa Andrew , Mugabe Fortunate , Marere Tarisai , Mavenyengwa Rooyen T , Masson Lindi , Jaspan Heather B 
Published: November 2019

AbstractBackgroundDuring pregnancy, the vaginal microbiota is relatively stable. However, African women have more diverse vaginal microbiota than their European counterparts, in addition to high human immunodeficiency virus (HIV) prevalence and risk of adverse birth outcomes. Although HIV is associated with alterations in vaginal microbiota and inflammation in nonpregnant women, these relationships are underexplored in pregnant women.MethodsIn this study, we characterize the vaginal microbiota and immune factors in pregnant African women who were HIV-uninfected (n = 314) versus HIV-infected (n = 42). Mucosal samples were collected once at the enrollment visit (between 15 and 35 weeks of gestation) and women were followed until delivery.ResultsVaginal microbial communities of pregnant women with HIV were significantly more diverse than women without HIV (P = .004), with community structure also differing by HIV status (P = .002, R2 = 0.02). Human immunodeficiency virus infection was also associated with increased risk of preterm birth (PTB) (31% versus 15.3%; P = .066). In a multivariate analysis, HIV infection was independently associated with diverse vaginal community state type (CST)-IVA (P = .005) and CST-IVB (P = .018) as well as PTB (P = .049). No association between HIV status and cytokine concentrations was found.ConclusionsLongitudinal studies with accurate gestational age assessment would be important to confirm these relationships.
Overall assessment of fermented feed for pigs: a series of meta-analyses
Authors: Xu Bocheng , Zhu Luoyi , Fu Jie , Li Zhi , Wang Yizhen , Jin Mingliang 
Published: November 2019

Abstract
As an alternative to antimicrobial growth promoters, fermented feed (FF) has been continuously developed for two decades; however, its effects on feed, performance, digestibility, and meat quality of pigs have yet to be systematically and comprehensively evaluated. This study aimed to (i) quantitatively evaluate the effects of fermentation on nutritional components of feed stuffs; (ii) quantitatively evaluate the effects of FF on pig growth performance, digestibility, and meat quality; and (iii) explore the dose–effect relationship. From PubMed and Web of Science (searched range from January 1, 2000 to April 4, 2019), we collected 3,271 articles, of which 30 articles (3,562 pigs) were included in our meta-analysis. Our analysis revealed that fermentation significantly increased the CP content in feed (P &lt; 0.05). For weaned piglets and growing pigs, FF significantly improved ADG, G:F, DM digestibility, N digestibility, and energy digestibility (P &lt; 0.05). However, compared with the basal diet, FF had no significant effects on growth performance and nutrient digestibility in finishing pigs (P &gt; 0.05). In the subgroup analyses, fermented ingredients increased the growth performance of weaned piglets and growing pigs, and fermented additives promoted the growth of pigs at all stages. The dose–effect analysis confirmed that the optimal doses of fermented ingredients and additives were 8% and 0.15%, respectively. Furthermore, FF had beneficial impacts on meat quality through increased lightness, redness, marbling and flavor and reduced drip loss (P &lt; 0.05). In conclusions, FF improved growth performance and meat quality primarily due to its positive effects on nutritive value and utilization.
Wild Bee Visitation Rates Exceed Pollination Thresholds in Commercial Cucurbita Agroecosystems
Authors: McGrady C M , Troyer R , Fleischer S J 
Published: November 2019

Abstract
Wild bees supply sufficient pollination in Cucurbita agroecosystems in certain settings; however, some growers continue to stock fields with managed pollinators due to uncertainties of temporal and spatial variation on pollination services supplied by wild bees. Here, we evaluate wild bee pollination activity in wholesale, commercial pumpkin fields over 3 yr. We identified 37 species of bees foraging in commercial pumpkin fields. Honey bees (Apis mellifera L. [Hymenoptera: Apidae]), squash bees (Eucera (Peponapis) Say, Dorchin [Hymenoptera: Apidae]), and bumble bees (Bombus spp., primarily B. impatiens Cresson [Hymenoptera: Apidae]) were the most active pollinator taxa, responsible for over 95% of all pollination visits. Preference for female flowers decreased as distance from field edge increased for several bee taxa. Visitation rates from one key pollinator was negatively affected by field size. Visitation rates for multiple taxa exhibited a curvilinear response as the growing season progressed and responded positively to increasing floral density. We synthesized existing literature to estimate minimum ‘pollination thresholds’ per taxa and determined that each of the most active pollinator taxa exceeded these thresholds independently. Under current conditions, renting honey bee hives may be superfluous in this system. These results can aid growers when executing pollination management strategies and further highlights the importance of monitoring and conserving wild pollinator populations.
Indications for hip arthroscopy in pediatric patients a systematic review
Authors: Awad Moayd Abdullah H , Bajwa Arpun K , Slaunwhite Erin , Logan Karl J , Wong Ivan H 
Published: November 2019

