bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does gender equality and availability of contraception influence maternal and child mortality? A systematic review
Authors: Bagade Tanmay , Chojenta Catherine , Harris Melissa L , Nepal Smriti , Loxton Deborah 
Published: November 2019

BackgroundCurrent global maternal and child health policies rarely value gender equality or women’s rights and are restricted to policies addressing clinical interventions and family planning. Gender equality influences the knowledge, autonomy and utilisation of contraception and healthcare, thereby affecting maternal and child health. This systematic review aims to analyse the concurrent effect of gender equality and contraception on maternal and under-5 child mortality.MethodsA systematic review was conducted to investigate the current evidence. Studies were eligible if three themes—namely, indicators of gender equality (such as female education, labour force participation, gender-based violence), contraception, and maternal or child mortality—were present together in a single article analysing the same sample at the same time.ResultsEven though extensive literature on this topic exists, only three studies managed to fit the selection criteria. Findings of two studies indicated an association between intimate partner violence (IPV) and infant mortality, and also reported that women’s contraceptive use increased the risk of IPV. The third study found that the mother’s secondary education attainment significantly reduced child mortality, while the mother’s working status increased the odds of child mortality. The researchers of all included studies specified that contraceptive use significantly reduced the risk of child mortality.ConclusionImprovement in gender equality and contraception concurrently affect the reduction in child mortality. These findings provide strong support to address the research gaps and to include a gender equality approach towards maternal and child health policies.
3 Advances in treating heart failure
Authors: Cowie Martin 
Published: November 2019

Abstract

The average age of a person with a new diagnosis of heart failure in the UK is now 80, and such a person is as likely to be female as male, to have 5–6 co-morbidities, and to be frail.1 Delivering appropriate care is a challenge, particularly where the evidence from clinical trials may be in patients who are typically 20 years younger and with less complex medical and social needs. Increased awareness of the need for a more holistic approach, with shared decision making, and advance care planning, is improving the experience and outcome of care, but there is marked variation across the NHS.2 3
This talk will briefly summarise some of the recent advances in treating heart failure – particularly for those with systolic impairment of the left ventricle, and for those with valve disease. Mechanical circulatory support has improved greatly in recent years but is only ever an option for a tiny minority of patients. Treatment of co-morbidities, such as atrial fibrillation and diabetes, have also improved the outcome for those with heart failure. Despite much effort, cellular and genetic therapies remain a distant prospect. Digital approaches to care, and self-management, show considerable promise but integrating such approaches into a traditional healthcare system has proven challenging.
The prognosis of heart failure has improved dramatically for many patients over the past 30 years –but the residual risk of mortality and urgent hospitalisation means that there is much work to be done.

References
6 Translating genomics for clinical benefit
Authors: Caulfield Mark 
Published: November 2019

Abstract
The UK 100,000 Genomes Project has focussed on transforming genomic medicine in the National Health Service using whole genome sequencing in rare disease, cancer and infection. Genomics England partnering with the NHS established 13 Genomic Medicine Centres, the NHS whole genome sequencing centre and the Genomics England Clinical Interpretation Partnership (3337 researchers from 24 countries). We sequenced the 100,000th genome on the 5th December 2019 and completed an initial analysis for participants in July 2019. Alongside these genomes we have assembled a longitudinal life course dataset for research and diagnosis including 2.6 billion clinical data points for the 3000 plus researchers to work on to drive up the value of the genomes for direct healthcare. In parallel we have partnered the NHS to establish one of the world’s most advanced Genomic Medicine Service where we re-evaluated 300,000 genomic tests and upgraded 25% of tests to newer technologies with an annual review. The Department of Health have announced the ambition to undertake 5 million genome analyses over the next 5 years focused on new areas tractable to health gain.
9 Low fidelity simulation in a high fidelity world
Authors: Scott A , Gartner A 
Published: November 2019

Abstract

Introduction
All aspects of medical training have experienced an exponential acceleration in the application of technology for learning needs.1 Research promotes the use of high fidelity models and ever more complex training methods with organisations keen to adopt and implement new technology. Models are utilised to minimise potential risks to patients through bedside learning and refine established technique.2 Simulation practice can also be used to develop non-technical skills pertinent to safe clinical practice.2–4 Simulation training can be employed from early stages of undergraduate education through to use in professional postgraduate exams giving a large scope of use in a multiplicity of environments.1 4 5

Methods
Forty Foundation Year 1 Doctors were taught clinical skills utilising Low fidelity part task training models. Four clinical skills were selected from pre-determined postgraduate curricula. Self assessment pre and post procedure were recorded with qualitative feedback sought as a secondary measure.

Results
Global increases are seen across 4 sampled clinical skills. Participants self-reported increased confidence and competence. A high value was placed upon trainees perceived value in training.

Conclusion
Fidelity has been shown to play an integral role in simulation.4 The authors conclude that simple part task trainers, low fidelity models, still have a valuable part to play in medical education. They remain cost effective, adaptable and accessible training tools in the era of increasing complexity.1 5 Simulation provides a safe space to develop both technical and non-technical aspects.3 4 Low fidelity simulation can be used to underpin the learning objectives of trainees through effective feedback in real time, access to repetitive practice and remain a feasible training tool for trainers and trainees alike.2 4 High fidelity simulation should not be excluded completely however appears to be best suited to defined roles in more complex moulage.1 4

Take home message
Technology has the ability to improve and evolve medical education. With the potential for increased feedback, self and peer assessment along with pragmatic assessment, simulation has firmly entrenched itself in medical education. Care should be taken however not to disregard lower fidelity models as they still provide proven effective learning, enable the teaching of non-technical skills and facilitate knowledge delivery.

References
Occupational exposure to organic dusts and risk of developing rheumatoid arthritis: findings from a Swedish population-based case–control study
Authors: Ilar Anna , Gustavsson Per , Wiebert Pernilla , Alfredsson Lars 
Published: November 2019

ObjectivesWe estimated the association between occupational exposures to five different organic dusts: wood, animal, paper, textile and flour dust and the risk of developing rheumatoid arthritis (RA).MethodsThis population-based case–control study analysed 12 582 incident cases and 129 335 controls. Participants were identified from national public authority and quality registers. Census data on occupations were collected 1960–2010 and we estimated the exposure to organic dust with the help of job-exposure matrices. We used logistic regression to assess the OR of seropositive or seronegative RA. Estimates were adjusted for the matching variables (sex, county, age and index year), education and occupational silica exposure.ResultsExposure to animal dust was associated with an increased risk of RA among both men and women. The OR was 1.2 (95% CI=1.1 to 1.4) for seropositive RA and 1.3 (95% CI=1.1 to 1.5) for seronegative RA among ever exposed participants compared with unexposed. The risk increased with duration of exposure for seropositive RA, and participants who had been exposed in five or more censuses had an OR of 1.6 (95% CI=1.1 to 2.2, p for trend=0.003). Exposure to textile dust also generated a significant dose–response relationship for seropositive RA (p for trend=0.014). We detected no association between exposure to wood, paper or flour dust and risk of RA.ConclusionsOverall, exposure to animal dust and textile dust was associated with an increased risk of developing RA. These observations give further support to the notion that airborne exposures are involved in the aetiology of RA.
A comparison of computational equations for understanding the effect of adhesion energy on mobility of DNTT thin-film transistors
Authors: Li Hanbing , Tong Yanhong , Zhao Xiaoli , Wang Haiting , Tang Qingxin , Liu Yichun 
Published: November 2019

In organic thin-film transistors (OTFTs), adhesion energy plays an important role in the morphology of the vacuum-deposited organic semiconductor film and hence affects the field-effect mobility. Currently, two equations have been reported to calculate the adhesion energy between semiconductor and dielectric. However, the differences of the two equations remain unexplored. Here, we reflect the differences by simulation, experiment and theoretical derivation methods. Results show that the change of mobility is consistent with the change of adhesion energy calculated by Eq. (1), which is ascribed to the good availability of Eq. (1) for both polar and non-polar dielectrics. Our results provide an exact guideline for calculation of adhesion energy and help the selection of dielectrics to obtain high-performance OTFTs.
Consistent Subtyping for All
Authors: Xie Ningning , Bi Xuan , Oliveira Bruno C. D. S. , Schrijvers Tom 
Published: November 2019