Abstract
The purpose of this study was to evaluate the current available literature on hip arthroscopy and determine the clinical indications in the pediatric patient population (age ≤ 18). In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), a comprehensive literature search was performed on the 23 October 2018 using PubMed, Cochrane Library, Embase and e-books to identify research surrounding the use of hip arthroscopy in the pediatrics. Exclusion criteria were studies that described joints other than the hip, animal studies, systematic reviews, open procedures and those that reported solely on patients aged 19-year-old and older. From 232 studies, 57 were reviewed in detail; 17 articles were removed as their indication fell into a category of ‘diagnostic hip arthroscopy for pain’ or no clear separation between the data on the adult and pediatric population could be made in a full text review of the paper. Eleven categories were identified as indications for hip arthroscopy in the pediatric population. At best a Grade C recommendation can be made to support the use of hip arthroscopy in the pediatric population. Our results support our hypothesis. Despite the exponential increase in hip arthroscopy over the last decade, limited evidence exists in support of its use in the pediatric (≤18) population. Our findings support the need for further research in delineating the indications for its use, as clearly arthroscopy may be advantageous in many situations, particularly in light of the alternatives.
Targeted delivery and enhanced gene-silencing activity of centrally modified folic acid–siRNA conjugates
Authors: Salim Lidya , Islam Golam , Desaulniers Jean-Paul 
Published: November 2019

AbstractOne of the major hurdles in RNAi research has been the development of safe and effective delivery systems for siRNAs. Although various chemical modifications have been proposed to improve their pharmacokinetic behaviour, their delivery to target cells and tissues presents many challenges. In this work, we implemented a receptor-targeting strategy to selectively deliver siRNAs to cancer cells using folic acid as a ligand. Folic acid is capable of binding to cell-surface folate receptors with high affinity. These receptors have become important molecular targets for cancer research as they are overexpressed in numerous cancers despite being expressed at low levels in normal tissues. Employing a post-column copper-catalyzed alkyne–azide cycloaddition (CuAAC), we report the synthesis of siRNAs bearing folic acid modifications at different positions within the sense strand. In the absence of a transfection carrier, these siRNAs were selectively taken up by cancer cells expressing folate receptors. We show that centrally modified folic acid–siRNAs display enhanced gene-silencing activity against an exogenous gene target (∼80% knockdown after 0.75 μM treatment) and low cytotoxicity. In addition, these siRNAs achieved potent dose-dependent knockdown of endogenous Bcl-2, an important anti-apoptotic gene.
ATIM-01. NIVOLUMAB AND BEVACIZUMAB FOR RECURRENT GLIOBLASTOMA; A TRANSLATIONAL TRIAL IN PROGRESS
Authors: Eibye Simone , Hasselbalch Benedikte , Marie Svane Inge , Reker Hadrup Sine , Rønn Olsen Lars , Skjoeth-Rasmussen Jane , Scheie David , Østrup Olga , Skovgaard Poulsen Hans , Lassen Ulrik 
Published: November 2019

Abstract
Glioblastoma multiforme (GBM) is an aggressive brain tumor with a poor prognosis. Standard of care at diagnosis is surgical resection, followed by radiation and temozolomide. Receiving this therapy, the median survival is 14.6 months [1]. We have no standard treatment for relapse and known options have limited effect. There is an urgent need for novel treatment interventions to improve clinical outcomes and quality of life. Recently, improved overall survival has been achieved with immune therapeutics in melanoma and renal cell carcinoma. Accordingly, it has been posited that immunotherapy may offer promise in other difficult cancers such as GBM [2]. We present our translational study; a phase II open label, two-armed translational study of Nivolumab and Bevacizumab for recurrent GBM, who have failed Stupp’s regime [1]. Patients are included in two arms depending on possibly salvage neurosurgical resection. Both arms receive Nivolumab and Bevacizumab administrated every second weekend, but the surgical arm also receive Nivolumab 7 days prior surgery. We expect 40 patients; 20 in each arm. Enrollment period is expected to 20 months, started October 2018. Our primary objective is to make preliminary assessment of immune related biomarkers, including PD-L1; therefore, we perform full genome sequencing on tumor biopsies from the surgical arm and on blood samples from both arms. We evaluate changes in the transcriptomic landscape caused by the check-point inhibition and relation to response as compared with baseline sequencing data, as well as the impact of tumor mutation burden and neoepitope load. We investigate the tumor microenvironment by harvesting tumor infiltrating lymphocytes and study the composition by flow-cytometry. The patients are evaluated by blood samples, FET-PET as wells as clinical examinations to evaluate PFS and OS. Overall the study will provide us with a unique possibility to investigate and thereof predict which patients will profit from the treatment.
ATIM-07. EFFICACY AND SAFETY OF NIVOLUMAB IN PATIENTS WITH FIRST RECURRENCE OF GLIOBLASTOMA: A MULTICENTER, OPEN-LABEL, NON-COMPARATIVE STUDY (ONO-4538-19)
Authors: Kagawa Naoki , Aoki Tomokazu , Sugiyama Kazuhiko , Wakabayashi Toshihiko , Arakawa Yoshiki , Yamaguchi Shigeru , Tanaka Shota , Nishikawa Ryo 
Published: November 2019

Abstract

BACKGROUND
The anti-programmed cell death protein 1 (PD-1) immune checkpoint antibody, nivolumab, may be beneficial in patients with recurrent glioblastoma.