Consistent subtyping is employed in some gradual type systems to validate type conversions. The original definition by Siek and Taha serves as a guideline for designing gradual type systems with subtyping. Polymorphic types à la System F also induce a subtyping relation that relates polymorphic types to their instantiations. However, Siek and Taha’s definition is not adequate for polymorphic subtyping. The first goal of this article is to propose a generalization of consistent subtyping that is adequate for polymorphic subtyping and subsumes the original definition by Siek and Taha. The new definition of consistent subtyping provides novel insights with respect to previous polymorphic gradual type systems, which did not employ consistent subtyping. The second goal of this article is to present a gradually typed calculus for implicit (higher-rank) polymorphism that uses our new notion of consistent subtyping. We develop both declarative and (bidirectional) algorithmic versions for the type system. The algorithmic version employs techniques developed by Dunfield and Krishnaswami for higher-rank polymorphism to deal with instantiation. We prove that the new calculus satisfies all static aspects of the refined criteria for gradual typing. We also study an extension of the type system with static and gradual type parameters, in an attempt to support a variant of the dynamic criterion for gradual typing. Assuming a coherence conjecture for the extended calculus, we show that the dynamic gradual guarantee of our source language can be reduced to that of λ B, which, at the time of writing, is still an open question. Most of the metatheory of this article, except some manual proofs for the algorithmic type system and extensions, has been mechanically formalized using the Coq proof assistant.
Modular Product Programs
Authors: Eilers Marco , Müller Peter , Hitz Samuel 
Published: November 2019

Many interesting program properties like determinism or information flow security are hyperproperties, that is, they relate multiple executions of the same program. Hyperproperties can be verified using relational logics, but these logics require dedicated tool support and are difficult to automate. Alternatively, constructions such as self-composition represent multiple executions of a program by one product program, thereby reducing hyperproperties of the original program to trace properties of the product. However, existing constructions do not fully support procedure specifications, for instance, to derive the determinism of a caller from the determinism of a callee, making verification non-modular.
We present modular product programs, a novel kind of product program that permits hyperproperties in procedure specifications and, thus, can reason about calls modularly. We provide a general formalization of our product construction and prove it sound and complete. We demonstrate its expressiveness by applying it to information flow security with advanced features such as declassification and termination-sensitivity. Modular product programs can be verified using off-the-shelf verifiers; we have implemented our approach for both secure information flow and general hyperproperties using the Viper verification infrastructure. Our evaluation demonstrates that modular product programs can be used to prove hyperproperties for challenging examples in reasonable time.
Photo-Fenton Degradation of RB5 Dye in Aqueous Solution Using Fe Supported on Mexican Natural Zeolite
Authors: Domenzain-Gonzalez José , Castro-Arellano José J. , Galicia-Luna Luis A. , Lartundo-Rojas Luis 
Published: November 2019

A Mexican natural zeolite (MNZ) was impregnated with Fe at concentrations of 5 and 10 mg FeCl3/g MNZ (MNZ/Fe) in order to study the photo-Fenton degradation of Reactive Black 5 (RB5) dye. Two samples were prepared and calcined at 550 and 700°C for each concentration. These samples were also characterized by the following techniques: X-ray diffraction (XRD) to determine crystalline phases of mineral, X-ray photoelectron spectroscopy (XPS) to observe the elemental composition of the material where the main element was Fe as Fe2p, Mössbauer to establish the phases in the material which were magnetite (Fe3O4), fayalite, and chlorite, Raman to corroborate that magnetite clusters in natural material were presented, and transmission electron microscopy (TEM) by which magnetite nanoparticles were observe on zeolite surface. Afterwards, the catalytic degradation of RB5 dye was performed by photo-Fenton process using a 2.2 W lamp as a radiation source. Four initial concentrations of RB5 dye ((RB5)0) were evaluated which ranged from 40 to 100 mg/L. Then, the evaluation reaction was carried out by UV-Vis spectroscopy to know the change in RB5 concentration and chemical oxygen demand (COD) removal to determine the organic carbon. The best results on the photo-Fenton degradation was 91% discoloration and 68.5% chemical oxygen demand removal based on an initial concentrationRB50=100 mg/L and 10 mg MNZ/Fe (700°C of calcined temperature) atMNZ/Fe=0.05 g/L catalyst dose in aqueous solution,H2O2=3 g/L,pH=2.5, and 180 minutes of reaction time. Subsequently, variations on (RB5)0, pH, (H2O2), and (MNZ/Fe) were assessed in order to optimize the process by keeping 10 MNZ/Fe. The optimal RB5 dye degradation was achieved atRB50=100 mg/L in the presence ofMNZ/Fe=0.2 g/L,H2O2=3 g/L andpH=2.5where the highest discoloration and chemical oxygen demand removal were 93 and 70.5 at 180 min. Finally, the kinetic reaction was evaluated as a pseudo-first-order kinetics with an apparent rate constant (kapp) of 0.0225 min-1at latest conditions.
Commercial Gene Expression Tests for Prostate Cancer Prognosis Provide Paradoxical Estimates of Race-Specific Risk
Authors: Creed Jordan H. , Berglund Anders E. , Rounbehler Robert J. , Awasthi Shivanshu , Cleveland John L. , Park Jong Y. , Yamoah Kosj , Gerke Travis A. 
Published: November 2019

Abstract

Background:
Commercial gene expression signatures of prostate cancer prognosis were developed and validated in cohorts of predominantly European American men (EAM). Limited research exists on the value of such signatures in African American men (AAM), who have poor prostate cancer outcomes. We explored differences in gene expression between EAM and AAM for three commercially available panels recommended by the National Comprehensive Cancer Network for prostate cancer prognosis.

Methods:
A total of 232 EAM and 95 AAM patients provided radical prostatectomy specimens. Gene expression was quantified using NanoString for 60 genes spanning the Oncotype DX Prostate, Prolaris, and Decipher panels. A continuous expression-based risk score was approximated for each. Differential expression, intrapanel coexpression, and risk by race were assessed.

Results:
Clinical and pathologic features were similar between AAM and EAM. Differential expression by race was observed for 48% of genes measured, although the magnitudes of expression differences were small. Coexpression patterns were more strongly preserved by race group for Oncotype DX and Decipher than Prolaris. Poorer prognosis was estimated in EAM versus AAM for Oncotype DX (P &lt; 0.001), whereas negligible prognostic differences were predicted between AAM and EAM using Prolaris or Decipher (P &gt; 0.05).

Conclusions:
Because of observed racial differences across three commercial gene expression panels for prostate cancer prognosis, caution is warranted when applying these panels in clinical decision-making in AAM.

Impact:
Differences in gene expression by race for three commercial panels for prostate cancer prognosis indicate that further study of their effectiveness in AAM with long-term follow-up is warranted.
Impact of Serum Bicarbonate Levels on Muscle Mass and Kidney Function in Pre-Dialysis Chronic Kidney Disease Patients
Authors: Kittiskulnam Piyawan , Srijaruneruang Somrath , Chulakadabba Adhisabandh , Thokanit Nintita Sripaiboonkij , Praditpornsilpa Kearkiat , Tungsanga Kriang , Eiam-Ong Somchai 
Published: November 2019