OBJECTIVE
This open-label, non-comparative study assessed the efficacy and safety of nivolumab in Japanese patients with first recurrence of glioblastoma.

METHODS
Patients with a first recurrence of histologically confirmed World Health Organization (WHO) Grade IV glioma, after treatment with temozolomide plus radiotherapy, received nivolumab 3 mg/kg every 2 weeks until confirmed disease progression based on Response Assessment in Neuro-Oncology (RANO) criteria or development of toxicity. The primary endpoint was 1-year overall survival rate (1y-OS) assessed using a Bayesian approach. The prespecified efficacy criteria were that the Bayesian posterior mean 1y-OS with nivolumab would be 49%, and the Bayesian posterior probability threshold for exceeding the 1y-OS of bevacizumab (34.5%) from the Japanese Phase II study (JO22506) would be 93%.

RESULTS
Of the 50 patients enrolled, 44 (93.5%) had recurrent malignant glioma (glioblastoma and gliosarcoma), 26 (59.1%) had measurable disease, and 4 (9.1%) received corticosteroids at baseline. The posterior mean (90% Bayesian credible intervals) 1y-OS with nivolumab was 54.35% (42.27–66.21), and the observed posterior probability of exceeding the 1y-OS of bevacizumab (34.5%, JO22506) was 99.7%. The median (90% confidence interval) overall and progression-free survival (PFS) was 13.09 months (10.38, 17.68) and 1.45 months (1.41, 1.54), respectively. One partial response was observed (objective response rate [ORR] 1/26 evaluable patients [3.8%]). The grade 3–5 treatment-related adverse event rate was 16.0%; most adverse events resolved and were manageable.

CONCLUSION
The 1y-OS with nivolumab monotherapy in Japanese patients was higher than that in the bevacizumab group in the JO22506 study. However, PFS and ORR were not improved compared with JO22506. The safety profile of nivolumab was consistent with that observed in other tumor types.
ATIM-13. MULTIMODAL IMMUNOTHERAPY WITH IO-VAC® FOR PATIENTS WITH GBM: A SINGLE INSTITUTION EXPERIENCE
Authors: Van Gool Stefaan , Makalowski Jennifer , Stuecker Wilfried 
Published: November 2019

Abstract
Multimodal immunotherapy (Newcastle Disease Virus (NDV) + modulated electrohyperthermia + IO-VAC® + immunomodulatory strategies) is an innovative treatment for primary GBM and might prolong overall survival (OS). IO-VAC® consists of DCs loaded with autologous tumor antigens and matured with cytokine cocktail and NDV. We retrospectively reviewed 132 cases of primary GBM. Multimodal immunotherapy was integrated as individualized treatment approach and following different scenario’s in combination with standard treatment in the first line treatment in 71 patients, used at time of first or subsequent relapse as treatment with or without chemotherapy in 61 cases. Median ages were resp. 55 and 53 y. Median KPI at start of immunotherapy was 90 and 80. Median OS for the patients treated with immunotherapy as part of first-line treatment was 20 months with 2-y OS of 40% (CI95%: -13,+13). Median OS for patients treated at time of relapse was 7 months with but still with 18-m OS of 16% (CI95%: -12,+9). Two resp. 1 patients were lost of follow up. A subgroup of 34 GBM patients (10 females) with median age 58y (20–67) was detected, who received NDV + modulated electrohyperthermia during Temozolomide maintenance cycles followed by two IO-VAC® DC vaccinations, and further NDV + modulated electrohyperthermia courses. Median KPI was 70 (60–100). MGMT status was methylated (12), unmethylated (13), unknown (9). Median OS for this subgroup was 23.4 months with 2-year OS of 48% (CI95%: -18,+20). Immunotherapy was feasible without immunotherapy-related side effects of grade III or more. The data suggest that multimodal immunotherapy with IO-VAC® already during and after maintenance chemotherapy, at time of achieved minimal residual disease with local therapy, might help in prolongation of OS. Prolongation of OS in a small group of patients at time of relapse was also demonstrated. IO-VAC® is an approved advanced therapy medicinal product (DE-NW-04-GMP-2015-0030).