<b><i>Background:</i></b> Treatment of metabolic acidosis to target the higher serum bicarbonate level than guideline recommendation may downregulate muscle protein degradation and improve renal function among chronic kidney disease (CKD) patients. We conducted a study to test the effects of increased serum bicarbonate level on muscle parameters, nutrition, and renal function in pre-dialysis CKD patients. <b><i>Methods:</i></b> This was a randomized, controlled study. CKD stage 3–4 patients with serum HCO<sub>3</sub><sup>–</sup> &#x3c;22 mEq/L were randomized to either receive oral sodium bicarbonate with high target bicarbonate level of 25 ± 1 or standard level of 22 ± 1 mEq/L as control group using protocol-based titration of dosage adjustment. The changes of muscle mass measured by bioelectrical impedance analysis (BIA), muscle strength by hand grip dynamometer, estimated glomerular filtration rate (eGFR) using CKD-Epidemiology Collaboration equation, nutritional markers, and muscle-related biomarkers were determined. Data at baseline and after 4 months of sodium bicarbonate supplementation were compared between groups using Student <i>t</i> test or chi-square test as appropriate. <b><i>Results:</i></b> Forty-two patients completed the study (<i>n</i> = 21 per group). The mean age and eGFR were 61.2 ± 9.8 years and 32.4 ± 14.1 mL/min respectively. Serum bicarbonate levels at baseline were 21.0 ± 2.1 mEq/L. Baseline data including sex, diabetes, serum bicarbonate level, creatinine, and blood pressure were similar. After 4 months of treatment, the average serum bicarbonate levels in both groups were 24.0 ± 1.4 and 20.7 ± 2.3 mEq/L (<i>p</i> &#x3c; 0.001). Both BIA-derived total-body muscle mass and appendicular lean balance were increased at 4 months in the higher bicarbonate group (26.0 ± 5.3 to 26.7 ± 5.5 kg, <i>p</i> = 0.04 and 19.8 ± 4.1 to 20.7 ± 4.4 kg, <i>p</i> = 0.06, respectively) despite comparable body weight and protein intake. Patients in the high bicarbonate group had a significant reduction of plasma myostatin levels, a surrogate of muscle degradation, at the study exit after adjusting for baseline values (–3,137.8; 95% CI –6,235.3 to –40.4 pg/mL, <i>p</i>= 0.04), but unaltered insulin-like growth factor-1 level, as the mediator of muscle cell growth, (141 [106–156] to 110 [87–144] ng/mL, <i>p</i> = 0.13) compared to the control group. Muscle strength, eGFR as well as serum prealbumin were not significantly different between 2 groups (<i>p</i> &#x3e; 0.05). Neither worsening hypertension nor congestive heart failure was found throughout the study. <b><i>Conclusion:</i></b> Bicarbonate supplementation to achieve the serum level ∼24 mEq/L demonstrates better muscle mass preservation in patients with pre-dialysis CKD. The impact of alkaline therapy on renal function may require a longer period of study.
Clinical Outcomes in Patients With Type 2 Diabetes Mellitus and Peripheral Artery Disease
Authors: Badjatiya Anish , Merrill Peter , Buse John B. , Goodman Shaun G. , Katona Brian , Iqbal Nayyar , Pagidipati Neha J. , Sattar Naveed , Holman Rury R. , Hernandez Adrian F. , Mentz Robert J. , Patel Manesh R. , Jones W. Schuyler 
Published: November 2019

Background:
Recent trials have identified anti–diabetes mellitus agents that lower major adverse cardiovascular event (MACE) rates, although some increase rates of lower-extremity amputation (LEA). Patients with peripheral artery disease (PAD) have greater incidence of diabetes mellitus and risk for LEA, prompting this investigation of clinical outcomes in patients with diabetes mellitus and PAD in the EXSCEL trial (Exenatide Study of Cardiovascular Event Lowering).

Methods:
EXSCEL evaluated the effects of once-weekly exenatide (a GLP-1 [glucagon-like peptide-1] receptor agonist) versus placebo on the rates of the primary composite MACE end point (cardiovascular death, myocardial infarction, or stroke) among patients with type 2 diabetes mellitus. In this post hoc analysis, we assessed the association of baseline PAD with rates of MACE, LEA, and the effects of exenatide versus placebo in patients with and without PAD.

Results:

EXSCEL included 2800 patients with PAD (19% of the trial population). These individuals had higher unadjusted and adjusted rates of MACE compared with patients without PAD (13.6% versus 11.4%, respectively) as well as a higher adjusted hazard ratio (adjusted hazard ratio, 1.13 [95% CI, 1.00–1.27];
P
=0.047). Patients with PAD had higher all-cause mortality (adjusted hazard ratio 1.38 [95% CI, 1.20–1.60];
P
<0.001) and more frequent LEA (adjusted hazard ratio 5.48 [95% CI, 4.16–7.22];
P
<0.001). Patients treated with exenatide or placebo had similar rates of MACE and LEA, regardless of PAD status.

Conclusions:
EXSCEL participants with PAD had higher rates of all-cause mortality and LEA compared with those without PAD. There were no differences in MACE or LEA rates with exenatide versus placebo.

Clinical Trial Registration URL:

https://www.clinicaltrials.gov
. Unique identifier: NCT01144338.